Source: The Associated Press
For almost 30 years, Dr. Marty Hill treated patients in the emergency room of what started as Southern Oregon Medical Center and evolved into Three Rivers Community Hospital in Grants Pass.
Dr. Bernie Hill-no relation-began his medical career in primary care, then spent 25 years in emergency care, first at Southern Oregon, then at Three Rivers.
Today, both board-certified emergency room physicians practice primary care medicine at Valley Immediate Care, a walk-in clinic that opened in 2007 in Grants Pass.
As more people either can't get a timely appointment to see their private physician, or they don't have a regular doctor, the popularity of walk-in "retail" clinics is growing.
A report released in January by the National Center for Policy Analysis estimates the number of walk-in clinics will nearly triple from about 1,100 to about 3,200 nationwide in the next four years.
"These retail health care clinics offer evening and weekend care solutions at a fraction of the cost of emergency rooms and often charge less than a physician office visit," says Devon Herrick, of the National Center for Policy Analysis.
Herrick points out that emergency room care is among the most expensive types of patient care available.
"Of the 119 million annual visits to hospital emergency rooms, 55 percent are for non-emergencies," he adds.
"Keeping truly non-emergencies out of emergency rooms can only help all of us," says Brent Kell, administrator of Valley Immediate Care's Grants Pass office and two Medford offices.
Both Bernie Hill and Marty Hill had their own reasons for switching from treating emergencies in a fast-paced environment to providing non-urgent or only slightly urgent care.
For Bernie Hill, it was the changing face of emergency room medicine over the past five years.
With more patients using the hospital's Emergency Department as the clinic of last resort whether they have a true emergency or not patient load is up, according to hospital administrators. Some patients, worrying about finances, let conditions worsen into true emergencies, rather than visit a doctor for preventive or less urgent care.
"It was not a game I could keep pursuing," Bernie Hill says. "It was harder to do so many things at once. I still wanted to practice medicine, but not as intensely anymore. (Joining Valley Immediate Care) was a way to continue practicing without having to get set up in my own practice."
Marty Hill retired from the hospital in April 2007, then traveled to Africa with his family. There, he and his wife, Cherryl Walker, met a woman who was running a preschool for children with AIDs. When he returned, Marty Hill went to work at Valley Immediate Care, using his salary to help build and support the school in Africa.
With their longtime experience in an emergency room, both doctors know an emergency when they see one.
"For true emergencies, we speed-dial 911 and get them to the hospital as quickly as possible," says Marty Hill, who adds that he still enjoys the challenge of a fast-paced environment and calls Valley Immediate Care an efficient, patient-friendly place.
"If there is a wait, they give you a pager or they take your cell phone number, so you can go out and do errands. You don't waste time two or four hours in the waiting room," he adds.
Valley Immediate Care is open from 8 a.m. to 8 p.m. Monday through Friday, and on weekends from 9 a.m. to 6 p.m. The office also is open from 10 a.m. to 4 p.m. on major holidays. The average price for a new patient office visit is about $177, and established patients who visit the clinic within three years pay an average of about $120.
Valley Immediate Care can bill most insurance companies, but doesn't accept Medicaid patients covered by the Oregon Health Plan. That bothers Lyle Jackson, medical director of Mid Rogue Independent Physician Association in Grants Pass.
"The only people they see are people who can afford it, either through insurance or payment up front," Jackson says. "As a result, the people with no money, or the people on the Oregon Health Plan, go to the emergency room or are seen by private doctors who are willing to accept Oregon Health Plan patients."
He adds, "When they're selective, it puts an undue burden on other doctors in private practice. Everybody in the IPA sees Oregon Health Plan people. We see it as our mission in this community."
Jackson pointed to the Grants Pass Clinic, which offers an urgent care department for clinic patients who need to be treated quickly, but can't get in to see their regular doctor.
"Valley Immediate Care is not an urgent care setting. They're seeing people for convenience sake," he says.
But both Grants Pass Clinic's urgent care and Valley Immediate Care have something in common, Jackson notes: They're "a reflection that we don't have enough doctors in this community. There is an overall doctor shortage here."
Kell says the Valley Immediate Care's philosophy is, "We try to provide care for everybody at the least cost for everyone. We've been as inventive as we can be with follow-up appointments."
He explains that if a patient is ill or injured, and if they have questions or more symptoms, they can come back to the office for additional treatment of the same condition at no charge.
Patient visits at the Grants Pass office have been growing to an average of about 50 per day, Kell reports. Sundays are slower, with between 30 and 35 patients a day, but during the recent flu season, the clinic saw 100 or more patients a day. If demand continues to increase, Kell envisions a day when the Grants Pass office will either expand in its present location, or the clinic might open a second office in Grants Pass.
"For the amount of time we've been open in Grants Pass, we've gotten busy much more quickly than we expected," Kell says. "I think there's a greater need in Josephine County for this type of care."