Third walk-in clinic announces plans to come to Keene

Sept. 23--Two's company, but will three Keene walk-in clinics be a crowd?

After Cheshire Medical Center/Dartmouth-Hitchcock Keene and ClearChoice MD Urgent Care each recently announced plans to open urgent care centers, New Hampshire company ConvenientMD says it will also open a walk-in clinic in the Elm City.

All three clinics will treat non-life-threatening illnesses and injuries that don't require a visit to the emergency room.

The announcements signify the feast after the famine.

Keene has been without an urgent care clinic for the better part of 14 years, after the hospital closed its urgent care facility in 1999 due to financial troubles. It started walk-in services for children two years ago, and expanded hours for all patients at the hospital in January.

In August 2013, a married couple briefly opened the Evening Hours Clinic, a walk-in primary care clinic on West Street. The clinic was open for about a month but closed after Keene police arrested owner Michael McNeilly, who was later found guilty of violating a restraining order from his wife, the clinic's nurse practitioner.

Walk-in clinics have opened all over the state, but they've been slow to come to western New Hampshire, according to John B. Martin, manager of the bureau of licensing and certification for the N.H. Department of Health and Human Services.

In the past few years, the number of clinics in the state has doubled, Martin said. There are now 37 in New Hampshire, but there's only one in the western part of the state, in West Lebanon.

"It doesn't surprise me it's taken them longer to come to the less populated areas," Martin said, adding the North Country is another area with no clinics.

These clinics are run by varied providers, including some hospitals and private companies. Some are run by pharmacies such as CVS, which opened "Minute Clinics" in several locations across the state late last year.

ConvenientMD CEO and co-founder Max J. Puyanic said his company is focused on delivering a high standard of care for minor illnesses and injuries such as sprains and broken bones.

The company, which has offices in Windham, Exeter and Concord, often employs doctors from the local area, he added, and many of them are emergency care physicians who have transitioned into a somewhat less stressful work environment.

"We always have a physician present," he said. "The team is used to seeing both low-acuity and high-acuity visits."

Puyanic said ConvenientMD clinics always have a physician, registered nurse and radiology technologist in the building. Clinics also have a "moderately complex lab" and an X-ray machine.

ClearChoice MD Urgent Care is run similarly, according to Dr. Marcus J. Hampers, its founder and CEO.

Hampers, who also has a background in emergency medicine, said he wants staff and management of ClearChoice to have a clinical background.

"People in the senior management should understand clinical care and what quality care is," Hampers said. "It's not lost on patients; it's certainly not lost on the providers we hire."

ClearChoice, which has clinics in Vermont, including in Brattleboro, will open its Keene clinic in the Kohl's Plaza on West Street in November.

The ConvenientMD clinic will be at 315 Winchester St., and Puyanic said it will be in a new building, yet to be constructed.

He said ConvenientMD is dedicated to providing fast, excellent care, for less than it would cost to visit the emergency room.

"We bill like a primary care office," Puyanic said. "It's very cost-effective for patients."

If a patient goes to the emergency room for a simple illness, it can cost about $800, he said. For more complex problems, such as broken bones, fees can easily rise into the thousands.

In comparison, a visit to a ConvenientMD clinic typically costs $150-$200, Puyanic said.

"Typically, even a broken bone is going to be under $200," he added.

The clinics accept nearly all forms of insurance, including Medicaid, Medicare and insurance plans on the state's health exchange.

ConvenientMD does not intend to compete with Cheshire Medical Center/Dartmouth-Hitchcock Keene, Puyanic said, even though that organization just announced its own clinic, to move into The Center at Keene. The Cheshire Medical Center clinic will open in the fall, but officials did not have a specific date.

"We do not see ourselves as competing with Cheshire in any way," Puyanic said. "They do an exceptional job at family practice ... we can complement (that)."

But Hampers said three clinics in the local area will mean competition. And that's good for patients, he said.

"Competition is a good thing and the free market is a very efficient process," he said. "When there's competition, the patient benefits."

Cheshire Medical Center/Dartmouth-Hitchcock Keene CEO Arthur W. Nichols agreed, saying three walk-in centers in Keene would provide for "a competitive environment."

"CMC/DHK will compete in the dimensions of price, quality and convenience," he said in an email statement. "And our electronic medical record and its detailed information will be invaluable to our providers in caring for patients."

Puyanic says the ConvenientMD clinic is hoping to open its doors by September 2015. The company also plans to open more locations, including in Bedford, Dover and Nashua, but doesn't plan to expand past New Hampshire.

Ella Nilsen can be reached at enilsen@keenesentinel.com or 352-1234, extension 1409. Follow her on Twitter @ENilsenKS.

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