Expansion on tap at St. Peter’s Broadway urgent care location

Jan. 08--St. Peter's Urgent Care, at 2475 E. Broadway, is expanding their clinic after seeing 70 percent more patients in 2016 than they did five years ago.

The increased need for urgent care is being felt across the country, but the drastic increase at St. Peter's can be attributed to more patients with coverage due to the affordable care act and a local urgent care closure last year. Despite people having better access to coverage, the clinic is seeing a spike in patients as people replace primary care with urgent care due to rising healthcare costs, wait times for appointments and doctor shortages.

St. Peter's Urgent Care saw 9,910 patients in 2011. That number steadily rose each year until peaking at 16,941 patients in 2016. While some months are busier than others due to a flu outbreak or vehicle accidents, the clinic typically saw 1,300 to 1,400 patients a month in 2016. In March, the clinic saw a record 1,825 patients.

The $200,000 project will add two exam rooms, create a more private waiting room and move the entrance closer to the emergency room. The expansion is scheduled to be finished at the end of January and won't close during any part of construction.

The clinic transfers 5 to 10 percent of patients to the emergency room. Emergency Room Director Susan Noem said the ER sees 2,100 patients a month. While some patients are unsure of where they need to be treated, others are forced by their insurance to come to urgent care before going to the emergency room. Noem said patients aren't charged for care at both locations if they have to be transferred.

In the existing waiting room, patients had difficulty discussing their symptoms without the entire waiting room hearing. The renovated space will have glass walls to provide patient privacy.

While the expansion will appear to patients as more private and convenient, St. Peter's is expanding to adapt as patients forego regular preventive care. As healthcare costs rise, patients are only seeing a doctor when they are sick and doing everything they can to stay out of the emergency room.

According to the Urgent Care Association of America, the average cost of an urgent care visit is $150 while the average ER visit costs $1,354. Urgent care patients are likely to wait less than 30 minutes for care, while the average wait time in the ER is four hours.

"I don't think that's inflated, unfortunately," Noem said.

Urgent care was created to support primary care physicians after business hours and on weekends, but Joan Davis, urgent care manager, said a lot of her patients aren't seeing a primary physician.

"Very often they say 'I don't have one,'" she said.

The clinic is equipped to treat illnesses like the common cold and minor lacerations or breaks, but they can't provide comprehensive care for patients with chronic illnesses. Davis said it's difficult when someone needs consistent care because of high blood pressure, heart disease and diabetes, but are unable to get an appointment or afford care. Davis said she refers them to a clinic and informs them if she knows of a provider with a short wait time.

Patients in Helena often have to wait three to six months to see their primary care physician, Davis said. Instead, some are choosing to go to urgent care, where they don't have to make an appointment. Davis said urgent care isn't designed to replace primary care, but a doctor shortage doesn't leave Helena residents with many options.

St. Peter's is actively recruiting 12 physicians, but hospitals nationwide are experiencing a shortage, which is expected to worsen as America's population rapidly grows and ages.

By 2025, a report by the Association of American Medical Colleges estimates a shortfall of between 14,900 and 35,600 primary care physicians in the United States.

The process to make sure a doctor is a good fit for a hospital is tedious, and St. Peter's is struggling to keep the physicians they already employ. The hospital recently lost seven doctors due to social reasons and four to retirement, Brian Lorber, digital marketing specialist at St. Peter's, said. In the meantime, the hospital is trying to recruit physician assistants and nurse practitioners to support a physician's workload.

Davis said the Affordable Care Act expanded Montanans access to insurance.

"So many people were able to get on Medicaid," she said. "It gave them the ability to come in and be seen."

In Montana, 61,000 people got coverage through Medicaid expansion, and Montana's uninsured rate dropped from 22 percent to 7 percent since the Affordable Care Act was enacted.

In Helena, St. Peter's Urgent Care and Cost Care are the only options after Urgent Care Plus closed it's doors in December 2015. The physician, Mark Ibsen, said he saw approximately 11,000 patients each year. While St. Peter's likely received some of Ibsen's patients, their clinic was already experiencing a drastic increase in patients before Urgent Care Plus closed.

Cost Care, the only other operating urgent care center in Helena, did not respond to a request for comment on how many patients it sees annually.

Davis said she expects the demand for urgent care to remain in Helena. The expansion takes future need into account, and has room for the clinic to adjust their operations. With more exam rooms, they could hire additional staff if necessary, and a daily wait time report will help Davis manage the clinic's efficiency.

"We'll be watching that really closely," she said.

Davis said her clinic sees 40 to 45 patients a day, but she's seen as many as 70. As wait times fluctuate, she said the longest wait times are when the clinic first opens, near the lunch hour and in the evening after people get off work.

If a patient is experiencing symptoms such as shortness of breath, chest pain or repeated vomiting, they should immediately go to the emergency room. Patients with minor illnesses can go to St. Peter's Urgent Care from 9 a.m. to 8 p.m. each day, including holidays. St. Peter's other urgent care location, at 3330 Ptarmigan Lane, is open 8 a.m. to 6 p.m. each day except for Thanksgiving Day, Christmas Day and New Year's Day.

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