You’ve come down with the flu, your doctor’s office is closed and you can’t stand it anymore, so you head to the emergency room. It’s mobbed. You get shuffled back and forth between three or four people, wait two hours for a room and wait another two hours before you see a doctor and are sent home with a prescription.
You get a bill a week later for a $75 co-pay, or, if you don’t have health insurance, a few hundred dollars.
Mark Pundt has lived in this system for the last two decades – from the doctor side of things.
Dr. Pundt, 51, of Lancaster, is an emergency room physician who decided there had to be a better way to treat non-emergency cases than in a hospital ER, and who helped pioneer the urgent care center concept in Western New York: Think in and out in an hour, often with a $20 or $30 co-pay, or out-of-pocket cost of $135, even if you need an X-ray.
The regional medical establishment was hesitant at first, particular primary care doctors who saw the concept as a professional threat. Many still do. But in the decade since Pundt and a group of nine other ER docs founded MedFirst, the concept continues to gain steam, and Pundt – a University at Buffalo Medical School graduate who saw his first urgent care centers while doing his residency in Cleveland – has established himself as a key player.
Pundt is the CEO of the Medical Division of the MASH Care Network. Along with MASH Urgent Care, this includes MASH Emergency Services – which staffs emergency departments at the Gates Vascular Institute, Brooks Memorial and Lakeshore hospitals – as well as MASH Medical Solutions, a medical billing and management company.
Urgent care is here to stay, Pundt said, particularly the kind he and his partners have helped to shape since MedFirst folded into the MASH Care Network in 2012.
“Doctors can affect not only the care at the bedside but the delivery of care in the community, enhance its quality, and together we can reduce the cost,” he said.
Pundt stressed that hospitals are for really sick people. Those who show up with a stuffed nose, sore throat or cut that can be closed with a few stitches best be prepared to wait behind those folks when they show up at a hospital emergency room. Here’s the new rule of thumb for those who plan to go the ER for something they don’t expect will land them in the hospital for an inpatient stay: go to a primary doctor or an urgent care setting instead or plan to wait, and pay more; the emerging health care system is deliberately designed this way.
Why can you provide care more quickly for minor emergencies?
We’re not working through the bureaucracy of many departments to create flow. The other thing is that there are higher regulations to meet with lab testing in hospitals. Their radiology department is not doing just plain X-rays but also doing CT and MRI, so radiology time is being taken by higher-level testing. … We can do chest X-rays as well as those for broken bones, knee injuries. The (radiation) tech is here, so she takes these images and literally we read them in five minutes, so it allows us to make our (diagnosis) very, very efficiently. In a hospital, it’s going to take a half-hour to an hour and a half, depending on the flow. And the lab time in the hospital is about a half-hour to an hour. Literally, by the time I walk out of my second patient room, I have all of the data on my first patient.
What are your hours?
We open at 8:30 a.m. and provide medical care from 9 a.m. to 9 p.m.; as long as you walk in by 9 p.m., you’re seen. And that’s 365 days a year across all seven sites. (Find locations at mashurgentcare.com)
What are the three or four most common health concerns you handle at your sites?
Upper respiratory infections such as sinus infections and sore throats. The next most common would be lacerations and fractures or sprains. Next would be respiratory illnesses like cough, pneumonia, bronchitis. Next would be rashes, insect bites, that kind of thing.
Occasionally, you’ll have someone come in who’s more sick?
We’ll have people who come in with heart attacks, with strokes, congestive heart failure. We’ve had people code.
At our Olean site, we had a gentleman who had a heart attack as he was pulling in and drove into the front window. Our staff went out, resuscitated him, he was taken to the hospital and survived. On the Niagara Falls Boulevard site (in West Amherst), the day before it was opened, a woman came in and was knocking on the door saying, ‘My husband’s sick.’ There was no physician there, because we weren’t open, but the nursing staff and our head nurse ran out to the car. The guy was having a heart attack and they were able to treat him there while the ambulance came. He was taken to the Gates Vascular Institute, catheterized and stented, and survived. People see us as a health care beacon. We have the ability to resuscitate and stabilize and then transfer. Probably 5 percent of our patients are transferred to hospitals for admissions.
On the Web: Can primary care doctors work with urgent care centers? Read more at blogs.buffalonews.com/refresh