Premium content from Portland Business Journal by Andy Giegerich, Business Journal staff writer
ZoomCare's newest health clinic, in downtown Portland's Standard Insurance Building, opened its doors for the first time at 9 a.m. Wednesday.
By 9:30 a.m., the facility had already scheduled 10 appointments for patients seeking check-ups, preventive care and treatments for illnesses and injuries.
ZoomCare is part of Portland's emerging accessible and convenient health care movement that seeks to bridge the gap between emergency services and primary care physician visits.
Doctors Express, based in Towson, Md., is looking to open its third regional office within the next year. The urgent care clinic treats injuries and illnesses, offers X-rays and lab work, and provides services related to occupational health and worker's compensation tests.
MeMD is an online service through which physicians and other providers diagnose conditions by using Web cameras. MeMD plans to launch Oregon operations within 30 days.
New York-based ZocDoc, an online appointment services company, will begin providing programs in Portland on Monday. ZocDoc allows patients to schedule time, often on the same day they request an appointment, with physicians and specialists. The company's revenue comes from listing fees paid by physicians. ZocDoc, which counts 1.7 million users, has received $95 million worth of funding from such sources as Amazon Inc.'s Jeff Bezos and Goldman Sachs.
Such companies are growing as national and state reforms shape health care business models. On the treatment side, patients suffering from chronic illnesses, such as asthma, are increasingly encouraged to avoid emergency room visits that can run between $1,000 and $2,000.
"There's a new national attitude of people seeking the care they need when and where they want it," said Dr. Albert DiPiero, ZoomCare's co-founder. "And not only do they want that care now, they want it to be affordable."
Quick-care health outfits could also fill a role as reform drives some 30 million previously uninsured Americans - including almost 650,000 in Oregon - into the health care system.
Yet the number of physicians isn't expect to grow at the same rate. The Washington, D.C.-based Association of American Medical Colleges projects that by the year 2025, the country could experience a shortage of 65,800 primary care physicians and 130,600 primary and specialty care doctors.
"There will be all these new patients who need care but the number of doctors is staying the same," said Guru Sankar, a director and owner of Portland's two Doctor's Express franchises. "Our goal is to fill the gap as those millions of people come onto the rolls."
Portland's convenient care clinics have collected buy-in from traditional medical institutions. For example, Oregon Health & Science University last year approved ZoomCare's services as an urgent care option for OHSU employees.
The Oregon Medical Association is officially neutral on whether on-demand care clinic models work. The group, though, counts several clinic physicians who are members in good standing.
Betsy Boyd-Flynn, OMA's deputy executive director, pointed out that clinics that can schedule same-day primary care appointments have fewer cancellations, which physicians like because their time's not wasted. Boyd-Flynn added that the clinics add uncertainty to the patient referral system, often required when a specialist's help is needed.
"It could be a life buoy for smaller independent (providers) because it's a way to get referrals" without insurers' approval, she said. "It could open up providers to more streams of patients." Dr. Craig Fausel, president and CEO of the Oregon Clinic, said his facility regularly receives referrals from ZoomCare and other such clinics.
"In that way, they sort-of screen people with clearly less serious problems who don't need to see specialists," Fausel said. "But that's the same sort of role that primary care providers, urgent and non-urgent, play." Fausel has mixed feelings about quick-care outlets. While he respects the business model that has allowed ZoomCare to open three locations since January, he fears the facilities could encourage patients to seek more medical attention than they really need.
"The 10 most common (billing) codes are for things like muscle or ligament strains or limited respiratory infections that don't need any medical care to begin with," Fausel said. "Places like ZoomCare are meeting Americans' demands that apparently aren't being met by primary care providers. But I'm not sure how much good it's doing for America."
For its part, ZoomCare isn't looking to over-serve the population, DiPiero said. Instead, the clinic plans to add locations at a measured pace while remaining centered in the Northwest.
"Portlanders in general are inquisitive and also very discerning," he said. "They're looking for high-quality affordable professional care and they're not afraid to test things out."
Portland patients often wait an average of two weeks for medical appointments, according to a study.