Thoughts on opening up an urgent care

[Guaifenesin]

A little bit about us, EM board certified physician and spouse is a PA. We both currently work for a franchised UC. We have great insight into the operations and how to manage/staff an UC and believe we now have the funds to open one up. The clinics we are at now routinely sees over 100 patients a day (mainly driven by COVID testing). I have gathered some info looking into opening our own franchise with the same company but the royalty fees, start up fees, and building costs seem exorbitant. Perhaps we missed the boat on starting one up, as the southeast region appears to be saturated. I have viewed data showing total revenue of over 150+ clinics but they are unwilling to share total expenses or net profit. I realize this type of business runs on extremely thin margins with the most expensive aspect being employee staffing.

Any successful urgent care owners on this board willing to chime in? At this point in our research we have decided that we would rather go the route of starting our own clinic from scratch. Is the juice worth the squeeze?

[CordMcNally]

I would definitely want a well thought out plan if most of the volume is driven by COVID testing once that volume driver begins to go away.

[Guaifenesin]

I would definitely want a well thought out plan if most of the volume is driven by COVID testing once that volume driver begins to go away.

From my research a profitable UC sees around 30-35 patients a day. Prior to COVID, the clinics we work at average around 70-80 a day, including other services such as occupational health (DOT, workers comp, drug screens, physicals).

[burritos]

Used to be that busy where I worked 20 years ago when there were 3 urgent cares in town. Now there are 12.

[Hatton]

A friend of mine who is an anesthesiologist opened up several maybe 10 years ago. I notice a billboards advertise Botox, weight loss, and IV hydration. ??money in regular urgent care.

[Panscan]

Seems like most places with the population to drive such volume likely have an academic center at least in the semi adjacent area that is likely branching out its tentacles into your future turf. Or if you are in BFE like middle of state PA then not sure the volume is there unless you find some random underserved area.

[Tim]

Not sure if insurance contracts would be easy for a stand-alone urgent care facility. You might have some overhead scale problems. For example, the software and call center functionality for one vs ten locations aren’t much different in cost, but certainly different in revenues.

[Sooner1]

Not sure if insurance contracts would be easy for a stand-alone urgent care facility. You might have some overhead scale problems. For example, the software and call center functionality for one vs ten locations aren’t much different in cost, but certainly different in revenues.

I agree.
Ability for small business to get insurance contracts would be a main factor.
location. Location. Location. An area with high traffic flow with easy access is a plus.
I was an urgent care director for a large corporation for about 10 years. 50-60 patients daily on average but a local ER and no less than 5-6 urgent cares opened up close by over the years and dried up our business.
I do primary care, sports medicine and previously- urgent care.

tight margins were/are key.
staff with AP not physician.
have staff with broad skill set- check in patients, function as MA, etc.
when I started out years ago- one clinic had the MA’s do x rays. This barely worked. Now WE utilize our x Ray tech to do poc testing, front desk stuff, etc.
main driver is access and wait times.
If you can kill wait times so people know they can get in and out with good care- it could take off.
downside- I just continue to see clinics merge with big corporations. And plan for the foreseeable future a lot of micromanaging.

passive income as best as possible is ideal in my book. What about being a director for a corporation?

[Max Power]

My buddy (ENT) is opening up shop, and half the commercial spaces they showed him last month were failed urgent cares (he is trying to save money and check for rental stuff already built out for medical space). As you said, the space is highly saturated, and that means competing daily for your patients and also for keeping your decent employees.

Anything is possible, but it is a VERY saturated space that basically any MD can try for. Even family med who failed their boards or some midlevels can compete in the space. Private practice is generally MUCH better for specialists who are rare or semi-rare in the locality. The ratio and the payers are key. Urgent care is certainly not that good ratio... maybe it was in 2002, but it is not at this day in age. Everyone from hospitals to PCP groups to ER to corporations of UC to etc etc are in the space. You would be basically starting a sandwich shop... it is that basic nowadays.

Why not just work for a hospital if you are board cert Emerg MD? You are protected in that space by your training, you can win the game financially unless you live a wild lifestyle, and you don't have the management headaches. And besides, do you really want to live and work with your wife every day? Wowza.