Urgent care clinics are growing in number, providing more access to less costly care.

IT’S NO ACCIDENT THAT THE MOGO URGENT CARE CLINIC DEVELOPED BY NONPROFIT MONTAGE HEALTH LOOKS LIKE A SLEEK COFFEE BAR. While urgent care visits are growing across all age groups in the U.S., younger generations between the ages of 18-44 are more likely to use the clinics according to research. High-top reception desks and sterile lobbies lined with chairs and side tables piled with old magazines are replaced by greeters, couches, high bar tops, and outlets built into furniture for charging smartphones and laptops.

At the MoGo clinic on Del Monte Avenue in Monterey, the lobby features a modern electric fireplace and wood-paneled walls. Instead of posters about covering coughs and washing hands, the wall is lined with inspirational phrases like “infuse ENERGY,” “feel CONNECTION” and “find SERENITY… ” Patients are handed off to a specialist who will perform intake, treatment and payment, all in the same private room.

The clinic’s creators did not forget the coffee – it’s free, along with tea and hot chocolate. That’s not to say patients will wait very long to enjoy their beverages – the goal is to move patients in and out within 30 minutes, says MoGo Chief Operating Officer Chris Stegge.

“The biggest part was keeping the patient in mind and improving their experience,” Stegge says. “They’re already feeling bad. We want to make the experience as good as possible.”

The plan is to keep the clinic open 8am-8pm, 365 days a year.

Montage spent about two years developing the Monterey MoGo, which is awaiting state approval to open its doors. Two more clinics in Marina and Carmel are slated to open later this year. The need is evident, Stegge says. Ever since the MoGo sign went up last fall, five to 10 people a day knock on the door and the phone rings throughout the day with people asking if the clinic is open yet.

The use of urgent care clinics is growing, with 400 to 500 new centers opening in the U.S. each year, according to Illinois-based Urgent Care Association. The latest count as of last June was more than 9,200 clinics, up from 6,400 in 2014. They provide increased access to medical care, thanks to a much lower cost than emergency room visits, as well as reduced wait times. Montage estimates the cost of a MoGo visit will be one-tenth of an emergency room visit, and the average wait time for emergency rooms nationally is about four hours.

In addition, clinics provide primary care for those patients considered “medically homeless,” meaning they have no primary care physician, or are having issues finding doctors who will take new patients. For those who do have physicians, getting in the same day for an illness is often impossible. Urgent care becomes a convenient choice.

Montage invested approximately $7.5 million in the three facilities, according to Mary Barker, chief communications officer. That investment could translate into savings for Montage, as more patients use the clinics instead of its more expensive-to-operate emergency room at Community Hospital of the Monterey Peninsula, which is visited by about 20,000 patients a year who could be seen by urgent care clinics or primary care physicians. 

One reason for the lower cost is that MoGo will not have a doctor on site, instead utilizing nurse practitioners as supervisors, along with medical assistants, licensed vocational nurses and X-ray technicians. The staff will have access to input from CHOMP doctors electronically and patients with more serious ailments and injuries will be directed to the emergency room. Multiple studies performed since the 1980s show nurse practitioners perform as well as doctors in delivering primary care and patient outcomes.

While doctor-staffed urgent care clinics are more the norm nationally, the nurse practitioner supervision model is used in about 20 percent of clinics, according to the Urgent Care Association. Hybrid models using physician assistants is a growing trend in the face of physician shortages in some regions.

Filling the need for primary care delivered by physicians will remain a focus of the current big player in Monterey County’s urgent care clinic landscape, Doctors on Duty, partially owned by Salinas Valley Memorial Healthcare System, says Doctors on Duty Medical Director Scott Prysi. He sees no direct competition between the two urgent care businesses.

“We realize there’s a big need in the county for primary care physicians,” Prysi says. “We fill a vital role for that.”

He says about 60 percent of the 400 total patients per day across nine clinics in Monterey and Santa Cruz counties are typical urgent care patients with coughs, colds and other ailments and injuries. (Doctors also staff the CSU Monterey Bay student clinic and the new SVMHS mobile clinic.) Another 20 percent are workers’ comp patients and the remaining 20 percent are seeking primary care treatment. Specialists like orthopedists, pain management specialists and a psychiatric nurse practitioner are on staff to rotate among clinics to provide a more full-service experience for patients who need it.

The primary care segment is growing at Doctors on Duty, Prysi says, and they expect more such patients in the future. They’ve already expanded clinics in Monterey and Salinas on South Main Street, adding about 30-percent more treatment rooms, and are about to do the same thing at their Abbott Street clinic. They will not be making their waiting rooms look like coffee bars, but fewer people are using them thanks to online appointment scheduling. The online option reduces wait times from about 60 minutes – where Doctors tries to keep it capped – to around 20 minutes.

While MoGo’s coffee shop-like design was by design, its location next to a Starbucks was serendipitous. “We did not know that Starbucks would be our neighbor when we chose the Monterey location, but we are thrilled to have them,” Barker says. “Urgent care works best when it’s convenient and accessible, located in high-traffic areas that people visit or drive past everyday.”