W?hen Carole Larry realized late one afternoon last week that she needed medical attention, she did some quick homework at the urging of her mother. The 18-year-old, who is uninsured, stopped by the Ohio Health Center at 1000 E. Broad St., a primary-care practice just two doors from her Near East Side house. There, she learned she could get treatment for a urinary-tract infection that evening without an appointment.
When Carole Larry realized late one afternoon last week that she needed medical attention, she did some quick homework at the urging of her mother.
The 18-year-old, who is uninsured, stopped by the Ohio Health Center at 1000 E. Broad St., a primary-care practice just two doors from her Near East Side house. There, she learned she could get treatment for a urinary-tract infection that evening without an appointment. The cost: $83.
Her parents, Kevin and Jennifer Williams, said that if the office had not been open, they would have taken her to the emergency department at Grant Medical Center at far greater expense.
“It’s a great alternative to the emergency room,” Mr. Williams said, minutes after a nurse practitioner had examined his daughter.
That’s the kind of case that Dr. Ralph Newman hopes to attract by keeping the office open late on weekdays. Starting last month, his practice, which focuses exclusively on walk-in patients, pushed back its closing time from 5:30 to 11 p.m.
Newman, who is 66 and has practiced medicine for 39 years, said his patients are among those who regularly clog emergency departments with less-severe ailments that should be treated by family-practice doctors. But those practices often aren’t open when families need them, he said. That lack of access comes at a cost to taxpayers, employers and patients when emergency departments are used instead.
The response so far has been enthusiastic but small, Newman said — about two to three patients per night, compared with more than 100 during the day. He said he hopes the word gets out about his later hours and more patients find their way to his office. If there’s enough demand, he plans to keep the practice open from 9 a.m. until 11 p.m. on weekends, too.
Newman’s practice has adjusted or expanded the work hours of some of its 30 staff members without adding full-time employees. It has added four part-time medical assistants. In addition to Newman and another doctor, the office has several nurse practitioners and physicians’ assistants.
The move comes as Grant Medical Center prepares to add eight beds in its emergency department this spring to keep up with growing patient volumes.
More than 20 percent of patients seen in Grant’s emergency department have less-urgent medical needs, the majority of which would be best handled by a primary-care doctor, said Duane Perry, nursing director of the hospital’s emergency department. “I think what this physician’s trying to do can only improve that,” Perry said of reducing the number of patients in emergency departments who don’t have emergencies.
The expanded hours of Newman’s practice are in keeping with a trend toward more retail-based health clinics that are open beyond normal business hours, said Reginald Fields, a spokesman for the Ohio State Medical Association.
“We are beginning to see an increasing number of primary-care physicians who are making themselves available during evening and night hours,” Fields said. The association hasn’t surveyed its members on the trend, he said.
A study published last year in the journal Annals of Family Medicine found that total expenditures for patients who had access to extended office hours were 10.4 percent lower compared with patients who didn’t have such access. About 34 percent of the 33,269 U.S. patients analyzed in the study had access to primary care during evenings and weekends. Those lower costs, however, were attributable to lower prescription-drug and test costs, not to a decline in emergency-department utilization.
“Although emergency-room visits are expensive, just in terms of sheer volume, they are very infrequent,” said Dr. Anthony Jerant, a study author and professor at the University of California, Davis. As a result, he said, emergency-department visits were a less-significant factor in health-care costs than prescription drugs and tests.
The study said extended office hours might be associated with “ more judicious use of health-care resources,” though it said further research would be needed to establish such a link.