Instagram comes to the OR


Seattle’s Swedish Medical Center will cover a cochlear implant surgery live Oct. 2nd at 7 a.m., displaying images from the operation on the online photo website Instagram while narrating the procedure simultaneously on Twitter, the micro-blogging site.

The surgery, which can help restore hearing, will be performed by Dr. Douglas Backous, from the Swedish Neuroscience Institute.

The online program is part of a month-long web series on hearing loss produced by the medical center. Swedish has been releasing videos discussing hearing loss and cochlear implant surgery, since early September.

The web series will end with two live, text-based chats on Oct. 10 at 10 a.m. and 6 p.m. (PT) that will be led by Dr. Backous, a patient and other medical professionals.

The chat will provide the public with the opportunity to submit questions and interact with these leading hearing-loss experts, as well as view footage from a cochlear implant surgery. The chats will take place

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Newspaper printer print

Today’s health headlines – Sept. 28, 2012


By Stephanie Stapleton

Today’s early morning highlights from the major news organizations, including reports about political and policy-oriented health care developments.

The Washington Post: Medicare Working To Boost Obama In Swing States, Poll Finds

Voters in three critical swing states broadly oppose the far-reaching changes to Medicare -associated with the Republican presidential ticket and, by big margins, prefer President Obama to handle the issue, according to new state polls by The Washington Post and the Kaiser Family Foundation. For seniors in Florida, Ohio and Virginia, Medicare rivals the economy as a top voting issue (Aizenman, Cohen and Craighill, 9/27).

Politico: What Obama Isn’t Saying About Medicare

As Woodward explains in “The Price of Politics,” Obama was willing to make significant changes to the cherished federal health care plan for seniors last year as part of a grand bargain with congressional Republicans. And 2011 was hardly the first time Obama considered confronting the costly and popular program; it’s also highly likely it won’t be the last if he’s reelected (Martin, 9/27).

The Wall Street Journal: Some Firms’ Workers Will Choose From Array Of Benefits

Is health insurance just the beginning? A handful of employers may go even farther than Sears Holdings Corp. and Darden Restaurants Inc., which plan to give workers a set sum of money next year to use in choosing among health plans (Mathews, 9/27).

The Associated Press: Public Citizen Advocacy Group Tracks Rise In Pharmaceutical Settlements With State Governments

Federal and state prosecutors have collected more than $30 billion from drug companies for alleged fraud and illegal marketing over the last 20 years, according to a new report by consumer advocacy group Public Citizen (9/27).

Los Angeles Times: Free Healthcare Clinic At LA Sports Arena Draws 4,800

Many of the 4,800 people seeking care at the annual massive free clinic this weekend will become eligible for health insurance in 2014 when the national law takes effect. Organizers said raising awareness about the healthcare changes is crucial (Gorman, 9/27).

The Associated Press: Md. Health Reform Panel Approves State Health Plan As Benchmark In Health Care Reform

A Maryland panel working on implementing federal health care reform voted Thursday to use the state employee health plan as a benchmark for other plans that will be available to small businesses and individuals for two years, starting in 2014 (9/27).

The Associated Press: Liberal Oklahoma Pastors Protest Hobby Lobby Suit Challenging Coverage Of Morning-After Pill

Christian activists attempted Thursday to deliver a petition to Hobby Lobby criticizing its challenge to a portion of the new federal health care law, but guards at the company’s headquarters turned them away. … Schmitz said more than 80,000 people had signed copies of a petition circulated nationwide by Faithful America, an online Christian group, and UltraViolet, which promotes women’s rights. Schmitz said he intends to mail the petition to the company. Lawyers representing Hobby Lobby this month sued the federal government claiming it should not be forced to provide workers with health insurance that covers the morning-after and week-after pills (9/27).

This article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.


LocalHealthGuide editor reports on U.S. elections for BMJ


LocalHealthGuide editor Dr. Michael McCarthy reports on the U.S. elections for the BMJ, the journal of the British Medical Association.

For free access to the full article:

Blue and white capsules spilling out of a pill bottle

Turn in your unwanted and expired prescription drugs on Saturday


King County residents can dispose of their unwanted and expired medicines anonymously and at no cost at a nationwide drug “take-back” day on Saturday, Sept. 29 from 10 a.m. to 2 p.m.

There are 22 take-back collection sites in King County currently with more expected by the day of the event.

To find a location go to:

Blue and white capsules spilling out of a pill bottle

Photo courtesy of Pawel Kryj

This one-day event is coordinated by the federal Drug Enforcement Administration and participating local law enforcement agencies.

About 30 percent of prescription and over-the-counter medicines sold go unused.  Unused prescription drugs too often fall into the hands of children and teens, where they cause poisonings and deaths.

Drug facts:

  • Prescription drug abuse is the fastest-growing drug problem in the country.
  • Drug overdoses have surpassed car crashes as the leading cause of accidental deaths in Washington – the majority involved prescription pain killers.
  • In Washington state 11 percent of teens use prescription medicines for non-medical reasons – a rate among the highest in the nation.
  • Over half of the 37,000 calls to the Washington Poison Center in 2009 were for young children poisoned by medicines found at home, and the elderly are also at risk of accidental poisonings.
  • Human medications are the leading cause of pet poisoning.
Photo courtesy of Pawel Kryj

To learn more:

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Flu virus - courtesy of NAIAD

New flu vaccines now available


Flu virus – courtesy of NAIAD

Vaccines against this seasons flu viruses are now available in Washington state.

This season’s flu vaccine protects against three different strains of flu virus, Washington state health officials said.

It doesn’t protect against the newer H3N2 variant virus that is showing up in other parts of the country.

Most cases of this new virus, however, have been from direct contact with pigs at county fairs. There are no reported cases in Washington state.

“Now’s the time to get a flu shot so you’re protected all season long,” said State Health Officer Dr. Maxine Hayes. “Vaccine is the best protection we have against the flu. Getting it now, before people around you start getting sick, will protect you through the flu season, which usually peaks in January but starts earlier.”

Health officials recommend that everyone six months of age and older get the vaccine but say it is especially important that individuals in the follow groups to be immunized.

  • Young children
  • Adults 65 and older.
  • Pregnant women
  • Parents of newborns
  • And people with medical conditions like –
    • Asthma and other lung diseases
    • Heart disease
    • Diabetes
    • Neurologic conditions.
Different types of flu vaccine are available. Besides the regular flu shot, there’s a high-dose vaccine for people 65 and older, and a nasal spray vaccine for healthy people ages 2-49. There’s also a vaccine that has a much smaller needle than regular flu shots. Ask your health care provider which is best for you and your family.

The Department of Health bought more than 721,000 doses of flu vaccine for kids. All recommended vaccines, including whooping cough, are provided at no cost for Washington children through age 18.

To help fight the ongoing whooping cough epidemic, the department also bought Tdap (tetanus, diphtheria, and pertussis) vaccine for uninsured and underinsured adults, so cost wouldn’t be a barrier for them, either.

Health care providers may charge an office visit fee and an administration fee to give the vaccine. People who can’t afford the administration fee can ask to have it waived.

Many health plans cover flu vaccines as preventive care.

To find a health care provider or immunization clinic, contact your local health agency or the Family Health Hotline at 1-800-322-2588.

Information about flu and flu vaccine is available on the Washington State Department of Health website and U.S. Centers for Disease Control and Prevention (CDC) Seasonal Influenza webpage

For information about the new H3N2 “Swine” flu virus go to the CDC’s Influenza A (H3N2) Variant Virus Outbreak page.


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Trader Joes

Sunland expands recall of products linked to Salmonella outbreak.


Sunland, Inc. of Portales, New Mexico has expanded its nationwide recall of its products linked to a Salmonella outbreak, adding its cashew butter, tahini and roasted blanched peanut products to the recall list, which already includes the company’s almond butter and peanut butter products.

The products are sold under a variety of brand names, including Trader Joe’s, Archer Farms, and Sprout’s.

The company has posted a list of the recalled products here:

The outbreak was first linked to Trader Joe’s Valencia Creamy Salted Peanut Butter, a Sunland product, which Trader Joe’s pulled from its shelves last week.

According to the U.S. Centers for Disease Control and Prevention (CDC), 30 people in 19 states have been infected with the outbreak strain Salmonella Bredeney, including 2 in Washington state.

The number of ill persons identified in each state is as follows: Arizona (1), California (2), Connecticut (3), Illinois (1), Louisiana (1), Massachusetts (3), Maryland (1), Michigan (1), Minnesota (1), Missouri (1), Nevada (1), New Jersey (2), New York (1), North Carolina (1), Pennsylvania (2), Rhode Island (1), Texas (4), Virginia (1), and Washington (2).

4 ill persons have been hospitalized, the CDC said, but no deaths have been reported.

The CDC recommends that “consumers do not eat recalled peanut butter and other products containing nuts and seeds and dispose of any remaining jars of product in the home or return the product to the place of purchase.”

“This is especially important for children under the age of 5 years, older adults, and people with weak immune systems,” the CDC said.

Sunland also advises consumers who have purchased the companies products subject to the recall should discard the product immediately.

Consumers can contact the company at 1-866-837- 1018, which is operational 24 hours a day, for information on the recall. In addition, a consumer services representative is available Monday through Friday between the hours of 8:00 AM and 5:00 PM MT at (575) 356-6638, the company said.


From the U.S. Food and Drug Administration:

What are the Symptoms of Salmonellosis?

Most people infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts 4 to 7 days, and most people recover without treatment.

However, in some people, the diarrhea may be so severe that the patient needs to be hospitalized.

In these patients, the Salmonella infection may spread from the intestines to the blood stream, and then to other body sites and can cause death unless the person is treated promptly with antibiotics.

Who is at Risk?

Children are the most likely to get salmonellosis.

The rate of diagnosed infections in children less than five years old is higher than the rate in all other persons.

Young children, the elderly, and those with compromised immune systems are the most likely to have severe infections.

It is estimated that approximately 400 persons die each year with acute salmonellosis.

Who Should be Contacted?

Consumers who show any signs of illness from salmonellosis should consult their health care provider.

The FDA encourages consumers with questions about food safety to call 1-888-SAFEFOOD or consult the website.

Additional resources:

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Three red and white capsules

Today’s health headlines — Sept. 25, 2012


By Stephanie Stapleton

Today’s early morning highlights from the major news organizations, including reports about a new study that details accelerating health care spending.

NPR: Romney Medicaid Remarks Raise Eyebrows

It’s not so much what Mitt Romney said about whether the government should guarantee people health care in his interview on CBS’s “60 Minutes” Sunday that has health care policy types buzzing. It’s how that compares to what he has said before (Rovner, 9/25).

The Wall Street Journal’s Washington Wire: Romney Rebuke On Emergency Care Draws Rebuke

Mitt Romney’s comments in a CBS “60 Minutes” interview Sunday that emergency rooms provide care to people who don’t have insurance drew a rebuke from a group representing emergency-room doctors and a jab from the Obama campaign. But the question and answer weren’t so clear (Radnofsky, 9/24).

The Associated Press: Double-Digit Premium Hikes Seen In 7 of 10 Top Medicare Drug Plans

Seniors enrolled in seven of the 10 most popular Medicare prescription drug plans will be hit with double-digit premium hikes next year if they don’t shop for a better deal, says a private firm that analyzes the highly competitive market. The report Monday by Avalere Health is a reality check on the Obama’s administration’s upbeat pronouncements. Back in August, officials had announced that the average premium for basic prescription drug coverage will stay the same in 2013, at $30 a month (9/25).

The Washington Post: Health Insurance Costs Accelerate

U.S. spending on health insurance grew at an accelerated rate in 2011, breaking a two-year trend of smaller cost increases. The culprit, a new study suggests, is not Americans seeking more treatment but rather rapid growth in the price of medical care. Spending for private health insurance surged by 4.6 percent in 2011, according to a report from the Health Care Cost Institute. That growth rate is faster than the rest of the economy and higher than the previous year, which had 3.8 percent growth (Kliff, 9/25).

Politico: Medicare Advantage Bonuses Boost Plan Quality

The Obama administration will announce later this week that the quality of private Medicare plans is on the rise, thanks to an $8 billion demonstration project that pays them bonuses for good performance. And Republicans say that same project is covering up cuts to the popular program under the federal health care law (Norman, 9/25).

USA Today: Prescription-Drug Use Drops Among Young People

Prescription-drug abuse in the USA declined last year to the lowest rate since 2002 amid federal and state crackdowns on drug-seeking patients and over-prescribing doctors (Leger, 9/25).

This article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Cimicifuga - Version 2

No evidence that black cohosh relieves menopause symptoms


By Glenda Fauntleroy, Contributing Writer
Health Behavior News Service

Although many women coping with hot flashes and other distressing symptoms of menopause have turned to black cohosh supplements as a treatment alternative, a new review by the Cochrane Library finds no evidence that the herb is effective.

“I was a little surprised of the outcome of the review given the large number of perimenopausal women that use the herb across the globe for the management of menopausal symptoms, as well as the many manufacturers and therapists that promote the herb for this purpose,” said lead reviewer Matthew Leach, Ph.D., a research fellow in the School of Nursing & Midwifery at the University of South Australia.

Leach and his co-reviewer evaluated 16 studies involving 2,027 menopausal women. Study participants used an average daily oral preparation of 40 mg of black cohosh for an average of 23 weeks.

Treatments for randomly assigned comparison groups included using placeboes, hormone therapy, red clover, or antidepressants.

The reviewers found there was insufficient evidence to support the effectiveness of black cohosh for menopausal symptoms. There was no significant difference between it and the placebo groups in changing hot flash frequency. Compared to black cohosh, hormone therapy significantly reduced hot flash frequency.

“I have many women patients who have tried black cohosh,” said Brent A. Bauer, M.D., director of the Complementary and Integrative Medicine Program at the Mayo Clinic in Minnesota.

“I would say the response seems to roughly fall into three camps: those that get a pretty noticeable improvement in symptoms and continue to use it long term, those that get some improvement but not enough to get enthusiastic about it, and those that try it and perceive no benefit at all.”

Health Behavior News Service is part of the Center for Advancing Health

The Health Behavior News Service disseminates news stories on the latest findings from peer-reviewed research journals. HBNS covers both new studies and systematic reviews of studies on (1) the effects of behavior on health, (2) health disparities data and (3) patient engagement research. The goal of HBNS stories is to present the facts for readers to understand and use for themselves to make informed choices about health and health care.

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Evidence does not back-up spinal manipulation for acute lower back pain


By Joan Vos MacDonald, Contributing Writer
Health Behavior News Service

Manipulating or “adjusting” the spine is a popular way to treat occasional or acute lower back pain and is covered by many health insurance plans, but a recent review by The Cochrane Library finds no evidence to suggest it is more effective than other therapy options.

According to the National Institutes of Health, lower back pain affects eight out of 10 people, and is commonly caused by injury or overuse.

Spinal manipulation (SMT), a technique used by chiropractors, osteopaths, naturopaths and some medical doctors, is used to improve the range of motion of the joints in the spine.

“SMT is a worldwide, extensively practiced intervention; however, its effectiveness for acute lower back pain is not without dispute,” said lead reviewer Sidney Rubinstein, senior researcher at the VU University Medical Center in Amsterdam.

Key Points:

  • Acute lower back pain, defined as pain lasting six weeks or less, resolves on its own in most cases.
  • Spinal manipulation, often used by chiropractors and osteopaths, is no more effective than exercise, NSAIDs or other physical therapy to treat acute lower back pain.

The reviewers studied the results from 20 randomized controlled trials representing 2,674 participants with lower back pain of less than six weeks duration.

Reviewers concluded that SMT neither reduced pain nor sped recovery faster than treatment options such as exercise, the use of NSAID pain medications or physiotherapy.

Surprisingly, the review also found no evidence to suggest that SMT was more effective than therapies known to be ineffective.

“This last finding would suggest more research is needed,” said Dr. Rubinstein. If SMT is just as effective as accepted interventions, it should be better than ineffective therapies, such as using ultrasound or heat therapy.

“Such reviews may be confusing because they are not comparing apples to apples,” said Mitchell Freedman, D.O., director of Physical Medicine and Rehabilitation at the Rothman Institute at Thomas Jefferson University Hospital in Philadelphia. “For a start, there are different kinds of manipulation, some more aggressive and some limited to stretching. Also, while spinal manipulation is not useful in all circumstances, it can be in some. You do need to look across a whole spectrum.”

Another complicating factor is the nature of acute lower back pain. Defined as lasting six weeks or less, it tends to go away on its own in almost 90 percent of all cases.“Studies do promote the use of manipulation in subacute to chronic pain which is different from acute pain,” said Freedman.

Health Behavior News Service is part of the Center for Advancing Health

The Health Behavior News Service disseminates news stories on the latest findings from peer-reviewed research journals. HBNS covers both new studies and systematic reviews of studies on (1) the effects of behavior on health, (2) health disparities data and (3) patient engagement research. The goal of HBNS stories is to present the facts for readers to understand and use for themselves to make informed choices about health and health care.

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Group Health Icon

Group Health Cooperative plans layoffs and cuts – Seattle Times


Group Health Cooperative must cut $250 million over the next 16 months through layoffs, better cost control and some reorganization at the top, Seattle Times health reporter Carol Ostrom reports in today’s issue of the paper.

Ostrom writes:

Group Health, which insures about 600,000 people in Washington and has annual revenues of $3.5 billion, is aiming to climb back up to a 3 percent operating margin, Armstrong said in a Friday memo to staff, first reported by the Puget Sound Business Journal. The memo noted there had been three years of sharp declines in finances.

“This cannot continue,” Armstrong wrote. “We are better than this, and I am not going to let us have another year like this one.”

To learn more read Ostrom’s article: Group Health announces layoffs, cuts.



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Snohomish Health District honors KSER host Sondra Santos for public health programming


The Snohomish Health District has honored Sondra Santos, morning host of The Takeaway program on KSER 90.7 FM, in Everett, Wash with the Distric’s Public Health Hero Award

The award honors individuals who have demonstrated unparalleled support of local public health activities or policies in Snohomish County.

Since the Health District’s debut on The Takeaway in September 2011, Santos has hosted 47 segments devoted to educating her listeners about public health programs and services to the community.

She interviewed Health District staff experts on topics that touched most aspects of community health, communicable disease, environmental health, and public health emergency preparedness.

“Sondra Santos has significantly developed the community’s understanding of local public health through her radio program,” said Dr. Gary Goldbaum, Director and Health Officer of the Snohomish Health District. “We commend Ms. Santos for her sustained effort, and greatly appreciate our partnership with KSER for their collaborative spirit.”

Santos interviews Snohomish Health District staff during a regular segment on The Takeaway at 8:30 a.m. on Thursdays.

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Family physicians reject suggestions to have nurses lead practices


By Ankita Rao

With a shortage of primary care providers looming, the idea of using nurses and physician assistants to fill the gap often appears to be gaining traction.

But according to a report released Tuesday by the American Academy of Family Physicians, having more nurse practitioner-led medical practices is not a viable solution.

“Perceived shortages don’t justify less than qualified care for our family,” said Dr. LaDona Schmidt during a conference call about the report. She was a nurse practitioner before receiving her medical degree in family medicine.

Instead, the organization urges the adoption of physician-led, patient-centered medical homes, a model of care that promotes integrative care to help lower health care costs.

The model is supposed to decrease referrals to specialists and help doctors diagnose and treat patients with the collaboration of their staff and administration.

The tension between some nurse practitioners and physicians has become more palpable in recent years as these nurses with advanced degrees have received more authority in some states to diagnose, treat and prescribe medicine. In 16 states, they can practice independently of a physician

Physician assistants receive different training and work under the direction of doctors, but some have also advocated for them to have more independence from physicians.

In physician-led, patient-centered medical homes, nurse practitioners work under the supervision of doctors, often managing pain and long-term treatment. AAFP members said this model cuts down on readmission rates and increases patient satisfaction.

Citing a difference in education, the report’s authors said nurse practitioners receive 5,350 hours of training and study on average, compared to the 21,700 hours that physicians accumulate through medical school and residency.

Nurses can practice at the end of their studies, which include clinical training, while doctors go on to their internship and residency, a difference that the report said is crucial to treating a patient.

Describing her experience in both roles, Schmidt said medical school provided a depth to her understanding of the human body that wasn’t clear as a nurse.

The report said that while nurse practitioners are vital to performing procedures and long-term care treatment, the complexities of the human body are better handled by a physician.

Research on the health care outcomes of nurse practitioners suggests two sides to the pro-physician argument. A study published in the Journal of the American Medical Associated (JAMA), for example, found that there were no significant differences in patients’ health status when they were treated by nurse practitioners instead of physicians for primary, ongoing or urgent care.

But THE AAFP board chair, Dr. Roland Goertz, said that recognizing the strength of both health care providers and integrating them into patient-centered medical homes was the only way to address a shortage that hits rural areas especially hard.

“I think we’re beyond testing it,” said Goertz about the medical home model. “I think the evidence is there supporting it in a very large way.”

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What are medical homes? – Video


The Commonwealth Fund is launching new series of videos designed to increase understanding of some of the most important changes happening in the U.S. health care system.

As the reforms in the Affordable Care Act start to roll out, each video in this series will feature a Commonwealth Fund expert explaining a facet of health reform, and how it will impact Americans.

In the first video, Melinda Abrams, vice president for the Fund’s Patient-Centered Coordinated Care Program, explains how primary care doctors’ visits are changing.

Abrams outlines the problems many people have getting care today, such as trouble making appointments after regular office hours, and shows how medical homes—a way of delivering primary care that is supported by the Affordable Care Act—are improving access to high-quality care while lowering costs.

Upcoming videos in the series will explore improving care for vulnerable populations, U.S. health spending, coverage expansion, and more.

Find more health policy videos, podcasts, and narrated slideshows in the Commonwealth Fund’s multimedia center.

Urgent Care

Urgent care centers are booming, which worries some doctors


Photo: Suzanne Nathan (Flickr/CC)

By Phil Galewitz
KHN Staff Writer

This story was produced in collaboration with wapo

When Emily Auerswald and her children need care for minor illnesses or injuries, they head to a shopping center near Annapolis, Md. that has a Starbucks, a Five Guys hamburger joint and an urgent care center.

Doctors Express in Edgewater is open nights and weekends, and accepts walk-ins without an appointment.

“I have a doctor, and my kids’ pediatricians are great, but we’d prefer not to have the long wait in the office. So we come here and everything seems so much faster,” said Auerswald, 36, who was having a doctor remove the stitches he had put in her foot after a weekend boating accident.

Such centers treat the most common injuries and illnesses – including colds, ear infections, cuts and back pain – in addition to taking X-rays and performing simple blood, urine and drug tests.

And they are booming: An estimated 3 million patients visit them each week, according to the Urgent Care Association of America.

Since 2008, the number of facilities has increased from 8,000 to 9,300 — and that’s not counting smaller and more limited walk-in clinics in pharmacies and big-box stores such as Target and Walmart.

Some physicians groups warn that the overreliance on the centers can complicate efforts to improve health through better coordination of care.

“Family doctors take a more holistic view of a person,” said Glen Stream, president of the American Academy of Family Physicians.

If a teenager comes in with lacerations, for instance, a family doctor might broach the subject of alcohol or drug use, he  said. Similarly, a series of seemingly minor illnesses might indicate a larger, less obvious problem.

Next Gold Rush?

Dr. Rinde Fadirepo speaks to a patient at Doctors Express Urgent Care Center in Edgewater, Md. (Photo by Larry French/AP Images for KHN)

But consumers seeking to avoid long waits in emergencies rooms and grateful for more convenient evening and weekend hours are driving a steady growth in urgent care centers.

Rick Morani, owner of the clinic near Annapolis, said he bought the Doctors Express franchise — one of 54 nationwide — because he expects the growth curve to look “like a hockey stick.”

Many urgent care centers are stand-alone doctor’s offices, sometimes called “doc-in-a-box” locations. But much of the recent growth has come from chains, said Tom Charland, chief executive of Merchant Medicine, a Minnesota consulting firm that tracks the industry.

Concentra, the nation’s largest chain, has 324 centers, including 14 opened in the last nine months.

“There’s plenty of funding out there from private equity people who feel this is the next gold rush,” said Robert Graw Jr., the chief executive of locally based Righttime Medical Care, which has nine centers in Maryland and is planning new ones in Maryland and in Virginia.

Growth is expected to increase even faster in 2014, when the Affordable Care Act starts to bring health-care coverage to as many as 30 million Americans, many of whom do not have regular doctors, said Charland.

While urgent care centers typically offer hundreds of medical services, they do not perform surgery and are not equipped to deal with life-threatening emergencies. In most cases, a doctor is on site, although care may be provided by a nurse or physician assistant who is also on staff. Many centers are busiest in the evenings and on weekends, when most doctors’ offices are closed.

In the past, at least some of the patients who now go to urgent care centers would have ended up in hospital emergency rooms. While the typical $100 visit to a center is comparable in price to a visit to a doctor’s office, an emergency room visit can cost more than twice as much.

A 2010 Rand Corp. study found that almost one in five visits to hospital emergency rooms could be treated at urgent care centers, potentially saving $4.4 billion annually in health-care costs.

Medical assistant Shaska Thomas perform triage on a patient at Doctors Express Urgent Care Center in Edgewater, Md. (Photo by Larry French/AP Images for KHN)

The lower costs have drawn the attention of insurers. Many have added urgent care centers to their provider networks, and one has gone a step further. Humana, in 2010, purchased Concentra.

Even hospitals have jumped in, adding their own urgent care centers. In July, for example, Dignity Health, the nation’s fifth-largest hospital system, bought U.S. HealthWorks, the second-largest urgent care chain, with 147 centers.

Inova Health System, in Northern Virginia, has four urgent care centers and is looking to add a fifth.

“Strategically, we want to be able to provide better access for patients in our market where there are shortages of doctors,” said Loren Rufino, director of business operations for Inova’s ambulatory services division.

Selling Efficiency

For patients, convenience and lower costs seem paramount.

Diantrey Thompson, 26, of Glen Burnie, Md., recently had a cyst removed from his head at Righttime’s location in nearby Gambrills. Although the restaurant manager has insurance and a regular doctor, he says, “I’ve been coming here for years because they are just so efficient.”

Urgent care center executives clearly understand that saving time is a major selling point. Righttime, for example, has a goal of getting patients in and out within an hour.

From a command center in Crofton, Md., an employee tracks all Righttime centers via cameras set up at front desks and in hallways.

A computer system monitors how long people have been waiting.

While showing a visitor around, Graw notes a monitor with a flashing bar — an alert that a patient has been at one of his centers for longer than an hour. Graw checks details and sees that the patient is having his ears cleaned. He relaxes, saying that’s “a good excuse.”

Photo courtesy of Suzanne Nathan “Zoup” via Flickr/Creative Commons License

This article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.