On any given Sunday afternoon you can walk into Leawood Family Care and find a buzz of activity — and it's not the cleaning crew.

Leawood Family Care, at 11301 Ash St. in Leawood, is among a limited — but maybe growing — number of doctors' offices that offer extended hours.

Lisa Pioli, one of the seven doctors who own the practice, said patients can come in without an appointment and be seen by a doctor within a relatively short amount of time. The walk-in portion of the practice is available until 8 p.m. Monday through Friday, on Saturdays from 10 a.m. to 4 p.m., and Sundays from noon to 4 p.m. The walk-in service is open every day except Thanksgiving, Christmas and New Year's Day.

Formerly owned by Carondelet Health, Leawood Family Care started offering extended hours several years ago because of patient requests.

"It takes a tremendous amount of work, money and staff," said Pioli, who had worked in retail walk-in clinics before coming to the Leawood practice. "You have to have doctors willing to work regular hours and after hours."

The extended hours also are expensive, Pioli said.

"We bled financially," Pioli said about the first three years of extended hours. "We had to bring in a lot of front-desk staff using both full-timers and part-timers."

But Pioli said the walk-in word spread, and eventually business began to grow.

"By keeping it busy, it made it lucrative," she said.

Charges for services are dictated largely by insurance companies, but the practice does not differentiate between walk-in and appointment patients. However, there is one thing that's distinctive between the two types of patients.

"The patient who uses walk-in (service) has a different mind-set," Pioli said. "The kiss of death to a walk-in is the wait — they want to get in and out."

Offering extended hours is one of several recommendations for improving patient care put forth by the Leawood-based American Academy of Family Physicians, whose members include 20,000 family medicine practices and 95,000 individual physicians.

The academy's Future Family Medical Report also suggested more use of technology in managing practices, such as electronic files, portability and advanced scheduling options, as well as being sensitive to ethnic and diversity issues.

"They decided (the field) needed to refocus ... to a more patient-centered focus," said Terry McGenney, chief executive of TransforMed, a subsidiary of the academy that was created to encourage members to make such a transformation.

McGenney said the academy started a two-year national demonstration project this year working with 36 practices across the United States to implement the TransforMed model. Online tools are being created for these practices to assess their progress.

McGenney said anecdotal information from those using the new model indicate a win-win situation.

"Implementing the new model not only increases patient satisfaction but increases the financial performance of the practices," he said.

James W. Hall, a primary care physician, has been offering extended hours at his office, Landmark Medical Center in Kansas City, for more than two decades.

Hall, along with another doctor and practical nurse, see walk-in patients as well as scheduled appointments beginning at 7 a.m. Hall's office is also open from 7 a.m. until noon on Saturdays and offers same-day scheduling.

"Patients love those early-morning hours," Hall said. "Medicine is to serve. We're in the personal service business, so we need to be there" when there is demand.

Hall said overhead costs are high in family practice, especially staffing.

"Forty-four cents of every dollar that comes in goes to employee salaries," Hall said. "The rest (of expenses) are fairly well fixed — utilities, rent and malpractice insurance."

Medical service providers also can benefit from extended hours.

Diagnostic Imaging Centers offers extended hours beyond the traditional business day in order to meet patient demand. The centers offer such services as mammography, ultrasound, CT and MRIs, and general radiology testing. Diana Holek, chief operating officer, said all seven locations offer early-morning or evening hours for patients, as well as Saturdays. Staffing is key in meeting the demand, she said. About 54 percent of the centers' budget goes to salaries.

"We watch our schedule closely. If you're going to open two more hours, than you have to look at your reimbursements and the other things you need — front-office staff, technologists, doctors," Holek said. "You have to do your due diligence before adding staff … but if we have to add staff to meet demand, we will."________________________________

Convenience factor


Over the past two years, drugstore health-care clinics have popped up in the Kansas City area. They are now operating in some Walgreens and CVS stores.The clinics, which are staffed by nurse practitioners, offer walk-in service without need of an appointment, quick visits and the ability to get a prescription and fill it in one stop. Terry McGenney, who leads the American Academy of Family Physicians' new TransforMed program, was not surprised by the emergence of these clinics. "They were probably more a response to the old (family practice) system," said McGenney. There has been some criticism from the physician community that the care provided by a nurse practitioner — without direct supervision by a doctor — can't be compared to what a physician provides. And the American Medical Association has expressed concerns that the clinics "cherry-pick" locations in affluent areas. The in-store clinics contend that they provide health-care services that are needed and that they offer high-quality care as well as convenience.

Labels: No Prescription, Online Pharmacy, Prescription Drugs