By Linda F. Jarrett
Downtown dwellers and workers will soon have a convenient place to go for medical help, instead of trekking west.
When he saw the historic Truman Building at 916 Olive St. sitting empty, Dr. Sonny Saggar saw the perfect place for an urgent care facility. He purchased it for $1.1 million, and will spend $2 million to convert 4,000 square feet on the ground floor into the Downtown Health and Wellness Center.
Saggar, who currently works as an emergency room physician at St. Luke’s Hospital in Chesterfield, Mo., says a facility such as this was sorely needed downtown.
“They say ‘If you build it, they will come.’ But, in this case, they’re already there,” he says. “There are 20,000 people who decided to live downtown and 9,000 people work there. Can you imagine the turbo boost when Schnucks opens and my urgent care follows? Two of the main obstacles were no grocery stores and no doctors. So, if you can address those two, will you move down here?”
Opportunity Knocks
Saggar had been taking notes about how he would manage a center, should the opportunity arise
“I was looking at many locations, and downtown appealed to me,” he says. “When I heard Schnucks was planning to move in at 9th and Olive, and this building was for sale, it was a no-brainer.”
Some told him it would be a good location for a restaurant.
“I said, ‘No, it would be a good urgent care center. It was beckoning me to open!” he says.
The fact that Schnucks was opening later this year or early next year, and that it would have the downtown’s only pharmacy made Saggar more determined to place a center in this location.
A major obstacle was cleared away a couple of months ago when City Treasurer Larry Williams approved taking out two parking meters clearing the way for an ambulance bay at the center.
“We needed that to transport patients to a hospital, if necessary,” Saggar says.
“We’re grateful to him for allowing that to happen. His office saw that need and very quickly approved removing the meters.”
At the St. Luke’s Emergency Room, Saggar sees many patients with a 63101 area code, because there are no urgent care centers near the downtown area. “They’re traveling 45 minutes to an hour out of the city to be seen for half an hour, and then go back.”
Others, he says, come by cab from other emergency rooms closer to the city. “When they get there, they see that they’re overflowing, so they come out here. There’s a huge unmet demand for acute care for minor injuries and ailments in the downtown area.
“The demographics and market analysis say we’ll be seeing upwards of 100 patients a day,” he says. “But, in terms of revenue, I’m anticipating 25 people a day, at least at first.”
Saggar knows that the first six months to a year will be a learning process. He plans on being open from 11 a.m. until 8 p.m. Monday through Friday, and weekends noon until 5 p.m.
“Eventually, we want to be open 12 hours a day, seven days a week,” he says.
“We’ll be putting out surveys and taking suggestions from patients and neighboring businesses. If we open the door and find 20 people standing there, that’s a clue. By the same token, we will get an idea if there are people still in the waiting room at closing time.”
The office will have eight exam rooms with one physician, one nurse and one medical assistant who will do basic lab work and x-rays. For more extensive testing such as CAT scans or MRIs, or if their condition is assessed as “life threatening,” patients will be sent to the nearest hospital.
“If one of our intentions is to relieve ER overcrowding, we donÕt want to add to it,” Saggar says. “If patients need to be admitted, we can bypass the emergency room, and they can get care from their own doctor.”
St. Louis Via London
Saggar grew up in London, England, and got his medical degree from the University of London. He came to St. Louis as part of an exchange program with St. Luke’s, who offered him a job.
“I didn’t take it, because I didn’t know if I wanted to move here, but I kept it in the back of my mind as an option,” he says.
After traveling around for a couple of years, Saggar says he called St. Luke’s and asked if the job was still available.
“After traveling the world, I found that I liked St. Louis quite a bit,” he says. “It’s like New York, London and Chicago without the big city negatives. There are a lot of progressive and conservative people, simultaneously, and they have a healthy blending of science and technology without surrendering their traditional values.”
Saggar’s enthusiasm for his new venture extends beyond his own planned center. He hopes to fill the building with health professionals and health-related practices such as a dentist, pediatrician and family practice group.
He already has one tenant for the basement, a boxing gym that should prove attractive to some downtown health aficionados.
Making it Affordable
He also wants to have an arrangement with downtown business to make it financially easier for employees to come to the center.
“We are actively seeking grants for the unfortunate category of people which I define as not poor enough for Medicaid,” he says. “They have the pride to keep their jobs, not claiming welfare for free medical insurance.”
Patients falling into that category will fill out an application, and while they will still have to pay the copay, should they meet the criteria, they will be reimbursed for the copay and treatment.
“We went into this business to help people,” Saggar says. “I do not want to refuse to see any human being.”
He has no problem with criticisms of some primary care physicians who say urgent care centers do not provide continuity.
“I’m planning on having an internal medicine practice here also, and you can come back and see me,” Saggar says. “My practice will be a subsidiary of the urgent care center. Patients will have a reduced or subsidized copay.
They Will Come
Raineri Conceptions is handling the general construction work.
“In my opinion, the whole movement itself is pretty significant for the growth of downtown,” President Tony Raineri says. “The biggest complaint of residents was that there were no amenities downtown. You have to have groceries and you have to go to the doctor, now there is the Wellness Center and Schnucks.”
He says the building has a high ceiling; so they plan to build a mezzanine that will eventually have more space should Saggar decide to expand.
Saggar has no doubts that his Center will be a success.
“This is a recession-proof industry,” he says. “People will get sick and they will hurt themselves.”
| Evolution of the Urgent Care Center |
Since its inception in the early 1970s on the East Coast, urgent care centers have sprouted up like mushrooms in the United States. The Joint Commission and the Urgent Care Association of America, who are partnering to provide oversight for the clinics, estimate the number to be 8,000 with two or three more opening every week.
Urgent Care Centers are also expanding in the United Kingdom, Ireland and New Zealand.
While many were started by physicians who wanted to provide a service for those seeking unscheduled medical care, others have grown as offshoots from hospitals wanting to alleviate crowded emergency rooms.
The centers target those who need to see a doctor quickly, but who do not have life-threatening conditions, and while they have been tagged with the "doc in a box" label, they are providing a convenient service for a particular and popular type of medical care.
They are designed to offer ambulatory medical care on a walk-in basis, and offer services sometimes not available in a physicianÕs office such as x-rays and laboratory work.
According to the Centers for Disease Control, patient visits to hospital emergency rooms average over three hours. Many of those same non life-threatening visits take an hour or less in an urgent care center.
“The urgent care center is between the primary care physician and the emergency room,” Dr. Sonny Saggar says. “If you have a sore throat or a urinary infection, the doctor probably won't be able to see you that day. When he does see you, he probably won’t be able to do lab work immediately. While the emergency room has all the resources, you might wait several hours to see a doctor if you don’t have a severe problem. The copay is also higher than a primary care physician.”
Saggar says there are “thousands of minor urgent care centers and these can be two categories. Some are staffed by doctors and some, such as those in retail centers like Walgreen’s, are staffed by nurse practitioners.”
He says since many are unregulated, the 8,000 number may be low. “The Joint Commission is developing an accreditation process. While it is not mandatory at this time, it should be in the next year or so. They’re trying to get on top of this explosion.”
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Original Link: http://www.stlcommercemagazine.com/archives/september2008/groundup.html