The waiting area of City MD

by Amanda Woods

“In the past, the emergency room was your only option for receiving care for any minor or not-so-minor injury,” said Mark Melrose, D.O., co-founder of Urgent Care Manhattan on the Upper West Side. “The ER was the only game in town.”
Today, about 40 percent of visits to hospital emergency departments are for nonurgent or semi-urgent problems, resulting in unnecessarily overcrowded emergency rooms, according to the Centers for Disease Control and Prevention. For many conditions, urgent care is a more suitable option. Urgent care centers offer treatment for a variety of ailments, ranging from strep throat to broken bones and fractures. In some centers,
physical exams for schools, summer camps and employment are also provided.
Urgent care is not a new concept—it has existed for about 25 years, according to Bill Foresman, the administrative manager of Mount Sinai Urgent Care—but it has recently taken off both nation- and citywide, Melrose said.
Urgent care centers are open to walk-ins, and patients are usually seen within minutes of their arrival.
Citywide urgent care is a necessity that fits into the rhythm of Manhattan life, said Samuel Fisch, the CEO of MedRite Urgent Care in Midtown East.
“An urgent care center is definitely a model that belongs to New York City,” Fisch said. “People [have] busy schedules and it’s so hard to get in to see a doctor. We felt it’s a service that’s needed in the city more than any place else.”
Many issues play into the surge of urgent care in the city.
“You hear of the financial strife of hospitals closing, and they’re having trouble providing efficient care to all patients,” said Anthony Ruvo, M.D., a co-owner of New York Doctors Urgent Care. “Patients still need to be seen in a timely manner.”
Previously, it was too expensive for urgent care centers to open a Manhattan office. The financial crisis has actually helped that situation, Melrose said, and many urgent care centers can now afford to open up.
Many of the urgent care centers that have cropped up in Manhattan are staffed by board certified emergency physicians—a huge plus in a city filled with large medical institutions, said Douglas Kaiden, M.D., a doctor at MedRite.
Below is a list of some of the urgent care centers on the Upper East and Upper West sides and in surrounding neighborhoods.

Urgent Care Manhattan

Upper West Side—199 Amsterdam Ave., 212-721-4200, www.urgentcaremanhattan.com

Urgent Care Manhattan is a walk-in medical center that provides pediatric and adult care for common illnesses, minor emergencies, wound repair and X-rays. Patients can also receive travel vaccinations, diabetes and cholesterol screenings and blood tests and lab analysis. Students are welcome at the center for school and summer camp physical screenings. Alcohol and drug testing, along with HIV screenings, are also available at the facility.

CityMD

Upper East Side—336 E. 86th St., 212-772-3627; Upper West Side—2465 Broadway,

212-721-2111; Columbus Circle—315 W. 57th St. Another Upper East Side location (1150 3rd Ave. at East 67th Street) is set to open in the fall. citymd.net

CityMD physicians treat injuries, common illnesses and pediatric needs. They also provide X-rays and conduct health screenings for employment, STD testing and flu and mononucleosis screenings. The facilities also offer travel vaccinations. Besides the four locations mentioned above, CityMD also has an office on West 23rd Street in the Flatiron District.

MedRite Urgent Care

Midtown East—919 2nd Ave., 212-935-3333, www.medriteurgentcare.com

MedRite treats non-life-threatening illnesses including upper respiratory infections, the flu and migraines and injuries such as sprained ankles. X-rays are also available on-site. The doctors on staff are board-certified emergency physicians, said Douglas Kaiden, a doctor at MedRite. The office is open seven days a week, and patients can come in for school, sports, occupational and other physical exams. Patients have the option to fill out a check-in form online before they arrive at the office.

New York Hotel Urgent Medical Services

Upper East Side—952 5th Ave., Ste. 1D, 212-737-1212, travelmd.com/site1/home/new-york-hotel-urgent-medical-services

This center handles minor medical emergencies for city tourists, and its doctors follow up with patients’ primary care physicians back home, providing detailed reports. New York Hotel Urgent Medical Services also offers 24-hour in-room medical care—doctors usually arrive at the hotel room either within the hour or at the patient’s requested time. The doctors carry portable medical equipment, and most medications are immediately available.

EMERGeCARE

Upper East Side—210 E. 86th St., Ste. 203, 212-510-8092, www.emergecare.com

This center treats various medical needs, ranging from the common cold to bites and stings to dehydration. Most major insurances are accepted here, but those who aren’t insured pay an all-inclusive $125 fee.

Manhattan Physician Group

Upper East Side—215 E. 95th St., 212-996-8000; Upper West Side—154 W. 71st St.,212-496-4600. www.mpgcares.com

Here, patients can receive treatment for common illnesses. General and vascular surgeries, as well as social services, are also available at the Upper East Side location. Internal medicine services are offered at both locations.

DR Walk-in

Upper West Side—775 Columbus Ave., 212-932-8060, www.drwalkin.com

This urgent care center is located inside a Duane Reade pharmacy. Here, patients can receive general checkups, treatments for back and joint pain, physical exams for work and school and blood sugar testing, to name a few.

The Urgent Care Center of Memorial Sloan-Kettering Cancer Center

Upper East Side—1275 York Ave., 212-639-7081, www.mskcc.org/doctor/department/department-medicine/urgent-care-service

Memorial Sloan-Kettering patients are treated for problems related to cancer, medical and surgical illnesses and side effects of cancer treatments. Staff at the center evaluate patients’ hospital records, take a brief medical history, do a physical exam and conduct tests based on the physical symptoms. Then, the staff will determine whether the patient should go home or be admitted into the hospital.

Mount Sinai Urgent Care

Upper West Side—638 Columbus Ave., 888-407-1848, mountsinaifpa.reachlocal.net/about-us/locations/upper-west-side/urgent-care

This is a brand-new urgent care facility. Many of the urgent care doctors here also treat in the hospital’s emergency department, but at the urgent care center, they are able to treat patients more quickly and with greater privacy. This center has a unique perk—access to Mount Sinai’s clinical pathology and diagnostic services.

One Medical Group

Columbus Circle—1790 Broadway, Ste. 182, 212-530-0624, www.onemedical.com/nyc/doctors

One Medical Group offers same-day appointments for patients in need of immediate attention. On the center’s website, there is a link to the member services portal, My One, which allows patients to sign up for an appointment whenever they like. Using MyOne, patients can enter their medical history online and, after their appointments, follow up with doctors and schedule their next visit.

New York Doctors Urgent Care

Greenwich Village—65 W. 13th St., 212-414-2800; new office at 205 Lexington Ave. (Murray Hill) to open July 16. www.nydoctorsurgentcare.com

At this office, the two doctors, Anthony Ruvo and Alvaro Alban, treat immediate health needs such as acute lacerations, minor fractures and occupational-related injuries. The doctors—both with experience in emergency medicine—also handle common illnesses such as allergic reactions, bronchitis and upset stomachs. Patients usually wait only 10 minutes in the casual, café-style waiting room to be seen by a doctor, Ruvo said, and they usually spend no more than an hour total in the office.

Emergency Dentist NYC

212-486-9458; www.EmergencyDentistNYC.com

Located near Union Square, Emergency Dentist NYC specializes in treating all dental emergencies, traumas and pain relief.

Seven days a week including weekends and holidays.

Dr. John Andrilli Consults with Denis Tejada, RN

by David Gibbons

For many observers, the closing of St. Vincent’s Hospital—one of the oldest community hospitals in the nation and a New York City icon throughout the 20th century—was a disaster, a disgrace, a moral failure, an avoidable tragedy. After its demise at the end of April 2010, professionals in other downtown medical centers noted a surge in ER visits and ambulance runs. Now, just over two years later, the question is: Have the others been able to fill the gap?
The two major area players are Beth Israel Medical Center, part of Continuum Health Partners (CHP), and the North Shore-LIJ Health System. Beth Israel had already doubled the size of its emergency room after the closing of Cabrini Medical Center in 2008, so it was well prepared for the St. Vincent’s surge; other local hospitals also expanded and adapted to pick up the slack. Meanwhile, both CHP and North Shore-LIJ, as well as several independent partnerships of doctors, have begun to offer more options for urgent care.
In March, 2011, North Shore-LIJ partnered with VillageCare to open an urgent care center at 121A W. 20th St. Around the same time, North Shore-LIJ announced its trump card; plan to convert the O’Toole Building—the white wedding cake-like landmark on 7th Avenue between 12th and 13th streets that was part of the St. Vincent’s complex—into “the first stand-alone emergency and ambulatory facility in the New York City metropolitan area.”
“We developed what we felt was a realistic proposal to restore comprehensive health care to the West Side,” said Terry Lynam, a North Shore-LIJ spokesperson. “We’re investing $110 million to build a true community resource that will go a long way toward giving people access to health care that has been lacking since the closing of St. Vincent’s.” It is scheduled to open as The Lenox Hill Hospital Center for Comprehensive Care in early 2014.
“North Shore is doing a commendable job trying to rebuild some services,” said Dr. Fred Hyde, clinical professor at Columbia University’s Mailman School of Public Health and an expert on management and policy. “Still, the closing of a hospital is irrelevant to the utility of urgent care centers, since hospitals were never much good at outpatient care in the first place. Urgent care is a substitute for available primary care physicians, of which we may have too few—local, state and national.”
Hyde estimates that an individual physician, depending on how “muscular” a schedule he or she is willing to tackle, can serve a primary care base of
2,000 to 2,500 patients. These figures, together with a projection from the Urgent Care Association of America of one clinic per every 40- to 50,000 people, suggest that roughly 50 hardworking doctors staffing urgent care clinics in an area the size of southern Manhattan
could have a significant impact.
“If St. Vincent’s was like a lot of hospitals, it had an ER half-full of non-emergency patients who could have been treated in an urgent care clinic,” said Lou Ellen Horwitz, the Urgent Care Association’s executive director. “So while urgent care can’t replace hospital beds, it can create access for a lot of patients who would have gone to an ER.”
CHP’s strategy is to build neighborhood primary and specialty care practices that accept walk-ins, one of the many ways it strives to meet the needs
of the community, according to spokesman Jim Mandler. Marked by their familiar awnings with the blue Beth Israel logo, they are currently located in the West Village (222 W. 14th St.), Chelsea (202 W. 23rd St.) and lower Midtown (55 E. 34th St.).
The Chelsea practice is expanding and will relocate to the northwest corner of 23rd Street and 8th Avenue on Sept. 1 with 12,000 square feet of space on two floors.
Tom Poole, vice president of Continuum Medical Groups, who oversees development and operation of CHP’s community medical centers around
Manhattan, calls it “our newly renovated state-of-the art facility for walk-in primary and specialty care, one-stop shopping sorely needed to serve Chelsea and Penn South,” a neighborhood development with a large elderly population.
In November, Continuum will open another new Beth Israel facility on 8th Street in the West Village, able to handle 36,000 patient visits per year at full capacity.
“Our model for the future is easy, open access,” said Poole. “We’ve found this is what patients increasingly expect; they don’t want to wait six weeks to see their doctor. We aim to treat patients who need immediate or urgent care and create an environment that provides a satisfactory experience for everybody. To put it simply: We want happy patients, happy physicians and happy staff.”
“We’re able to see this with our practice on 14th Street, and we hope it will continue with the new locations on 23rd and 8th streets,” Mandler added. Poole says he feels a year from now will be a good time to re-evaluate the success of this new model; he also expects the increasing demand for urgent care to grow hand in hand with new housing development along the West Side.
(For more information on Beth Israel’s practices, visit www.bethisraelmedicalgroup.com or www.wehealny.org.)
At CityMD (www.citymd.net), they are equally bullish: “From our perspective, we see a major need for quality urgent care throughout the city and
particularly in the downtown area,” said COO Dr. Nedal Shami, adding that business is good. The company opened its new Flatiron branch at 37 W. 23rd St. on May 8 of this year, has another scheduled to open on 67th Street in the fall and is actively seeking a location in Tribeca or the Financial District for the near future.
Other private partnership practices along the lines of Beth Israel’s primary care walk-ins are opening up, among them the One Medical Group (www.
onemedical.com), which has five locations, including in the West Village, at 408 W. 14th St., and the Wall Street area, at 30 Broad St.
Additional urgent care options in Manhattan’s Lower West Side include New York Doctors Urgent Care, 65 W. 13th St.; Emergency Medical Care, 200 Chambers St. (www.emcny.com), and Medhattan Immediate Medical Care, 106 Liberty St. (www.medhattan.com).
According to rules of thumb and guesstimates from several experts, it appears that southern Manhattan’s urgent care needs are being addressed, and that the closing of St. Vincent’s, in the cold light of history, may one day be considered more of a transition than a
debacle.