Doctors Express Franchise

Doctors Express hopes to franchise urgent care in U.S.
By Sonja Y. Foster, USA TODAY

DR. SCOTT BURGER

Born: Aug. 20, 1972.
Hometown: Glen Head, N.Y.
Education: B.A., Loyola College (Maryland), 1994; New York College of Osteopathic Medicine, 1999; Emergency Medicine Residency at Beth Israel Medical Center in New York City, completed in 2002.
Family: Wife, Kathleen, 38; son Jack, 11 weeks.
Hobby: Tennis.

CENTERS, BY STATE

There are approximately 8,000 urgent-care centers in the USA. Doctors Express wants to add 3,000 more.

Estimates as of June:

Top 5
California: 974
Florida: 730
Texas: 679
Michigan: 411
North Carolina: 406

Bottom 5
Wyoming: 18
New Hampshire: 15
South Dakota: 13
Vermont: 9
District of Columbia: 8

Source: Urgent Care Association of America

By Charisse Jones, USA TODAY
At his Doctors Express center in Towson, Md., Dr. Scott Burger has spent the last three years tending to the community's night-time fevers and weekend hurts.

Now, the former emergency room physician wants to take the center's model nationwide, doing for urgent health care what, say, Papa John's did for pizza — making sure the public can find it anywhere and always knows what it's going to get.

"In every community, at least one," Burger, 36, says of his ultimate goal, "so when people think of where they need to go for their health care needs, the first thing they think. .. is 'Where's the Doctors Express?'

At a time President Obama is pressing Congress to radically overhaul the nation's health care system with an eye to affordable insurance for everyone, Burger and his partners are trying to launch the nation's first urgent-care franchise, applying a model often associated with fast food and car repair to centers that would deliver affordable, non-emergency treatment to almost anyone who walks in.

They're hoping to open 3,000 centers around the country, at which members of the public can come in without an appointment, in the evening or on weekends when their own doctors' offices are closed, and get stitches, something for a sore throat or even a broken bone treated for a fraction of what they'd pay for a trip to an emergency room, and without the wait.

They say they'll differ from the roughly 8,000 other urgent-care centers, as well as smaller retail clinics that have sprung up in shopping centers in the last decade, by offering a consistent, broad range of treatment and service on the spot. Every Doctors Express will have a physician on duty at all times, unlike some centers that leave patient care to the supervision of a nurse practitioner or other professional. All will have digital X-ray equipment, a lab and a pharmacy to dispense drugs, which other urgent-care centers may not have.

And unlike most other centers, many Doctors Express franchises can be owned by corporate managers who don't have a medical background. The company says it will guide them in everything from what credentials to look for when hiring staff to how to pick the best location.

"It is novel since it's the first one," says Lou Ellen Horwitz, executive director of the Urgent Care Association of America. "We've seen a variety of different ways of setting up (urgent-care centers) and managing them on both a regional and a national level, just not this particular franchise model."

Burger is close to seeing whether his center, which has been open three years, can be replicated elsewhere and if his idea takes off.

The first franchise is scheduled to open July 30, in Temple, Texas. The private company says it has sold roughly two dozen more in Texas, Georgia, New Jersey, South Carolina, North Carolina, Colorado and Virginia, but there's no schedule yet for them to open, and they cannot be independently confirmed.

'Committed to this idea'

In the beginning, Burger says his dreams were more modest than delivering health care across the country.

As an emergency medicine resident in New York City during the late 1990s, Burger says he grew frustrated seeing the long waits endured by patients who came to the emergency room with less critical injuries or illnesses.

"People would come in with sore throats, lacerations, possible broken bones, and they had no other place to go," he recalls. "We wanted to take care of them, but we couldn't do it in an expeditious fashion. I felt there was a better way to do this."

He and his wife, Kathleen, scrimped and saved to open a single center that could tend to sprains, infections and myriad other aches and injuries that too often pop up when a primary care doctor's office is closed.

"We only recently purchased a home because we didn't commit any of our finances to anything other than this business," he says. "Financially, we put all our eggs in this basket … because we were committed to this idea."

Burger also teamed with two partners, his former college roommate Tony Bonacuse and Peter Ross. Together, they co-founded Doctors Express in 2005, opening the Towson center a year later. Bonacuse serves as the company's president, and Ross is CEO. Burger is chief medical officer.

"There is no way I would've ventured out on my own, being an emergency room doctor … without having the support of intelligent people with business sense," Burger says. "Our skill sets blended."

About two years ago, after Ross and Bonacuse found franchising success with a separate venture, an in-home medical assistance company called Senior Helpers, Burger began to see the potential in doing something similar with Doctors Express.

"The emergency room crisis and lack of primary-care physicians is not a problem isolated to New York City, where I used to work, or Maryland. … This is a national problem," Burger says. "We felt it was something we wanted to bring across this country, and (franchising) has proven to be the most effective way to grow a brand in a quick fashion."

The Towson center is a test site of sorts. Burger figured out the best equipment and strategies to expedite patient care — such as taking X-rays next to the exam room — that could be replicated throughout the country.

"In about 35 minutes, we can see the patients, take the X-ray, diagnose the problem, splint the broken bone," Burger says. "It's about efficiencies."

Seeking 80 locations in Texas

As lawmakers, consumers and the health care industry debate how best to deliver affordable care to all Americans, Burger sees the urgent-care industry as one that's growing and profitable.

"We've yet to find a market … where there are enough providers for the care that people need," he says, adding that the Towson center turned a profit in less than a year.

As at most urgent-care centers, Doctors Express patients without insurance will have to pay for services at the time they're given, Burger says. While prices will vary slightly from state to state, the average patient at the Towson center pays about $125.

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