Bolivar clinic works to increase patient access

“We have a goal that no one waits longer than 10 minutes after checking in before seeing one of our providers,” said Liz Redman, Butterfield Park Medical Center manager. “We have not met that goal. Most patients have about a 15-minute wait. We do guarantee, though, that you will see a provider today when you call today.”

The same-day appointment policy began Sept. 1, 2005, at the direction of Dr. Donald L. Maples Jr. shortly after he joined the medical center.

“Before coming to Butterfield I offered same-day appointments in Kirksville, Missouri, during the 15 years I practiced there,” said Maples, who holds a doctor of osteopathy degree. “I think patients at Butterfield are pretty excited about the same-day policy, even though they were a little surprised at first.”

On Jan. 7, Butterfield took patient convenience even further, offering walk-in service 8 a.m.-noon Saturdays for everyone. Children who need immediate care are seen as walk-in patients Monday through Friday.

Most of Butterfield's patients are now the result of same-day appointments, and the clinic is adjusting its internal procedures to accommodate the growth.

“We're in the process of going to a totally computerized chart system,” said Redman, who has been in health care for 23 years and with Butterfield since it was established in 1991. “We will have patient information available at a glance on the computer screen, and everything will be processed by the time a patient checks in. It's just a natural flow right on back to the nurse's station, so that the nurse can room the patient and the provider will be in there to see them.”

Same-day appointments are shared among Maples, Monte Kahler, M.D., and Malissa Phillips, a registered nurse. Phillips has been with the clinic since 2003.

Butterfield Park Medical Center was established when Kahler sold his private clinic to Citizens Memorial Healthcare, the only hospital in Bolivar. The clinic is located on the hospital campus. Kahler has practiced in Bolivar for 34 years.

The hospital also owns Butterfield Park Pediatrics clinic, which has same-day appointments for urgent needs when called before 4 p.m. Butterfield Park Pediatrics does not see walk-in patients.

Butterfield Park Medical Center patients are seen for the full spectrum of illnesses associated with a family practice, as well as osteopathic manipulation.

Although emergency accident patients are less frequent at the clinic than those with everyday illnesses, the clinic does handle emergencies.

“This is a rural and farming community, so in the wintertime we'll get a few chainsaw accidents,” said Redman. “In the spring, when farmers are working their cattle, we do have persons come in who have been worked over by a cow or a bull.”

Lower costs are one reason why an emergency patient might seek care at the clinic rather than the emergency room.

The fee to see a physician at Butterfield is $95, plus lab work and X-rays. Citizens Memorial Healthcare would not disclose a specific fee for emergency room use, but officials confirmed it could be several hundred dollars and could vary considerably, depending on the complexity of each situation.

“The public is very busy. We're trying to give them the availability to come to a physician's clinic to try to keep their health care costs at a minimum and to not have long waits in an emergency room,” Redman said.

Same-day appointments are not new to Bolivar's largest medical clinic, Bolivar Family Care Center. “We've had same-day appointments for most of our more than 20 years,” said Bill Marr, clinic administrator. “We have 10 physicians and three physician assistants. Two of the physicians and one physician assistant are available each day for same-day appointments, and one of the physicians stays after regular hours if necessary. Once the day's schedule is filled, we begin screening calls to determine whether it is urgent to see a patient that day.”

He said the clinic sees few walk-in patients. Bolivar Family Care Center also is located on the campus of Citizens Memorial Healthcare, but it is not owned by the hospital.

Bolivar's other medical clinic, Associates in Medicine, established in 1999, offers same-day appointments by its one physician and two nurse practitioners, and does not see walk-in patients, according to clinic manager Alisha Sharp.

Elsewhere in the Ozarks, Family Medical Walk-in Clinics are the only independent urgent care centers in Greene County.

The first clinic was established in Nixa in 1997.

“We see primarily patients with episodic minor illnesses and injuries, such as sore throats and sprained ankles,” said Tammy Mallow-Elly, administrator of the clinics.

“Our primary objective is to keep people from unnecessarily going to an emergency room. If patients are in serious condition, we stabilize them and then transport them to a hospital. Our fees are based on the complexity of the illness or accident,” she added.

Besides Nixa, there are two Family Medical Walk-in Clinics in Springfield and one in Republic.

The Nixa and Republic locations are designated as rural health clinics by the U.S. Department of Health and Human Services.

“We take some appointments at our Nixa and Republic clinics from persons with Medicaid and Medicare who are looking for primary care,” Mallow-Elly said.

Local health systems also offer quick service for patients who need it.

Springfield's CoxHealth has urgent care facilities for walk-in patients at Cox Walnut Lawn and Cox North. “The facilities free up our emergency rooms for more serious cases and trauma, which are what emergency rooms are designed for,” said Donna Barton, media relations coordinator.

Some of the physicians' offices affiliated with Springfield's St. John's Health System offer same-day appointments, according to Cora Scott, director of media relations. “Our urgent care facilities are for non-emergency problems such as sore throats, ear infections, minor burns, or cuts and bruises,” she said.

St. John's has three urgent care locations for walk-in patients in Springfield, two in Branson, and one each in Nixa, Monett, Lebanon, and Rolla.