Dr. Gil's grows, adds insurance acceptance

Dr. Gil's ImMEDiate Care and Occupational Health Center, located at 3000 E. Division, has grown in all aspects since it opened in February 1997, said Todd Lutes, marketing director for the center.

The center is owned by Dr. Gil Mobley, who also owns a second location in Republic that opened in January 1999.

Lutes said when the Springfield center opened, only a few patients were seen each day, but that, and other things, have changed.

"Patient visits we see over 100 a day now. Employees, when we originally opened, I think we had five employees ... now, we have 35 at both centers," Lutes said.

Lutes added that the staff for both centers includes other physicians, physicians' assistants, nurse practitioners and clinic support staff.

Another big change at Dr. Gil's is that most major medical insurance is accepted now, but it wasn't when the center first opened.

Mobley said Dr. Gil's ImMEDiate Care and Occupational Health Centers accept "pretty much anything," as far as insurance plans go. The centers are providers for Cox Health Systems' Primrose Plan, but they are not providers for St. John's.

Lutes said that in the beginning, not accepting insurance was more of a convenience issue, because the Springfield center didn't have the staff to handle insurance billing, but he said that wasn't the only reason.

"One of the reasons we've gotten into insurance now, and we didn't when we opened is ... you learn to crawl before you learn to walk' type of philosophy. So, when we first opened, we wanted to get the place running smooth, get our system down pat, before we started getting into some of the more difficult areas, like insurance billing," Lutes said.

Mobley added that occupational medicine and providing services to the clinics' client companies are the main focus of Dr. Gil's ImMEDiate Care and Occupational Health Centers.

He said initially, he was reluctant to open the centers' services to insurance reimbursement and to the general public, because it was important to build the occupational medicine practice and follow through with what the center was designed to do.

"We can't have immediate care' plastered all over our building and around town and not deliver on that, so we've only expanded into separate and additional markets carefully, and when we can assess, expand, accommodate and continue to over deliver," Mobley said.

Under the occupational health aspect of the centers, Dr. Gil's contracts with area companies, and the centers essentially serve as the "company doctor" for those companies.

Lutes said the fact that insurance is now accepted at the centers has added some patients, but added that the increase is also tied to the occupational medicine availability.

The insurance acceptance has "added some, but surprisingly, the biggest patient volume ... has skyrocketed in the occupational side, though," Lutes said. "We're still only seeing probably 10 patients out of our whole day that are insurance patients. About 90 percent are still occupational medicine they are still work-related."

Mobley said his clinics are in the same market as other walk-in clinics and urgent care facilities, as far as advertising goes, but those other clinics don't have the same focus on occupational medicine.

"We find that most companies want the same things that the general public wants, which is that they don't want the long wait or the high emergency room prices. That seems to be a trend in what the general American public wants and is turning to, and that's the same thing with companies," Lutes said.

Mobley said one reason the centers are able to offer services at lower rates than emergency rooms is that Dr. Gil's still actively pursues the markets with the highest reimbursement, which is payment by cash, checks and credit cards.

"We don't allow patients to come in and say they'll pay later. It's pay at the time of service, unless they have an insurance plan or something like that," he said. Mobley noted that his centers also do not accept Medicare or Medicaid because of the low reimbursement rate.

In spite of the fact that Mobley is now willing to accept insurance, he said he's still "100 percent against" managed care, and he doesn't participate in it.

"We'll see managed care patients, but I still get reimbursed for every CBC, blood work, chest X-ray and amount of time I do ... I still consider it an insult to the integrity of a physician to get paid more for doing less," he said. "We don't do capitated patients and I hope I will never have to see capitated patients. (Capitation) means that somebody is looking over my back and questioning the money I spend on the patient, and comparing me to other physicians in my practice category."

He said he hopes he never has to be in the position of many of his colleagues, where bureaucrats tell him he'll be paid less for ordering too many tests or spending too much money for a patient.

"Our way of doing medicine (at Dr. Gil's) is still based on fee-for-service. Patients can get what they need without distractions; without worrying about how much the physician has to spend to get to the end diagnosis," Mobley said.

Mobley said as far as the future for his centers goes, there are plans in the works for possible growth at the Springfield location, and he added that 15 percent of that center's profits are reserved for expansion.

He also said he's looking at a couple of different locations on the outskirts of Springfield where new centers could be built, but added that he's not yet ready to discuss specifics.

Mobley said the center in Republic has recently gotten into the black, but he eventually plans to use 10 percent of the profits from that location to fund some sort of charity, possibly a medical clinic for the poor in Guatemala.