LAMORINDA WEEKLY | When you need a doctor and you need one now

A medical industry trend has descended upon Lamorinda with the opening in August of a third urgent care facility over the past four years.

The urgent care industry developed out of the frustrations of medical patients who, with little time and patience for doctors and hospitals, demanded unscheduled appointments, an accessible location and lower costs, all with the presumption of superior service.

The business model appears to be delivering what customers expect, as according to the Urgent Care Association of America, at 90 percent of urgent care centers the wait time to see a provider is 30 minutes or less, and patients are in and out in one hour or less at 84 percent of all urgent care centers. There are more than 8,000 urgent care centers in the U.S., and some estimates project more than 12,000 centers within two years.

Urgent care facilities tend to be positioned in high-visibility, consumer-accessible locations, which may explain why two centers have opened in Orinda and one in Lafayette, but none in Moraga. "I'm not aware of any requests for these kinds of business uses in my five years here," said Ellen Clark, Moraga planning director.

The first Lamorinda urgent care center opened in Lafayette in 2013. "It's doing very well," said Rob O'Reilly, Moraga resident and one of the principals of Stat Med, an urgent care facility that specializes in staffing trained emergency room doctors. "Lafayette is not our model clinic, though, as it is in a medical building and not in a retail location."

O'Reilly said the ideal site for an urgent care center provides accessibility to 50,000 people within a seven minute drive, another reason why his home town may not be an ideal location for a clinic. His company has opened a second facility in Concord.

Often hospitals themselves will open an urgent care center to siphon off some of their own emergency room patients and to help reduce health care costs. The Sutter East Bay Medical Foundation opened an urgent care facility in Orinda in 2016 but temporarily closed it in May due to challenges with doctor staffing, according to company spokesman Clayton Warren. "Providing quality care to our patients is our highest priority and we won't compromise our promise to deliver the safest level of care until we have the necessary clinical staffing levels at this location," Warren said.

It did not take long for a competitor to step into the Orinda void. On Aug. 31, John Muir Health opened an urgent care center directly across the street from the closed Sutter Health location. The new Orinda center has seen more than 100 patients a week. "This exceeds our projections and the number of patients continues to grow," said Ben Drew of John Muir Health. "And there are no physician staffing issues despite the increased volume of patients."

Younger patients mentioned one of their specific reasons for using urgent care facilities. "All of my friends used them in Oregon," said 20-something Eden Gavce of Moraga. "That way parents don't have to know every time you go to the doctor."

For those who feel that even urgent care clinics are not convenient enough, a 2015 San Francisco-based startup may fill the bill. Plush, an online urgent care provider, will set up an online chat for $99 with a physician who can provide a diagnosis and prescribe medications. Company representative Amanda Windsor said that Plush is taking health care to rural areas and will provide a way for the uninsured to enjoy health care, though she said that millennials would be more likely to try the company business model.

Though none appear in Lamorinda, free-standing emergency rooms are also gaining momentum. According to Hospital and Health Networks, there are more than 500 of these stand-alone facilities in the country and industry experts project there could soon be as many as 2,000. Unlike urgent care centers, these facilities are open 24/7, they typically charge standard ER rates and provide more sophisticated diagnostic equipment than urgent care centers, such as X-ray machines, CT scanners and labs.

All companies mentioned in this article stress that, while urgent care facilities provide outpatient care for acute or chronic illnesses or injuries, if you encounter a true medical emergency, call 911 for transport to a hospital emergency room. Emergency ambulance transport is provided in Lamorinda by the Moraga-Orinda Fire District and the Contra Costa County Fire Protection District, which according to Patricia Frost, director of emergency medical services for Contra Costa Health Services, are not permitted to take patients to urgent care centers.

"We sometimes get calls from the urgent care center, and we will transport patients from the urgent care center to a hospital," said MOFD Interim Fire Chief Jerry Lee.