Could walk-in clinics ease the opioid crisis?
June 05, 2018
As a physician in psychiatry at a New York hospital, University of Chicago Booth School of Business student Dr. Tamir Aldad sees countless mental health patients in the emergency room each year, only to have to send many of them home with referrals to seek treatment on their own.
It is frustrating. The nation’s opioid epidemic and related mental health crisis have prompted millions of Americans annually to seek treatment in emergency rooms. They arrive with such mental illnesses as substance use disorder, depression, bipolar disorder, post-traumatic stress disorder, or potential risk of self-harm.
But most of these emergency room patients—7 out of 10 by some measures—go home untreated. They are unable to see an inpatient psychiatrist because their symptoms aren’t severe enough to be admitted to the hospital.
Instead, they “boomerang back to the ER in a couple of weeks with the same or worse problem than they came in for in the first place,” says Aldad.
Outside the hospital, the outlook isn’t much better. The wait to see a psychiatrist in an outpatient clinic or doctor’s office is four to eight weeks in New York, and longer in rural parts of the country where the shortage of psychiatrists is more acute.
To fill these potentially life-threatening gaps in U.S. healthcare, Aldad, 33, enrolled in Chicago Booth’s Executive MBA program intent on finding a way to address the problem. Aldad took part in the Booth’s Executive MBA entrepreneurship track and launched a startup called Mindful Urgent Care with fellow Booth students.
Mindful Urgent Care is a walk-in psychiatric clinic designed to provide same-day mental health and addiction treatment to both insured and cash-paying clients. Staffed by a team of mental health professionals, including psychiatrists, nurse practitioners, and physician assistants, Mindful Urgent Care aims to increase mental health access and speed quality and affordable treatment to a population of patients with unmet needs.
“The Executive MBA program introduced me to extraordinarily talented individuals who are leaders in their fields and who are passionate about collaborating.”
- Tamir Aldad
The first retail clinic, at 3,000-square-feet, is under construction in West Hempstead, NY, and is scheduled to open this summer. A second 2,000 square foot clinic is slated to open in midtown Manhattan later this year. Aldad’s business plan calls for opening 25 centers in New York, Connecticut and New Jersey in the next five years.
"The Executive MBA program introduced me to extraordinarily talented individuals who are leaders in their fields and who are passionate about collaborating,” says Aldad, who is a physician at John T. Mather Memorial Hospital in New York and a research fellow at Yale School of Medicine. “The sense of camaraderie in the program is strong and you're surrounded by experts who are humble, approachable, and eager to help.”
The Mindful Urgent Care pilot team comprises nine Booth Executive MBA students who specialize in healthcare franchise development, medicine, finance, marketing and operations.
The Mindful Urgent Care team placed first in Booth’s Global New Venture Challenge (GNVC) in April, a Shark Tank-style business competition for Booth’s Executive MBA students, designed to help students turn their ideas into viable companies. The team advanced to compete in Booth’s top-ranked New Venture Challenge on May 30 with startups from across the university, where they won second place. Between the two competitions, the startup raised $140,000 in funding. The NVC competition is the premier startup competition launch program run by the Polsky Center for Entrepreneurship and Innovation.
“The sense of camaraderie in the program is strong and you're surrounded by experts who are humble, approachable, and eager to help.”
- Tamir Aldad
Booth’s Executive MBA program connected Aldad to a strong alumni network that is “incredibly loyal and cohesive,” Aldad says. He hears from the extended Booth community regularly about partnership opportunities.
“The program itself is known for its quality, and introducing yourself as a graduate demonstrates that you are a serious individual and have the skills to bring a concept to market successfully, " said Aldad. “During class, I often posed strategic questions about Mindful that fueled a robust discussion between the professor and my peers. It felt like having an advisory board you can always turn to."
Aldad’s strategy is to meet patient need through a mix of psychiatrists and “physician extenders” such as nurse practitioners and physicians assistants with mental health and psychiatric specialties.
“Because we use physician extenders and not strictly psychiatrists, we are able to scale our model,” Aldad says. “By no means are we trying to compete for business and take away from traditional psychiatrists in their practices, but we want to get these patients the help they deserve. We want to start treatment with medication as soon as possible and provide symptom stabilization so patients can receive some relief.”
More people are seeking mental health treatment, but there aren’t enough psychiatrists to meet the demand.
For years, the U.S. health system has lacked enough primary care providers, such as family physicians and internists, as more Americans with a pent-up demand for treatment gained the ability to pay under the Affordable Care Act. Mental health needs in communities across the country are becoming just as critical, with no way of filling the void in sight. Behavioral health facilities, hospitals and addiction centers cannot find the psychiatrists they need.
“We face a broad range of mental health issues, including the acute problems of opioid addiction and increasing rates of depression and suicide,” Dr. Darrell Kirch, a psychiatrist and chief executive of the Association of American Medical Colleges said in a report earlier this year on the psychiatrist shortage. There are 28,000 psychiatrists in the U.S., but three in five are 55 years of age or older, AAMC data shows.
For now, Mindful Urgent Care has contracts with more than 30 health insurance companies on behalf of the New York psychiatrists who will be staffing and supervising the staff at the clinics.
Aldad is hopeful his business model will be attractive to health insurers on a broader scale as the healthcare industry moves away from the fee-for-service medicine that emphasizes volume of medical care delivered. Instead, insurers are starting to emphasize value-based care that encourages patients to get better treatment upfront in a doctor’s office. Such value-based models measure and reward providers based on how well they care for patients, treating them more holistically.
“In value-based care, patient outcomes really matter,” Aldad said. “What we are seeing now is that patients in mental health are costing more and more. If a patient winds up in a hospital because they couldn’t get in to their doctor’s office or have a medication refilled, the healthcare costs escalate. We have an opioid crisis, and we have to proactively work to find ways to prevent mental illness from getting worse.”
-- By Bruce Japsen
Content and Communications
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