American Family Care: It’s All about the Patient

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AFC-thumbDr. Bruce Irwin, Founder and Chief Executive Officer, and Randy Johansen, President

by Pete Fernbaugh

Randy Johansen has been employed with American Family Care (AFC) for 22 years and has served as president for the last 10 years. He was employed at a for-profit hospital when Dr. Bruce Irwin, founder and chief executive officer of AFC, hired him to spearhead a growth strategy for the company.

Throughout his more than 30-year career, Irwin has focused on accessible primary, urgent care, family practice, occupational medicine, and emergency care. His first comprehensive healthcare center, the Hoover clinic, was opened in Birmingham, Ala., in 1982. The Hoover clinic provided the template for American Family Care’s eventual national presence.

When Johansen joined AFC in June 1994, it had five clinics. Today, AFC has over 100.

“What impressed me about American Family Care was the mentality,” Johansen said. “It was one of patient satisfaction, taking care of the patient. We’ve never worried about making a profit. If we offer what people need and we do it better than anybody else, the profit takes care of itself. And that has been our mentality: patient satisfaction, high-quality care, treating them appropriately.”

Realizing AFC’s potential for growth

American Family Care has two divisions. First, there are its clinics. With 48 clinics already established, new locations for these clinics are being added rapidly in 2014 alone. So far this year, nine new clinics have been opened and an additional nine are expected to be added by the end of the year, bringing the total of AFC clinics to approximately 60.

The second division of AFC was recently formed: AFC/Doctors Express, a franchise of urgent-care centers. (Editor’s Note: HCE previously covered Doctors Express in 2011.)

With 72 locations spread across 22 states, AFC acquired Doctors Express in April 2013, rebranding it as AFC/Doctors Express. By year’s end, those 72 locations will have added 13 new clinics for a total of 85 locations. In 2015, AFC expects to add another 15 to 20 AFC/Doctors Express clinics.

AFC also recently entered into an affiliation agreement with Baptist Hospital in Montgomery, Ala. Baptist has turned over its five Montgomery-area PriMed Clinics to AFC for co-branding under the AFC PriMed label. AFC already has three clinics in the Montgomery area.

Johansen said this agreement reflects the latest step in AFC’s growth strategy: affiliating with hospitals in a specific area.

“We’ve never done that before,” he said. “And we’re seeing where hospitals have become more and more interested in trying to work out an affiliation arrangement with physicians or physician groups, such as ourselves, in trying to reach different areas of their market.”

AFC believes it can help hospitals meet the quality requirements of the bundled-payment system in a way that will ensure their continued presence in their marketplace, while preventing readmissions.

“As we expand our national footprint and broaden our reach, we provide Americans the solution of affordable, accessible, and high-quality care,” Irwin said. “This is critical because as our nation’s healthcare model continues to evolve, the number of insured patients without a primary-care physician will increase.”

The commonsense behind AFC’s growth

According to Johansen, the secret behind AFC’s impressive success is two commonsense strategies: have great people in place and prioritize patient satisfaction above all else.

“If you look at the management of American Family Care, I’ve been here for 22 years, our chief financial officer has been here for 14 years, most of the people in the operations side have been here for multiple years,” he said. “…[S]o we have a strong management team in place that knows what they’re doing and knows how to go about it.

“We also believe that we have the best model for urgent-care facilities. We’re primary-care driven. We’re not just walk-in. We want to take care of you in your follow-up visit as well as your initial visit.”

Each clinic has multiple surveys it offers to patients for feedback. These surveys are accompanied on the back-end by an incentive program for employees known as PS, for patient satisfaction.

Implemented three years ago, the PS Program has been “tremendous in terms of getting our people to focus on patient satisfaction and being motivated to take care of that patient and making sure that a patient complaint doesn’t get out of the clinic,” Johansen said. “If there’s someone who’s unhappy in the clinic, take care of it now so that it’s addressed before they walk out the door.”

There are three primary criteria AFC has in place for its employees: patient volume, patient satisfaction, and timely clinical service. When an employee satisfies these three criteria, they are rewarded with a quarterly bonus.

The 10/15 Rule requires AFC employees and physicians to check in on a patient at least every 10 to 15 minutes after they’ve been taken back to an examination room.

Furthermore, AFC pushes for its employees to acquire all demographic and insurance information correctly the first time. Johansen said a negative image is cultivated when the simplest information is entered inaccurately.

Complaints are also handled efficiently by a patient advocate. Everyone named in the complaint is required to respond in writing to the patient, explaining what occurred, why it occurred, and how it will be fixed in the future.

Two years ago, Johansen said AFC’s patient-complaint rate was 1.1 complaints per 1,000 patients seen. It now stands at .47 complaints per 1,000 patients.

As part of the PS Program, the Ambassador Program was formed, where employees and physicians ask patients who are happy with the service AFC has provided to recommend AFC to their friends and families. The premise of the Ambassador Program was established upon Irwin’s belief that the best source of new patients is referrals from current patients.

“When patients walk through our doors, they can rest assured they will receive the best accessible primary care, urgent care, family care, and occupational medicine,” he said. “It is our mission to provide the best healthcare possible, in a kind and caring environment, while respecting the rights of all patients, in an economical manner, at times and locations convenient to the patient.”

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