Righttime Medical Care
Quality Care When It’s Needed Most
By Martie Callaghan

Pediatricians and primary care physicians offer some very creative and accommodating schedules, but even the most dedicated practitioners cannot be available to their patients at all hours of the day and night. While convenience is important in times of medical crisis, quality and continuity of care are major factors to consider when choosing an urgent care or after-hours solution.

“We are not in competition with the patient’s physician,” says Robert G. Graw, Jr., M.D., CEO, Chief Pediatrician and founder of Righttime. “We strongly believe in the importance of a ‘medical home’ for every patient, so our services are reserved for times when the patient’s own doctor is unavailable. We always encourage prompt follow up with the primary doctor after every visit to Righttime.”

Righttime Medical Care (formerly Nighttime Medical Care and Pediatrics) was established to appropriately serve patients when their primary doctors are unavailable and has evolved to include daytime appointments as well. As Righttime Medical Care’s patient base grew, so did the scope of their services and physicians. What began as strictly a pediatric service now provides care for patients of all ages and includes a staff of internal medicine doctors, family practitioners, ER doctors and urgent care doctors, as well as pediatricians.

The need for an after-hours solution became apparent to Dr. Graw in the late 1980s. Many mothers had returned to the workforce and were unable to get their children to the pediatrician’s office during regular business hours. Dr. Graw, along with eight other Annapolis-based pediatricians, opened the first Nighttime Pediatrics office in 1989 and a second location five years later in Pasadena. Before long, parents began asking if they, too, could be seen by the Righttime physicians. In 1998, the team re-examined their practice model and added adult medical services under the new name “Nighttime Pediatrics and adult care too!” In order to better reflect the concept of care for the whole family, Nighttime changed its name again in 2009 to “Righttime Medical Care.”

THE RIGHTTIME EXPERIENCE

Unlike hospital emergency rooms, Righttime Care Centers make appointments so that patients can do their waiting at home. About 85% of patients call for an appointment and most of them ask for a very specific time; “walk ins” patients are also welcome. Most patients are in and out of the center in less than 60 minutes. All calls are handled by Righttime Medical Care's Technical Operators and Call Center located in Crofton, MD, which directs callers to the Righttime Care Centers located closest to their home. In some cases, callers may be offered an appointment at an alternate location that is a little farther away but is experiencing a shorter wait time at that particular hour. The Technical Operators Center also monitors Care Center operations remotely for risk management and clinical support purposes.

“The high level of technology in our operations center enables us to manage patient flow and track everything that happens,” Dr. Graw says. “We have 17 people answering the telephone. Each one is trained to apply a very specialized triage protocol to sort out patients that may be too sick to be seen here or patients whose needs are more elective and can best be served by their primary physician. It’s all based on doing the right thing for the patient. Our motto is, ‘The Right Care at the Right Time.’”

Staffers of hospital emergency rooms are actually happy that so many patients find it easier to access Righttime Care Centers. “They don’t want to see the 50% of people that really don’t need the specialty care they provide,” Dr. Graw says. Only 2% of people who call Righttime Care Centers are directed to call 911 or go to an emergency room. Less than 1% of patients seen at the care centers are taken to an emergency room or referred to a specialty hospital, clinic or local community specialist after being seen at Righttime Care Centers. The primary doctor is kept very much in the loop and receives documentation of all treatments, referrals and recommendations.

Righttime Medical Care's on-site laboratory is comparable to that found in any doctor’s office. Its capabilities include blood counts, urinalysis, urine cultures, strep and wound cultures and blood draws to test for less common conditions.

Radiologic imaging using Mini C-Arm x-ray technology is available for evaluation of extremity injuries by Righttime physicians, without the need for comprehensive x-ray facilities and hard-to-find x-ray technicians. “The majority of our patients have extremity injuries, “ says Dr. Graw. “We are proud to offer our patients the advantage of this cutting-edge application of radiation technology because it promotes greater safety with less x-ray exposure (about 1/100th of that generated by a traditional x-ray). No significant fracture will be missed.” The C-Arm produces a digital image when enhanced by the computer. A printout is generated, which is taken by the patient to a specialist or saved as part of the personal health record.

A CONTINUITY OF CARE RELATIONSHIP

Righttime Medical Care’s philosophy of medical care sets their practice model apart from that of retail medical clinics or other urgent care facilities. The physicians on the staff of Righttime Medical Care strongly believe that any medical care given outside a patient’s “medical home” should be delivered by or under the supervision of board-certified physicians who are committed to promoting the patient’s relationship with his or her primary care provider. Righttime never schedules well visits and does not see patients in follow-up. Instead, they call patients after the visit and encourage them to follow up with their primary care doctor. If the patient has no medical home, Righttime Medical Care will provide a list of physicians in the local area.

AN EVOLVING NICHE

Righttime Medical Care’s niche in the community is growing in every sense of the word. Its patient population has expanded to include senior citizens, many of whom live in assisted –living facilities. “In the case of an assisted-living resident who is in pain after a fall, we offer an alternative to making that patient wait for hours in an emergency room,” Dr. Graw says. “It’s really no different than a mother coming home from work and taking her child - and now her parent- to us for care. We are pleased to have expanded our level of service to the community in this direction.”

Righttime Medical Care's community service includes support of sports and other events to benefit local programs and charities. It is not uncommon to see one of Righttime Medical Care's dozen Volkswagen “Beetles”or the Mobile Care Center on the road throughout the community. The vehicles are easily recognized by their navy blue color and Righttime Medical Care signature stars and moon logo. Employees of Righttime Medical Care enjoy handing out water bottles and medical information from the vehicles. At a three-day soccer festival earlier this year, Righttime was on hand to offer medical care to players. One of Righttime Medical Care VW Beetles was recently used as a pace car in a 5K race in Montgomery County.

The company’s 44-foot Mobile Care Center sports the same Righttime Medical Care logo and paint job as the VW fleet and is also a frequent visitor to community events and health fairs. Staff members work out of the bus to provide health information and administer flu vaccines, blood pressure checks and other services to the public. The “tech-ed out” bus is also used to bring staff training to all of Righttime Medical Care's offices and is equipped with communication capabilities, which keep it in constant contact with all of the Righttime Care Centers and the Technical Operations Center. In the event of a public health disaster, Righttime’s bus can be used to house and transport doctors and supplies.