A New Urgent Care

Episode 45

Dr. Harris is joined by Dr. Tamara Beckford, an emergency medicine physician, and entrepreneur who sees a bright future for online medicine. Dr. Beckford has been taking care of “urgencies” in the ER that often could be addressed in the outpatient setting; however, our primary care physicians are overloaded and frequently overbooked. These urgencies go untreated and transform into emergencies that land people in the ER. Dr. Beckford asked herself if there was a better way, and if she could help. She harnessed the entrepreneurial spirit to create UR Caring Docs, a telemedicine platform to treat urgencies before becoming emergencies. Learn more about her approach and caring nature in this episode of the Strive for Great Health Podcast.

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Episode Transcript

Dr. Richard Harris: [00:00:00] Hello, and welcome to the Strive for Great Health Podcast. I’m your host, Dr. Richard Harris. And today we have another guest with us. Who’s also a fellow physician, and we’re gonna be talking about something that we both kind of dabble in and see a huge need for in the future. So I have with me, Dr. Tamara, Beckford, how are you today?

Dr. Tamara Beckford: [00:00:19] Doing well? Doing well. Thank you.

Dr. Richard Harris: [00:00:22] Oh, great. It’s great to have you on the show. Why don’t you give our listeners just a quick little background about you and, and kind of what kind of medicine you practice and where your interests lie.

Dr. Tamara Beckford: [00:00:32] Absolutely. So I am an emergency medicine physician, so I practice emergency medicine.

So I’m the doctor who you see when you go to the ER for any of your ailments, whether it be fully emergent or if it’s an emergency to you, but it’s not, not, not really as. That is United seem at the time. I take care of anything that walks in. I usually consider myself a physician who takes care of patients from the cradle all the way onward.

So, patients who might have, say, a heart attack, I can take care of that. Patients who have gunshot wounds, I can see. Stabilize that if you’re coming in and you’re unable to make it upstairs to the labor and delivery, then I might be the one delivering your baby also. So, I take care of anything that steps in; that is my training to see you take care of you, stabilize you, and then get you to the appropriate next phase.

Dr. Richard Harris: [00:01:30] Yeah. And it’s really interesting because, you know, ER, doctors, family, medicine, doctors, internal medicine doctors, we are that old school kind of trained in all diverse areas of medicine. And, you know, have a little bit of knowledge here, a little bit knowledge there, a little bit knowledge there and are able to take care of a whole range of patients.

Now it’s interesting because both of us have transitioned from our primary medicine activities. Into entrepreneurship. So why don’t you tell my listeners a little bit about your journey? We do a segment every Monday called wellness journeys. And so, I want to hear about your journey into entrepreneurship.

Dr. Tamara Beckford: [00:02:10] Absolutely. So my journey to entrepreneurship actually began at the beginning of this year. So we are currently in a pandemic season, within, where we are right now. So. I have seen throughout my many years in the emergency room, I’ve seen people who are coming in through the middle of the night for things that seem to be very inconvenient for them, but things that can be taken care of outside of the emergency room.

So I’ve asked a couple of the people, you know, why are you here? Tonight for something, say for a urinary tract infection that I thought that you know, this is something that’s very easy to treat. And, if you can get in contact with your doctor, you can, you know, be able to treat it based on symptoms. And I’d get answers like, well, One, I don’t have a family doctor, or I don’t have a primary care.

So I thought, okay, well, I understand why, too, I can’t get in contact with my doctor at this time. Or, for example, if it’s on the weekend, then, you know, usually they’re unable to get in contact with their family doctors. If they do want to, go to an urgent care, but they were unable to go because the timeframe.

Of the urgent care center that was open, they were working during that time. So then, you know, the last resort was to go to the emergency room. So I saw that as an opportunity to be able to take care of these patients. So as I kept thinking about it, I also saw how much that it would cost them to go to the emergency room for something that was really what we would call in medicine and medical urgency, and really not an emergency.

And I started to think that. If you were unable to get in contact with a doctor because you do not have a family doctor, then there is a possibility that sometimes your circumstances might be the one that’s putting you in that position. Maybe you are a single parent. You’re barely getting by. And, coming to the emergency room for something, that’s what we considered an urgency.

Your bill is still going to be high, irrespective of why you’re there. So I decided to do telemedicine urgent care for where I will help. These patients who have these non. Emergent issues that occur at inconvenient times help to take care of them at a cost that would be, a little bit, well, a lot more, for budget-friendly, then going to the emergency room.

So that’s the concept of my company, Ur Caring Docs.

Dr. Richard Harris: [00:04:51] Yeah, we see this all the time. You know, as internal medicine, I’ve worked a lot of admitting shifts where I’m the one after you stabilize them, you sent it to me.

So then I take over the care after that. And a lot of, a lot of times. You know, I stay on good relationships with the ER docs because we are working intricately together more so than a lot of the other physicians in the hospital; you know, we’re directly handing off patients to each other.

So I’ll stay in the ER, and I’ll see people coming in, you know, three o’clock in the morning with toe pain. And you’re like, wait, why are you coming to the ER, three o’clock in the morning for toe pain or shoulder pain that they’ve had for, you know, months or, you know, low-level abdominal pain that they’ve had for weeks.

And so some of these things that people are coming to the ER for. We know they’d be better served as, as an outpatient, cause you can take care of those things. You can, you can triage, and then you can get them the appropriate level of services that they need. And so this transitions and we talked about this a little bit, but in your view, how can telemedicine improve the care for these, these urgent patients?

You know, not the emergent patients, but these urgent patients that we’re seeing so much of in our ER.

Dr. Tamara Beckford: [00:06:08] Well, as you mentioned, these patients who I ended up having to hand over to you to admit at that point that they need admission, then their medical urgencies has gotten out of hand. So the way that we can help these people is if we can take care of these medical urgencies while they’re still at the minor phase, then we can prevent its progression.

To the phase where you now need it to be admitted because we quote-unquote have no choice because your medical issues have progressed to the point where, for example, if we go back to our patients, with a urinary tract infection, if we can have that handled within. You know, one visits, telemedicine, your antibiotic course, three to five days.

You’re done, right? If you’re ignoring those symptoms for whatever reasons, whether it be financial, whether it be for time and it progresses. Now you’ve progressed to a pyelo, which is your infection is now moved up towards from the bladder to the kidney. And if you become more and more symptomatic, you start having your fever is your chills, your vomiting.

If you’re vomiting, then there is at this point, we can’t handle your care at home because you’re going to vomit your medication. So how else are we going to be able to get that antibiotics in you now you’ve progressed to the point where you need to be admitted, and that’s where I will hand it over to Dr. Harris. Right? So if you need to be admitted at that point, You are so sick of that, you can progress to what we call sepsis, which is an overwhelming infection in the body. Now, this is a progression to an extreme, which started out as something very minor. So if we are able within the community to handle some of these minor urgencies that we can help it from progressing to the point where you’re having to deal with what we call the morbidity and the mortality, right. Where it just progressed into death when it was something that we could have done earlier, or it has now caused in a deficiency or a change in your lifestyle.

You were so sick. And you were in the hospital for sepsis. You become weak. When you come out, you can’t just go back to work. You might need to be rehabilitated. And so that’s, you know, will cause a lot of, flow to your daily  ADL’s right, your advanced daily living. You can’t really do certain things for yourself as quickly.

So you can see how something really, really small can progress to something large. And that’s our aim with helping our community. By, you know, being available to handle these medical urgencies at the beginning.

Dr. Richard Harris: [00:08:45] Yeah. That’s so important because, like you said, we see this all the time or a simple urinary tract infection.  People aren’t able to go to their primary care. So there’s a lot of primary cares are just overloaded. You know, when I was a primary care physician, I will be booked like a week in advance, with 20 25 people. And if you’re squeezing in more people than you really have a long day, and then you have to do your own refills, your own callbacks, all of that primary care doctors are under a lot of stress.

Dr. Tamara Beckford: [00:09:16] A ton of stress right now.  And then even when we do discharge our patients, we always say, get in contact with your PA with your family doctor and the, you know, if you’re talking about a family doctor who’s one week booked out and then you’re having 25 patients a day, you can imagine how challenging it is, you know?

So we are here to try to, like we said, to augment the care to the communities so we can help you to stay healthy.

Dr. Richard Harris: [00:09:44] It’s so important. Eh, you know, the number one reason, cause I ask people questions. Right? Cause I’m a curious guy, and that’s part of the entrepreneurial spirit is you’re always asking questions to the consumers, and you know, that’s my, my business, my MBA side, right.

The consumers are the patients, but I’m asking, I’ll ask them, well, why weren’t you able to go to your primary care? And they’re like, well, they’re booked up or, you know, I wasn’t, I didn’t think it was a big deal. I thought it would go away, you know, ignoring the symptoms. I didn’t; I didn’t want to bother them.

You know, I didn’t want it. I didn’t know who to talk to. You know all of these things are, are things that we frequently hear from patients. And I know that these if there is an easy telehealth solution that makes a big difference, and telemedicine is something that’s exploding. You know, my health and wellness business, a lot of my listeners are probably like, wait a minute, you’re talking about conventional medicine here.

We’re so used to you talking about your health and wellness stuff. You know, I’m naturopathic and allopathic. I’ve always said on this podcast, there was a role for both, you know, for chronic disease. I love the naturopathic approach for prevention. I love the naturopathic approach. If I’m in a car accident, I’m not going to an acupuncturist.

You know, I’m going to the ER, first making sure there’s nothing. Life-threatening. And then, if I have some chronic issues after that, I’ll go to the app. I’m curious. Right? So telemedicine is something that’s evolving and especially something that we millennials and, and, love because of the convenience that we’re able to get a provider.

That we’re able to do it on our schedule, and we can work it in and prevent some of these complications from happening. Now, most people think of telemedicine in the scope of primary care or or family medicine. You know, this is something, a concept that I really hadn’t heard about was tele urgent care.

It’s very new and very innovative. So what led you to the steps is to come up with this this idea, did you have like an aha moment? Where it just came to you or that it’s slowly come to you. How did this come to fruition?

Dr. Tamara Beckford: [00:11:56] Well, it was a slow progression, so. It’s, I am similar to you where I’m curious, and I’ll ask my patients, you know, the same questions that we’ve mentioned, you know, well, what made you come in?

And, and these questions, when we ask our patients, this, we do want to preface by saying we’re not being judgmental. We really want to know, you know, so we’re not judging you. So it’s not a, why did you come in as a judgemental, but it’s a, how can we help you to not be so inconvenienced to not have to get out of your bed and bring your three kids in, in the middle of the night?

And then they’re lying. In the chair or, you know, all four, you guys are trying to bundle onto the small ER gurney. You know, these are things that we wanted to just that I wanted to find out. And, as I kept asking more and more questions than I, you know, the answers were similar, it’s an inconvenience and, and the portion of the inconvenience coming up over and over and over, you know, I needed to do this because, you know, I work.

I can’t get in contact with the person that I want to. And, then I started to notice there are certain care that we, although we are physicians and we lay our hands on our patients for a lot of things, we’re trained that 80% of the diagnosis is really through the history. So if it’s really your kin, Capture some of this information and then just provide info to the patients ahead of time, saying, Hey, these are things that are appropriate for telemedicine.

And these are the things that are not appropriate. Then you can capture those patients and be able to provide the care that they need. So as it’s, as I kept thinking, and I. Kept going along more and more than I realized that, yes. You know this is something that’s out there. Now, the part that did help me to completely decide, I guess, maybe this is the aha moment was the pandemic.

When patients were afraid to go to the emergency room, as I stated, you know, I’m an ER doc. So I know if there are patients who are coming in on a regular basis for these issues and they’re not coming in any longer, then there’s a great possibility that they’re ignoring these issues. And that’s something that we know that can progress to worsening things.

So that’s me. That’s what made me say, you know what, let me do this. Open up this telemedicine urgent care to to get these patients seen.

Dr. Richard Harris: [00:14:29] Yeah, it’s really interesting because of my entrepreneurship professor in my MBA class talked about really an entrepreneur is someone who sees something and thinks that I can help, or I can improve upon this to help more people.

That’s really the true spirit of entrepreneurship is that you think that you can do something to help solve a problem. And so I did that with the health and wellness and our, our educational consulting company. You’re doing that with, with telemedicine and, and the ER problem. And, you know, it’s funny because we’ve been saying this for a long time to people that listen.

The ER, in the hospital’s not the place you want to be unless you absolutely have to be there because you can pick up some really nasty, bad infections from being in the hospital. And people just kind of were like, whatever, they didn’t really listen to it. And then COVID hits new like, Oh man, I guess.

Right. Absolutely said I’m not going in unless I have to. Okay. No problems, though. Right,

and that would be interesting. I wonder if, And this is just off the off-topic, but I wonder during this time and period, if you looked at the data, we see a big decrease in those hospital-acquired infections because of the people who were, you know, risks for those types of things.

We’re, we’re staying away from the hospital when they didn’t need to be as a sideline. If we have any researchers out there, if you were looking for a research project, let me know. But, in the whole, tell it, this is sort of related to telehealth. You know, I’ve heard of these starting to pop up now where we have ER, doctors like yourself going mobile, and it’s again, to get to the patients in a way that is convenient and easy for them.

So what’s your opinion on these, these mobile, ER, is that you, do you think this is something that’s going to last something that’s going to stick. Do you think that people will actually utilize these services?

Dr. Tamara Beckford: [00:16:27] Yes, I do think they’ll utilize the services now. Will it last, and will it stick? It all depends.

It is business. That’s a portion, and whenever someone opens up a business, as you said, you know, you have the MBA, we all know that there’s a statistically. There’s, there’s going to be a great portion that probably will not continue now. Also very important point that you made prior was what’s your business professor said, like the point; the reason for doing the business is one of the things that will keep you sticking to it other than finances if you’re able to.

So, will the majority, if everyone who is opening up, but this is opening up for the right reason, and it’s not just a quick, rich scheme. Then I think that they’ll last the test of time. If they can ride through the rough portion of entrepreneurship if it’s a rounded in the. A good foundation and beliefs then yes, I do think it can last, will all of it lasts?

Absolutely not. So, there’s going to be a good portion that will not be here, for various reasons. But I don’t plan on being one of those. I plan on lasting because I know my goal. And my goal started out as you, as I’ve said in really with helping and providing care, providing care for those who I feel that they are a little bit marginalized in the society.

And, I believe that everyone should have care. And that’s one of the things in the emergency room that we’re actually trained to take care of anyone who steps in. Irrespective of your reason for coming in, you know, for coming in, because you’re just tired and you just, you know, you’re feeling stressed, and you would like to be seen by someone from the psychiatric service.

You know, we’ll try to provide that for you. I mean, it doesn’t matter. That’s how we’re trained. So with that mentality of trying to just really help those who and, and the, the reason too, this might be a quick aside is that we know that a lot of people, as we’ve mentioned, or using the emergency room who are of lower-income because they just.

I don’t have any money. So if you don’t have the money to go to a larger, like care, then you’ll just show up to the ER; the unfortunate portion of that is that you have to deal with the repercussions of the bill that comes in afterward. You know, so even though immediately, you’re not, it’s not in your forefront, it’ll still affect you.

So those people, I want to bring awareness to them. I want to bring awareness to the small business owners, which is a lot of the people that I’m really going to try to target. You’re a small business owner. So your profit margin, it might not be very large. I don’t believe. That if you finally made a profit this month, one ER visit should wipe out that profit.

You know, so these are the people that I really want to help. So I do plan on staying because I want to help them.

Dr. Richard Harris: [00:19:33] Yeah. You know, I think this is it’s interesting because medicine is really a dinosaur when it comes to adopting new technology. And you know, like our EHR is, I think are still like dos prompt based.

Right, right. Like there’s so much technology and innovation out there that the rest of the world is applying. And medicine is stuck literally in the dinosaur ages compared to where a lot of the the world is. So you’re seeing a lot of businesses and technologies and companies trying to meet people where they are.

And so I think services like the mobile ERs. Who are being staffed by doctors and physician assistants, and nurses. I think that’s something that could be a vehicle, no pun intended, for a lot more people to get care, because again, you can meet people where they are. And so I think the more services that we have that do that, I think the better medicine, in general, is going to be for all parties involved. So, you know, we’ve kind of touched on this a little bit, and I just want to hear your thoughts more on this issue, because you know, we are talking about telemedicine here today. I do telemedicine; you do tell telemedicine medicine. This is sort of an esoteric kind of question, but what does the future of online medicine look like in your opinion?

Dr. Tamara Beckford: [00:21:02] I think the future is bright reason being we’re going to, we know that there are two sectors of society. We have those who will adapt them and to the technologies. And we’ll still have those who are hesitant to adopt now. The ones who will adapt to the technology. You know, I think that they’ll continue to use it.

Now, those who are hesitant, we just need to continue to educate them when, and that’s what I tell people. I’m not really here to say, Oh, you’re doing it wrong because you’re doing it a traditional way. No, I’m here to provide options. And that’s what you need to know. So you might not want to use these services today because you don’t feel like it applies to you, but in three, four months, you know, during the holiday season, you might realize like, wow, you know, I do remember hearing about this.

Something has now come up. I don’t want to leave my house, you know, so yes, I can now use these services. So. For those who are hesitant, it’s really is just educating, letting you know that there are options available. So I do see that we’re going to be able to convert some of those who are hesitant and the younger people, as we mentioned, the millennials, you know, they’re all for it.

They’re just like, I don’t have to leave my house. And then we have to remember our millennials at this point in time are now parents, you know, so gathering up the kids and packing them in the car and having to do this and that. And. You know, filling up a diaper bag, bringing change of clothes, then bringing in your formula, just in case I’m sitting in the waiting room for a longer period of time than I expected when they start to think about that, then it’s just like, you know, I do have this convenience care that I can just jump online. So I do see we being able to take more care of these people. Now, some of our older patient populations, some might adapt to it in some might not. There are some older people who are savvy, and they’re. Yeah. You know, they love adapting to new technology, and then you have some who might not feel so inclined, and that’s okay.

And that’s what I always tell people. It’s not; we’re not here to say that you’re wrong or you’re right for using telemedicine. We just want you to know it exists and that it’s an option. That’s there for you. Yeah,

Dr. Richard Harris: [00:23:28] That’s so true. I think that. The future of medicine is most likely going to be half online, half on person, because for numerous reasons, one it’s going to cut costs tremendously.

Right? That’s a huge problem in medicine right now. Most people don’t realize that about 70% of a hospital’s costs are salaries. 50% of outpatient clinics cost our salary. So it’s just having people there to do so many different jobs. You know, so you can have a people working from home doing the same jobs.

Part-time, you know, that could definitely help with quality of life. And a lot of us are burnt out. A lot of physicians are looking to decrease their hours, right. So we, we would gladly take a cut in hours. A lot of us. And that’s one someone would, but I know a lot that would; the second thing is the integration of these technologies online allows for multiple providers to help one person at the same time.

You know, you can have a complete literal care team that takes care of you. That’s all looking at the same information that can be shared in real-time. And, you know, you can see your primary care doc who sends a message to your psychiatrist, who talks to your nutritionist, who sends a message to your acupuncturist.

And they can all be linked into the literal same system. And so they’re going to see a lot of these things happening virtually, and then even the blood work. Now there are so, so many different services that will come to you to draw your blood. You know, so that whole convenience is proliferating in medicine.

And I think that that’s the way that the things are going to go. Is that

Dr. Tamara Beckford: [00:25:20] Right? You were talking about the integrative care, which is exactly what you’re saying. There’s going to be a huge shift back to integrative care where the left and the right hand actually knows what’s going on. You know, so. I totally agree.

Dr. Richard Harris: [00:25:37] And I know there are companies out there working on it because a lot of people don’t know that our EHR systems, our electronic health record systems, were literally designed not to talk to each other. Right. It wasn’t until recently that they pass laws saying, you guys need to fix this, but they gave them a pretty long leeway of when they have to fix it by.

So there’s still a lot of, lack of integration between these health record systems. So people are thinking that there’s just like one master record and you’re like, well, I went to Methodist. You know, I’m at Memorial Hermann now; why don’t you have my records? I’m like, well, it’s two completely different systems.

Dr. Tamara Beckford: [00:26:13] Absolutely.

Dr. Richard Harris: [00:26:14] But eventually, that’s going to be integrated into one cloud source where the provider can log in and see everything there. And, and then your online provider, as well as your in-person provider. And I think you’re a lot of people are going to have both. I think people are going to have someone that they see completely online, like me, and they’re going to have a conventional provider that they see for, you know, maybe some urgency cut things or some other things that we can’t do online, but I think people will have both in, in the future.

And I know that’s what my clients do. I say, look, I’m not replacing your primary care doc. I’m just augmenting what your primary care doc is doing. And so that’s the future that I see in medicine.

Dr. Tamara Beckford: [00:26:59] Absolutely. That’s a that’s a great portion. As we mentioned, you know, the integrative care, being able to have all different assets of medicine, especially integrating the traditional and what we call the nontraditional, which was there sometimes before the traditional medicine of care, like, you know, like you said, the acupuncturist, nutritionists, and, you know, that’s.

The left and the right hand, as I mentioned, In medicine, it’s often been frustrating from patient’s standpoint. You know, you’ve had to go through for one week. We say you know, follow up with your blank person, and you’re unable to get an appointment for three weeks from now. You’re unable to get an appointment with the nutritionist.

For example, you’re treating someone who’s diabetic, you know, you can see how complicated it can be. And the longer that it takes, it takes a strong mindset to not get frustrated by all the different roadblocks that it appears that there’s occurring through medicine. Even if we as physicians, when we as physicians, our patients, we still have some of these roadblocks, and it brings us and makes us so much more aware being a patient that, wow, this is what my patient’s going through.

No wonder A, B, or C has happened to them. So when we’re able to use the technology provided to be able to have a least a little seamless flow of information from the different facets it within healthcare. Then it, the only person that is that will win will be the patients. Not only the patient, I should say we’ll all win, but it will be a great assets for our patients.

You know, they’ll, we can get them healthier and, and they’ll have access and, you know, we’ll know. And we’ll be able to see their progression. We’ll be able to, to, to continue to motivate them. I say, look, we’ve seen how you’ve progressed. It’s all very positive at this point.

Dr. Richard Harris: [00:28:56] Absolutely. And you know, I was thought about something, as well, and to kind of clarify what I said earlier, you know, I think that the advent of online medicine will allow physicians and practitioners to be their own practitioners.

Again. All right, because now what most people don’t realize is the physician on groups are almost completely all gone. You know, they’re, they’re disappearing more and more every single day. And now you’re working for large organizations. And that’s where that those statistics I came in on the salary numbers go, but the advent of online medicine will allow physicians to be their own practitioner when they want to be practitioners, they’ll allow MPS and PAs and even pharmacists, you know, all of these other people to do the same.

And so it gets everyone back in that little bit of entrepreneurial spirit that used to be there in medicine where you are your own boss. You can do things your way under your guys with your expertise. And so that’s what I think is really powerful. And it allows us as providers to take back some of our power and our autonomy.

Dr. Tamara Beckford: [00:30:08] Absolutely. Absolutely. To provide the care that you would want to provide. How do you not been in a restraint environment?

Dr. Richard Harris: [00:30:20] Yep. Absolutely. So this has been a very interesting discussion for sure. I think telemedicine telehealth is the way we’re going. There’s no going back now. It was going to happen before COVID just accelerated everything.

And if people want to learn more about your services, how can they get ahold of you? How can they learn more about your business?

Dr. Tamara Beckford: [00:30:44] So they can go on www dot ur caring docs. That’s U R C a R I N G D O C s.com. I’m also on Facebook slash you’re caring docs on Twitter slashed or at your caring docs along with Instagram.

So it’s U R C A R I N G D O C S. UR Caring Docs.

Dr. Richard Harris: [00:31:07] Awesome. Well, thank you so much for coming on, sharing your story. We talked about medicine. We talked about entrepreneurship. We talked about life, and that is a strive for great health podcasts. We are literally all over the place, and just like my life, my podcast reflects my life.

But again, dr. Bedford, thank you so much for coming on the show, and thank you for all that you do for your, for your patients. For putting yourself at risk, taking care of people for these last nine months, 10 months. I don’t even know how long it’s been since lost track.

And again, thank you so much for, for all that you do. And for being a true hero and really trying to make the lives of people better.

Dr. Tamara Beckford: [00:31:49] My pleasure. Thanks for having me.

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