FOR LIFE'S MINOR EMERGENCIES, HOSPITALS OFFER CONVENIENCE

Johnny has an earache; Amy sprained her ankle. Such minor emergencies are dealt with daily in the emergency rooms of Cape Girardeau's two hospitals.

Both St. Francis Medical Center and Southeast Missouri Hospital have programs in place that provide low-cost and relatively quick treatment for minor medical problems.

St. Francis has Convenient Care while Southeast provides Minor Care. St. Francis launched Convenient Care in August 1991; Southeast began Minor Care in March 1992.

Both programs have proved popular with patients, officials at both hospitals say. In part, that's due to the low cost -- $35 at St. Francis and $39 at Southeast.

Those are the base fees. There are added charges for any additional services such as medicines dispensed or X-rays taken.

Linda Brown, St. Francis' emergency services director, said the Convenient Care fee likely will be increased within a year. But she said it will still remain a small price to pay for medical care.

Not having to wait for hours to receive medical treatment is another key factor in the programs' popularity.

In May the average time a patient spent in Minor Care at Southeast was 1.2 hours. At St. Francis, patients whose medical problems qualify for Convenient Care are guaranteed they will be treated within an hour from the time of computer registration or the $35 fee will be waived.

In terms of actual time, however, a patient may still be at St. Francis for over an hour, if there are a number of people waiting to see the triage nurse.

At both hospitals, triage nurses make the initial determination as to whether the patient's medical problems can be dealt with in Convenient Care or Minor Care.

Dr. Jim Fletcher, a part-time Minor Care physician, thinks the short turn-around time is the biggest attraction of such programs. "The waiting time to be seen in Minor Care is much shorter. The main emergency room tends to get backed up (treating patients) with major injuries," he said.

As to the cost, he said, "The majority of patients don't pay directly for their health care so economic conditions are not always uppermost in their mind."

Programs like Minor Care and Convenient Care are "a benefit to the community," said Fletcher. "We are copying a tradition that is well established in urban areas."

Convenient Care treated 4,760 patients in 1993, while Minor Care handled an estimated 6,000. The programs serve patients regardless of whether they have health insurance.

Officials at both hospitals say the number of people served by their two programs is growing.

Deanna Bennett, assistant nurse manager of Southeast's emergency room, said: "I think we are going to see 30,000 (patients in the emergency room) this year. About 25 percent of those patients will be Minor Care patients."

At St. Francis, Convenient Care handles about 20 percent of the more than 23,000 people treated annually in the hospital's emergency room, Brown said.

About 50 percent of the approximately 500 Minor Care patients seen monthly at Southeast are children. At St. Francis -- which this year is averaging 420 patients a month in Convenient Care -- nearly 60 percent of them are kids.

Southeast Hospital's program operates 24 hours a day, with a doctor assigned specifically to deal with Minor Care patients from 11 a.m. to 9 p.m. During other times the regular emergency room physicians deal with those patients.

St. Francis Medical Center has more limited hours for Convenient Care, which is open from 2-10 p.m. Mondays through Fridays and 10 a.m. to 10 p.m. Saturdays, Sundays and legal holidays. Two doctors are on duty in the emergency room during those hours.

Brown said many minor medical problems occur on weekends, holidays or during the evening hours, when doctors' offices are closed.

"Right now it appears those hours are still serving the needs of our patients," said Brown. But, she said, "I think we will see Convenient Care hours expanded, at least during the week."

When St. Francis began its Convenient Care program it required patients to pay at the time of service, either with cash, check or credit card, unless they were on Medicaid or Medicare. Soon, however, the hospital began accepting some of the major health insurance cards.

On June 1, the medical center began accepting all health insurance cards and "we will bill to the patient's home address," said Brown.

At Southeast, Minor Care patients are billed, with the financial information put on computer after the individuals have been treated. At St. Francis, the computer registration occurs before the patients are seen by the doctors.

Nationally, many hospitals and walk-in clinics -- particularly in urban areas -- have treated minor injuries and illnesses for years. But the concept was new to Cape Girardeau when St. Francis opened Convenient Care three years ago.

Brown remembers concern about whether the service would be viewed as cutting into doctors' practices.

"It turned out to be a non-issue," said Brown. In fact, many local doctors now see the two programs as aiding their practices.

"One of the things we are finding is that a lot of doctors' offices are using this as an adjunct to their practice," said Brown.

Sometimes a private doctor's schedule is full. Rather than tell a patient that he or she will have to wait another day for treatment, a doctor's office may now suggest that person go to Convenient Care or Minor Care to deal with such common ailments as ear infections, sore throats and sprains.

A broken arm won't quality for Convenient Care, explained Brown. She said Convenient Care is set up to deal with persons suffering from "single-system" medical problems.

A person with an ear infection and runny nose could be treated through Convenient Care because both conditions are considered symptoms of the same illness, Brown said.

Southeast's Bennett said Minor Care is designed to deal with patients whose medical problems are "clear cut."