Kim Ariyabuddhiphongs (seated) is chief medical officer of ConvenientMD, which is creating primary care centers in the region. With her is Emily Land, a nurse and practice manager at the Portsmouth primary care office, established as the first site in September 2022. (Photo by Paul Briand)
Having established itself as a reliable and accessible alternative to hospital emergency rooms with its creation of urgent care centers throughout the region, ConvenientMD is working to do the same for its next phase: primary care centers.
“We want to go deeper within the communities that we serve and broaden the health care services that we are bringing to the community,” said Kim Ariyabuddhiphongs, chief medical officer of ConvenientMD. “And what better additional health care service than primary care, which is really foundational to patients’ health.”
ConvenientMD opened its first urgent care center in Windham in 2012 with a mission of providing quality, affordable and fast health services. It currently has 50 clinics in three states, a model of care that Ariyabuddhiphongs said has been very successful at meeting the needs of people who might need treatment for a serious sprain or a deep cut or a nagging cough but don’t want to visit a hospital emergency room or can’t get a timely appointment with their doctor.
“There is a primary care access issue nationally, and in particular in the states that we serve. So I think, for us, it was furthering bringing solutions to the patient populations that we serve,” said Ariyabuddhiphongs.
The company, which is headquartered at West End Yards in Portsmouth, wasn’t content to cruise along with its urgent care model. While urgent care is “episodic,” according to Ariyabuddhiphongs, primary care is more “longitudinal,” in that it creates a longer-term relationship between a patient and a health care provider.
“We decided to go that route, and in the communities where we have set up, we have seen a real positive impact,” said Ariyabuddhiphongs.
It has established primary care offices thus far in five communities: Portsmouth, Exeter and Manchester in New Hampshire, and Bangor and Portland in Maine.
The first to open was the Portsmouth location at 1600 Woodbury Avenue in September 2022 as a beta site to test out the concept before rolling it out to other areas.
“We’ve learned a lot along the way,” said Emily Land, a nurse and practice manager at the Portsmouth primary care office, where NH Business Review interviewed both her and Ariyabuddhiphongs.
“Obviously, the core mission has remained the same, which is to provide excellent primary care along with access and just fostering a strong provider-patient relationship,” Land added.
ConvenientMD is trying to re-establish what it means to have a primary care physician — one that is accessible, that isn’t hurried by the stack of patients in the waiting room, that is focused on preventative care as much as continued care.
“At our practices, you are not processed; you are seen,” the organization says.
A key component for any primary care practice is its place in the often complex and confusing world of health care insurance. Medical plans cover the visits to the doctors in their networks, but anything done by a physician or practice outside a network can mean big charges to the patient.
ConvenientMD is establishing partnerships between its primary care practices and the major health insurers, such as Anthem and UnitedHealthcare.
“We obviously want to improve access to as many patients as possible, and so over time have added a significant number of payer partnerships to insurances that we accept within our clinics,” said Ariyabuddhiphongs. “We have expanded that since our early days.”
Time is of the essence at the ConvenientMD primary care offices, in that patients aren’t rushed in and out of examining rooms.
“I would say one of the biggest things that is different about our organization compared to others is that we ensure that our providers can spend the time that they need with the individual patient to address their care needs,” said Ariyabuddhiphongs.
“At minimum, our appointments are half an hour. We have half-hour and one-hour appointments,” she added. “The effect and impact of that is reflected in our patient experience. One of the biggest things is that our patients say that they’re able to spend the time that they need with the clinician.”
Doctors aren’t overburdened with patients at each office. For example, at the Portsmouth office, which has one physician and two nurse practitioners, the limit is 1,250 patients, called a patient panel.
“We also look at the health of each patient. So if there are more people who are more chronically ill and require longer appointment times and that kind of thing, then we adjust the panel expectation based on that so that we can make sure we’re seeing all those people, and giving them the time that they deserve,” said Land.
Limiting patient load is an important part of ConvenientMD’s mission to be more proactive about care than reactive.
“We really view that as the care team’s focus and not just a single clinician’s focus,” said Land. “For example, when a patient is due for an appointment next week, they’re looking before the appointment to see what are they due for? Do they need this screening? Do they need colon cancer screening? Do they need breast cancer screening?”
Each primary care office is prepared to handle ongoing care for newborns to seniors for annual physicals, immunizations, chronic ailments, etc. Each office has specialists to whom patients can be referred for specialized care. Each office has a lab to do blood draws.
The offices are deliberately decorated to look less medicinal, less clinical, with a layout, colors and even furniture that’s meant to calm a visitor.
According to Ariyabuddhiphongs, the company is assessing possible future locations for its primary care centers.
There’s a lot for ConvenienceMD to consider besides need, which is acute, particularly in the region’s rural areas. Since 2000, nine of New Hampshire’s 16 rural hospitals have closed their labor and delivery units, for example. Local clinics, such as the Ammonoosuc Community Health Services site in Franconia, have also faced closures.
“We are constantly looking at the need for primary care access as one of the factors when we make a decision as to where to place a clinic,” said Ariyabuddhiphongs. “I will also say that our ability to staff a clinic is important, and so those are all factors that we keep in mind when we’re thinking about where to open, but, certainly, I think that the need is the highest driver of where we go.”
ConvenientMD is trying to re-establish what it means to have a primary care physician — one that is accessible, that isn’t hurried by the stack of patients in the waiting room, that is focused on preventative care as much as continued care.
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