AZTEC — As demand for medical treatment and health care services is largely unaffected by economic conditions, many regional hospitals and urgent care providers have opted to expand services while economic times are tough.

This year both San Juan Regional Medical Center in Farmington and Mercy Regional Medical Center in Durango are opening doors at new facilities in an effort to expand health care offerings across the region.

Mercy in July extended its services down to Aztec, where it opened a satellite facility offering routine testing and X-rays, saving Mercy patients in northwest New Mexico a drive to Durango.

Economic conditions had little influence in Mercy's decision to expand its patient offerings, Mercy spokesman David Bruzzese said. Instead, the project was tailored to address underserved medical needs in the community.

"Southwestern Colorado, northwestern New Mexico are growing, so there's a greater number of people who need greater number of services. Our goal is to provide those services," Bruzzese said. "We wouldn't do that if they weren't in demand. Because there is demand, we could justify operating there" in Aztec.

Also included in Mercy's new Aztec facility is clinic space available for physicians in private practice and an urgent care facility operated by Durango Urgent Care, a private company unaffiliated with Mercy. Intended as a convenience, the Mercy facility in Aztec is working to establish contracts with some Durango physicians to offer clinic hours at the new expansion site.


Farmington's San Juan Regional Medical Center has invested million of dollars in recent years to expand its offerings with a new cancer center and an internal medicine facility dedicated to cardiology and pulmonology.

Hoping to further improve patients' access to their health care providers, the hospital later this month will open an expansion of the internal medicine facility to include added neurology and pediatric services, hospital spokesman Lee Lamb said in a prepared statement.

San Juan Regional officials declined interview requests to detail how changing economic conditions have affected the hospital's growth.


Changing services


With medical care experiencing increased demand and increased costs, urgent care facilities in the Four Corners are booming.

Demand for urgent care services in all Four Corners communities is being driven by an increasing shortage of primary care physicians, the traditional family doctors first called when someone gets sick or requires routine checks, said Suzanne Bowker, a co-owner of Durango Urgent Care and the new Aztec Urgent Care.

As fewer physicians accept new patients or have available appointments for last-minute concerns, the need for low-cost, walk-in medical services provided by urgent care facilities has rapidly grown in recent years.

"That, combined with the high cost and long waits of emergency rooms," Bowker said of the growing demand. "Urgent care has just kind of filled those gaps, and as a result, I think that's why we see the need not only in the Durango area but also in the Aztec (and) Bloomfield area."

More patients have found urgent care a cost-effective and timely alternative to an emergency room visit, causing business for Durango Urgent Care to grow steadily since the company opened in 2006, Bowker said.

Health insurance companies offering reduced co-payments for urgent care services also have driven added use of the walk-in medical facilities, she said.

Ripe for new growth, Durango Urgent Care looked for markets where the medical services were necessary.

"We had actually been looking at coming down to Aztec for awhile," Bowker said. "We saw that as a need in the market."


Employer-driven services falling


In Farmington, Reliance Medical Group has found the demand for urgent care treatment has held steady through the recession, company manager Jim Holgate said. Other services, however, were not as stable.

Reliance Medical Group offers occupational health services at facilities in Farmington and Aztec, services which include pre-employment drug screens, physicals or any other employer-paid services.

But Reliance has experienced a sharp drop for those services because fewer employers are hiring, Holgate said.

"On that side of things, there's definitely an impact, because if people aren't hiring, then you don't do as many drug screens, and you don't do as many pre-employment physicals," Holgate said. "There's just not that much activity out there compared to a couple years ago."

The reduced work force also means fewer work-related injuries requiring Reliance treatment, he said.

Occupational health services represent at least 50 percent of Reliance's annual business, the manager said. The private company also offers chiropractic services, which have remained consistent.

But Reliance isn't alone in Farmington. A new company, Basin Occupational and Urgent Care, opened its doors in March offering similar worker-based services with urgent care.

Seeing the high demand for medical care in the Farmington community and a limited number of providers, the new company didn't think twice about opening while the economy was down, clinic manager Jason Clark said.

"Despite the fact that Farmington was in a slump, we thought it was a great time to give the people of Farmington and the San Juan Basin a new choice," he said.

Although Basin Health expected a majority of its business to come from the occupational services, business is better than expected.

"We're growing a little quicker than we anticipated. We're very pleased with how it's been going so far. Fortunately for us ... the industry is starting to turn around, companies are starting to hire."

Although the competition to provide urgent care in the Farmington area is new, it's unclear whether that competition will affect other reliance care and occupational health business, the Reliance manager said.

"In some areas, we're up slightly from last year; in some areas we're down slightly," he said of urgent care competition. "There aren't any indications of differences yet."