Walk-in doc: FirstMed hits 51,000th patient mark

Thirteen years ago, William G. "Gaines" Talbott and his family took a big risk, selling their home to purchase UVA's urgent care unit on Pantops without a single patient lined up. It was a risk that appears to have paid off. Just last week, Talbott's FirstMed clinic assisted its 51,000th patient.

"Business is growing," says the 61-year-old physician, who points out that FirstMed is Charlottesville's only locally owned urgent care clinic. "We have ten examination rooms, and there are three to four providers working every day."

His risk paid off for some patients as well. As detailed in the Hook several years ago, one man who came into FirstMed complaining of abdominal pain might never have made home if it weren't for Talbott. Suspecting it might be something severe, Talbott got doctors at Martha Jefferson Hospital to rush a CT scan on the 57-year old patient, John Wade.

Turned out it was an abdominal aortic aneurysm, a rare condition for someone that young, which can cause massive internal bleeding, and, if not treated immediately, death. It was the same thing that killed television star John "Three's Company" Ritter in 2003. Doctors at MJH ordered surgery immediately, and Wade survived.

"Gaines has a great practice there," says Greg Gelburd, founder of Downtown Family Health Care. "His hours allow me to refer people to him when I'm closed and unable to see them or if I feel they need x-rays which I don't have. My patients like his practice and would rather go there than the ER, as the wait time is non-existent and the physicians there are high quality."

However, not all is rosy in the medical profession. Talbott says that CT scans, like the one he ordered for the man with the aneurysm, often get delayed because insurance companies now require pre-authorization, a procedural hoop that might have cost Wade his life.

"Pre-authorization is becoming more of an issue," says Talbott, "and it's going to get worse."

Recently, Talbott says, he had a patient who needed a Doppler ultrasonograph on her leg to detect a possible blood clot, but it was after 6pm and they couldn't get pre-authorization. So Talbott had to direct her to an ER.

Talbott points out that ERs have long been known as "safety nets" for indigent care, but pre-authorization can make them safety nets– "way stations" he calls them– for doctors trying to treat patients who do have medical insurance.

"We've still got the best medical care in this country," says Talbott, "but the system just needs to be tweaked."

Another worry on the horizon: a mandated change in the 32-year-old medical coding system. By 2014, all medical conditions will get new codes to qualify for insurance reimbursement.

"The current system has about 17,000 codes," says Talbott, "but the new system will have anywhere from 120,000 to 155,000 codes that have absolutely no relationship to the current ones. So my 32-plus years of coding familiarity will be useless. "

So why do they want this new system?

"More data," says Talbott. "On you and me."

What's more, the system will make medical records available on the Internet.

"You have to ask yourself," says Talbott, "is  it a good idea that my medical records will soon be accessible over the internet? Will passwords and encryption work to prevent professional hackers from finding a way in?"


Surprising that UVA " gurus" would have sold to a competitor that obviously refers to MJ and not UVA. Probably did it for the good of the community and for patient care without regard to financial considerations. Glad it worked out for Dr. Talbott.

Dr. Talbott continues to do Great Work. Since he opened I've been treated there sucessfully more than once, as have dozens of co-workers, and most recently my Father received the best of care from First Med. Also polite of Dr. T to not slam government involvement in OUR healthcare as it should be slammed, rejected, and at the very least re-vamped.

Thanks to Dr. Talbot. He rocks.

Is that an orange cleaning tag on the top of his trousers? Looks like one from Rudys.

I'm sure he's more concerned with the intrusive, controlling,
and denying insurance companies than the government.
Oh and erroneous data cranked out by low quality
programs which generate endless streams of
erroneous documents.

Concerned about medical records available over the internet? With several people in the family with complicated medical histories making the records available in an emergency without a delay could be life saving. We already have some of our records in an on-line medical record system and carry ID with us pointing to it.

But 150,000+ codes - coding is already nearly impossible to get right. The change will be a disaster.

UGH! All reputable medical facilities are going to electronic medical records. Each electronic medical record has safe guards that no one but classified people on classified computers can get into your med rec's online. Stop with the paranoia.
If there's a fire and your doctor hasn't gone with electronic medical records guess what happens to your med rec's people? Plus it's my understanding that First Med is not for your routine healthcare needs. You should have a physician of your own.

Took my daughter who had a bead in her ear to a UVA doctor’s office. Waited in their lobby for an hour and a half. Finally left there and went to Firstmed, she was looked at in 15 minutes, bead removed immediately, problem solved at what I thought was a very reasonable cost. Every time I go in there I get excellent care, quickly, and they don’t charge an arm and a leg for their service. Dr. Talbot is what a doctor should be, compassionate and professional. I highly recommend Firstmed.

Going to UVA Healthcare = BIG MISTAKE. I went there to have them look at some funny looking spots which turned out to be precancerous keratosis. Cost me $800 just to have them look. So I went to Dr. Bridgette Bryers who looked and did a full treatment for less than half what UVA charged just to look. UVA = RIPOFF

"The system needs to be tweaked"

Boy that's an understatement, We need to get the elected officials in washington out of the pocket of the major health care companies for starters.

All the confusing paperwork and pre-authorization hoops are part of "loss prevention" by the health care companies.
When competition is non-existent, and health care companies have guaranteed income from programs that are tax funded such as Medicare Advantage, we need more than "tweaking"

I pay about 500 bucks a month just in premiums, if I get sick I pay deductibles, 20% co-insurance and a $50 visit fee, all inside my network. And this is considered "affordable health insurance"

We are being made "air tight" by the health care companies (getting it in every hole at the same time)

In this economy, most businesses will roll out the red carped to get your business.
Health care companies don't and won't do this for their customers, cause they don't have to.

It won't matter if I pay off my mortgage responsibly and live within my means, save for retirement, and pay my taxes.....someday I will get sick or have and accident and the scum will take everything I have.

To Zombie: 650,000 records of students and alumni at the University of Nebraska, 760K records at Ohio State, and 350K records at UNC Charlotte, University of Maine, etc. have been compromised by hackers in recent memory. What would you prefer? The potential for internet exposure or possible deletion or manipulation vs. an office fire? My point is that this is America, and we should have the freedom to choose. Many patients prefer their records not be potentially exposed to the web. Complicated history of family members? How about data on a chip or thumb drive that you can carry with you, or the ability to choose which data you wish to make available. The one size fits all approach is not the answer in my opinion. GT

PS....Dr. Karen Poehailos (board Certified, UVA trained Family Practice) does scheduled primary care in our office and has for 13 yrs.