Dr. Jay Woody is the founder and Chief Medical Officer for Legacy ER & Urgent Care. He founded the company in 2008 with the goal of establishing a more efficient and cost effective model for delivering healthcare services to patients. Dr. Woody is board certified in Emergency Medicine and has been a notable and recognized patient advocate for over 20 years.
I’m originally from Texas, but I moved around a bit as my mom had a government job at the time, and so I went to high school overseas in England. After I finished high school, I went to a small liberal arts college there for a year, but ran out of money. School is less expensive in Texas and so I came back and went to Texas Tech. Really because it was more affordable for me.
Both my parents are school teachers in public education, so as a kid I thought that I’d also be a school teacher. I was really into science, so my plan in college was to get a teaching degree and also get a degree in Biology, and become a Biology teacher.
The further I got in my majors, the more I didn’t know if teaching was what I wanted to do, and so I kind of started to go down a different path. I knew I was interested in the Life Sciences, but I was also becoming interested in Pharmacology. At one point I thought I might actually graduate in Pharmacology.
I found out that I really needed more interaction with people. I thought to myself “You like the sciences, you like teaching, and you like working with people.” I realized that what I wanted to be was a doctor.
As I was on the path to medicine, I subsequently started looking at which specialization to do. But I liked everything. What I didn’t like was the monotony of working with the same patients, with same problems. In Emergency medicine you never know what’s coming. You see all sorts of crazy things. It was perfect for me. So I became certified and received my specialization in that.
I did end up spending a little more time in school because of the route I took, having to go back and take some classes I didn’t have, but the extra time was totally worth it in the end. It is very important that you go down the career path where you are going to be most happy.
Legacy is something that is definitely unique and new to the market space, because really what it’s doing is providing both emergency and urgent care services in the same facility. Typically you go to an ER if you need emergency care or to a minor care clinic if you don’t. But many times people wind up at the wrong place, because most people don’t know what they have or what services they need. On top of that, you are only billed for level of services that you actually need.
Say you cut your finger and have a laceration and you end up in hospital emergency room. You’ll experience great care and be provided with everything that you need, but because of the location and everything they do in the ER, it could end up costing you a lot of money.
You don’t need to be a doctor or healthcare professional to know you cut your finger or that you’re having chest pains and shortness of breath. But understanding what level of services you need for what situation isn’t the job of the patient, as they aren’t medical professionals. We take all of the guess work out of it.
Myself and others working in hospitals noticed that a lot of people don’t really need the level care of care delivered in the ER, and can end up going bankrupt because they get charged for more services than they actually needed. This isn’t a great way to deliver healthcare.
The genesis of Legacy was asking the question, “Why don’t we have both services available, so people don’t have to figure out what level of care they need?” This way, people are only receiving the care they really require.
The first huge obstacles we faced were at the legislative level. Nobody really knew what to do with the fact that we took emergency medicine out of the hospital setting. Sometimes we got reimbursed, sometimes we didn’t. We had to figure how to make that work in our niche of the healthcare system.
What happened was that, in 2009, the state of Texas (with our help and folks like us) crafted legislation that allowed for freestanding emergency facilities that were licensed by State of Texas Health and Human Services, and overseen at the state level.
Until we had the law backing us up, we weren’t sure how we were going to be treated. For the patients, this gave us standards and made it possible for us to make clear with patients how this kind of care would be handled in relation to their benefit plans and insurance.
Getting legislation that says what you are doing is legitimate, really helped sort things out. This legislation and Texas’s favorable operational environment are the reasons that the realm of Freestanding Emergency Rooms has really exploded in the state.
Recently, we made an acquisition of another company here in Texas that brought on new locations for us, as well as giving us a bigger geographical footprint in the North Texas area. We currently have six locations.
But not all states are favorable to this kind of delivery. There are only a handful of states where it is pretty easy to go in and do these kinds of things. For example, Colorado, Ohio, and Arizona are currently easy states in which to operate. Each state has their own nuances and requirements to make things happen.
We are working to expand both in the state of Texas and also those other states which are favorable to Freestanding Emergency Rooms.
It depends on who you ask. Smaller companies are starting to embrace it, but it’s more of a challenge with some of the bigger ones that are more dogmatic and move slowly. We show them how it works, and they seem to like it, but can’t find a way to fit it into their system. The larger companies have people handling ER only or Urgent Care only, and they really only care about their respective budgets.
We currently work with one of the big third party payers in the country, and they are some pretty smart people. Once we showed them how it worked and that it saved both the patient and the carrier money, we went into contract with them on the ER side. The bottom line ends up being good for all of us.
Legacy also works with a lot of businesses that are self-funded. Self-funded companies are typically larger businesses. They partner with companies such as United Healthcare that act as managers, but they are just administrators. If an employee goes in for care, the business itself is the one writing the check to pay for that care. That is why self-funded companies are so much more in tune with the real costs of healthcare.
They see that this model provides a huge cost savings for them, and we’re being approached by some big businesses. Self-funded companies pay for their employees’ healthcare plans out of their own pockets, and anytime they can partner up with somebody who can help their bottom line, that’s a good thing for them. Our edge is value-added for everyone involved.
Well, traditional healthcare will always be there. People are always going to want it, even if it isn’t the most efficient. Hospitals will also always be around. What I’m seeing more and more interest in, is the delivery system we are using, the hybrid. It is more value-based and good for the patient. What’s good for the patient and what saves money don’t always go hand in hand, so when they do, it can really have some staying power.
Over the next five to ten years, I think we are going to see an even bigger move towards nationalized healthcare. That where the forces have been driving things. The question is how would that look, and how will hospitals adopt it? Because of this, we’ve had several larger hospital systems reach out to us.
Also, the nonprofit population in medicine (similar to self-funded companies) is very in tune with saving money and the hybrid model lets them deliver better care with more control over the costs to their system.
As the model starts to be adopted by more and more groups, insurers will be forced to put companies like Legacy in their systems. Once that starts happening, you’ll see momentum start moving faster and faster, and eventually the hybrid model will become part of the conventional healthcare delivery system in the country.
Since I also hold a faculty position, I work with a lot of medical students and residents. The advice I give them is to get out there and find out as much as they can, and by going out and experiencing it, not just reading about it. Even if you’re still in high school, you can take flowers to a hospital and see what the whole experience is like. Get involved. Put yourself in situations where you can really see what people are doing. The more experience you have, the better you’ll know what suits you. Medicine is a long-term commitment, and you can’t experience it by reading about it, you have to immerse yourself in it.
It’s a good idea for students to get whatever job they can, just to be around medicine and folks in different fields; Even if it doesn’t pay a lot. It will be incredibly valuable to be able to work side-by-side with a professional like a PA or a doctor.
Just get into healthcare and see how everything works, how it runs, and how people interact with each other. Do whatever you can do to plug yourself in to some kind of system, the knowledge and experience you’ll get is invaluable.