Charlotte-area urgent care center stays open late to help patients avoid the ER (2024)

By Michelle Crouch

On a Friday night in late May, a soccer ball struck 12-year-old Dhruvtej Karande in the face, driving the edge of his glasses into his eyebrow and opening up a two-inch gash.

His parents rushed to the nearest urgent care center, but it was already closed when they arrived, said his mom, Priyanka Karande. Then it was off to another urgent care in Charlotte’s University City area. It, too, was closed.

That’s when they turned to Google, searching for an urgent care center with late evening hours. The only one they could find was 20 miles away in southern Mecklenburg County — a new facility called After Hours Urgent Care Center in Pineville.

“It was very lucky for us,” Priyanka Karande said. “It had only been open 12 days. We could have gone to an emergency room, but it would have been costly, and we would have had to wait for a long time. This was very easy: He got three stitches, and we were done in an hour.”

Urgent care clinics offer prompt medical attention when primary care isn’t available and the problem doesn’t require an emergency room. In addition to suturing simple cuts, the centers can treat conditions such as respiratory infections, minor allergic reactions, muscle sprains, earaches and eye infections.

Yet almost all urgent care centers in Charlotte and across North Carolina close at 8 p.m. — leaving patients with no choice but the ER if they need nonemergency care in the evening.

After Hours Urgent Care Center, which opened May 10, aims to offer patients an alternative, said Waseem Ghannam, a board-certified family medicine physician and the facility’s CEO.

It operates in a 4,900-square-foot space off Pineville-Matthews Road near Interstate 485. It’s open Monday to Saturday from 3 p.m. to 1 a.m., and Sunday 10 a.m. to 8 p.m.

“Charlotte is too big for everything to stop at 7,” Ghannam said, pointing out that centers typically stop taking new patients an hour before they close. “Things happen after 7 o’clock at night, and consumers need to have a choice. Not everything needs to go to the ER.”

Studies show between 13 percent and 27 percent of all emergency department visits are for nonemergency conditions that could have been treated at an urgent care.

Ghannam said he plans to open three more After Hours locations in the next year — in Charlotte’s University City area, in Raleigh and in Orlando, Florida.

Most urgent care centers close at 8 p.m.

North Carolina has 575 urgent care centers — triple the number it had in 2010, according to the Urgent Care Association, an industry group.

Charlotte’s largest health care systems, Atrium Health and Novant Health, each operate dozens of urgent care facilities in Charlotte, according to their websites, but almost all close at 8 p.m.

A handful stay open until 9 p.m., and one Novant facility provides care until midnight.

Both systems offer virtual urgent care visits and emergency room access 24 hours a day. Atrium also operates freestanding emergency rooms that are open 24 hours.

In 2018, Atrium opened a 24-hour urgent care facility in Charlotte’s uptown area and had another 24-hour facility in Union County, according to a WBTV news story at the time. Both facilities now close at 8 p.m.

“We discontinued offering 24/7 urgent care at bricks-and-mortar locations in April 2020, as the pandemic began to set in and we were making adaptations,” Atrium spokesman Dan Fogleman said in an email.

He added: “Based on the numbers of patients who utilized the service versus the cost to operate the clinics during the overnight hours, it was not sustainable from a cost perspective.”

A Google search turns up only two other urgent cares in the Charlotte region with extended hours, both operated by Iredell Health System.

Iredell Health spokeswoman Meagan Kowalski said the system opened a 24-hour facility in Mooresville in 2021 after conducting patient focus groups in which the No. 1 concern expressed by patients “was that if they needed healthcare outside of regular business hours, they would have to visit an emergency department.”

“With that knowledge, we chose to open a 24-hour urgent care facility that would always be open,” she said. “It is the only place to receive healthcare at any time of the day, on any day of the week, outside of an ER. Since Day 1, it’s been a tremendous success.”

She said the system opened a second facility that stays open until 11 p.m. in 2023, after Davis Regional Medical Center closed abruptly, which increased patient volumes at the Iredell Memorial Hospital ER.

A way to reduce nonemergency ER visits

Alan Ayers, president of Experity Consulting and senior editor of the Journal of Urgent Care Medicine, said the vast majority of the nation’s 15,000 urgent care centers are open 8 a.m. to 8 p.m. That’s in large part because it’s easier to hire health care providers to work a 12-hour shift, he said.

He said he knows of only a small number of centers that stay open late, and most focus on pediatrics. For example, he said, an urgent care center chain called PM Pediatric Care has about 100 locations, including several in the Triangle area that stay open until 10 or 11 p.m.

Ayers said there is a real need for care between 8 p.m. and midnight.

“When we look at nonemergent use of the emergency room, it’s the hours between 8 and midnight that are really pretty significant,” he said. “Typically, after midnight people aren’t going to leave home unless it’s a true emergency and they really need the ER.”

A 2021 study in the journal Health Services Research found that having an open urgent care center in a ZIP code reduced the total number of emergency room visits by residents in that ZIP code by 17.2 percent, due largely to a drop in visits for less emergent conditions.

Ayers said After Hours Urgent Care’s later opening hours could be a market differentiator when the urgent care market in urban areas like Charlotte is getting flooded.

Dog bites, cold symptoms and STDs

Ghannam said he has averaged about 12 patients a day since opening last month, and the center has so far exceeded his financial projections. The clinic takes Medicaid and most North Carolina insurance plans except for United Healthcare, he said. It offers a self-pay option.

So far, he said, the most common ailments the center has treated include respiratory illnesses like strep and COVID, lacerations, dog bites, musculoskeletal injuries and, interestingly, sexually transmitted diseases.

Why STDs?

“People don’t want that information in their Atrium or Novant medical record, so they will come here because we’re independent,” Ghannam said.

The center doesn’t treat head injuries, pregnant patients, babies younger than 6 months or patients looking for refills of pain medicines, he said.

Check out the Ledger/NC Health News guide on what to consider when deciding whether to go to an ER, a freestanding ER or an urgent care.

Filling the gap

Ghannam said he had the idea for After Hours Urgent Care after his own son fell near a pool in May 2023 and needed stitches. The fall happened at 7:45 p.m., he said, and with the nearby urgent cares already closed, they had to head to the ER.

“It was very dehumanizing. We literally sat from 9 p.m. to 4 a.m. in the ER to get this taken care of, and my out-of-pocket expense after insurance paid was $2,200,” said Ghannam, who at the time was taking a break from medicine after selling a telemedicine business he co-founded.

“I just kept stewing on it, thinking, ‘How in the heck does a city like Charlotte have one-plus million people in the area, and we as consumers don’t have more options at night?’”

Ghannam said he began researching urgent care clinic ownership and found that most are owned either by major health systems or private equity firms.

Eventually, he said, he hired a consultant who confirmed his business idea could be successful.

“I’ve always succeeded in finding gaps, and I felt that this was a gap,” Ghannam said. “I like the fact that I don’t have to compete with anybody else at night except the ER, and I’m always going to beat the ER on price and speed.”