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When the owners of DoctorsNow Walk-in Care LC sought to expand their fledgling network of urgent-care clinics, they looked to the south. Way south. South Florida south.

Last month, the Johnston-based company opened its first out-of-state clinic in the Miami suburb of Doral. It opened its first clinic at 5731 Greendale Road in Johnston just two years ago, and now has offices in Altoona and West Des Moines as well. The expansion into the Florida market is just the beginning of a national growth initiative for the company, said Dr. Tim Simplot, CEO of DoctorsNow.

“I expect our growth as we go into other states to be really exponential,” said Simplot, who said he hopes to open as many as 15 clinics outside Iowa within the next three years. The company is currently negotiating with a potential investor who wants to open a clinic in a suburb of Las Vegas this fall. “We’re always looking at new sites and are in conversations with people in California, Colorado and other states,” Simplot said.

The DoctorsNow clinics, which are open into the evenings until 8 and on weekends, specialize in having a physician available in each office who can generally see walk-in patients within 15 minutes. Each clinic is also staffed with either a certified medical assistant, a radiology technician or a nurse, as well as a receptionist. Because they always have a doctor available, the clinics can handle a wider array of medical problems than operations within retail stores that typically are staffed by nurse practitioners, Simplot said.

Simplot, who maintains his day job as an ear, nose and throat surgeon at The ENT Clinic of Iowa, is an owner in the company, along with Dr. David Stilley, a former emergency department medical director with Mercy Medical Center – Des Moines. A number of silent partners are also invested in the company. Stilley, who staffs the Johnston clinic and serves as the company’s chief medical officer, is the only owner who also works in one of the clinics.

As DoctorsNow expands, finding local investors who know their respective markets well will be important, Simplot said. “What we look for as we go into other markets is private local investment, preferably physician investors who really want to expand the scope of their community involvement, but really don’t have the time, ability or knowledge to open an urgent care,” he said. “It’s really been quite well-received. The interest, once you start talking in these other areas, has been massively high. That said, it takes time to work through each site to see if it’s a fit.”

With fees comparable to what someone would pay for a visit to a regular doctor’s office, DoctorsNow doesn’t try to compete on the basis of price, he said.

“It’s more to me about convenient, rapid access to good health care,” he said. “We live in a busy society and we want in-and-out (service), and we want good care and we want a nice environment and that’s what we try to provide.”

DoctorsNow has identified opportunities with potential joint-venture partners throughout the country, Simplot said.

“We have a couple of people who are involved with us who travel around the country for their day jobs,” he said. “They’re involved in multiple medically related functions, and they have a lot of ties into communities. They’re tied in with us, and they bring these opportunities to us. We come in and present it to local investors. What we bring in is our expertise from the trials and tribulations we’ve had over the past two years, how to run these sites effectively and efficiently. Of course, the bottom line is giving good patient care.”

The Iowa investors have formed a separate company, DoctorsNow National LC, which will have a stake in each out-of-state clinic, Simplot said. “All of the gentlemen who helped form the local company are involved,” he said. The new out-of-state investors will have ownership positions just in their local clinics, though some plan to open in multiple locations.

Simplot said the company’s three Iowa clinics collectively handle about 100 patients per day, with the Johnston clinic being the busiest of the three. Following their initial growth phase, the Iowa operations are approaching profitability, he said. “As you open new facilities, it takes time for people to really know what you’re about and what you’re there for and gain confidence from their experiences.”

The Florida clinic was already averaging 10 patients per day in its first week of operations, an indication that the clinics in large metropolitan areas will grow at a faster rate because of their larger population bases, Simplot said.

Incorporating electronic medical records in each clinic from the start has been a key factor in the company’s success, Stilley said.

“Because we were a start-up company, we thought it would be foolish to start with paper records knowing that we would have to convert at some point,” he said. “So we’ve been electronic from day one. So if we’ve ever seen a patient before at any of our locations (in Iowa), they’re already in the system; we don’t have to find a chart. It just simplifies the whole process.” Though the initial cost was high, Stilley said the payback for going electronic is fairly quick because of the elimination of the cost of wet-processing X-ray film, and not having to store paper records.

The company also expects to achieve savings by continuing to purchase supplies and services from Iowa-based vendors for the clinics it will open across the country, Simplot said. Among those Iowa companies are Triplett Office Essentials, J&D Computers in Grimes and Heartland Medical Supply in Iowa City.

“It’s a big advantage for us, since prices here for many services are so much lower than those in other parts of the country,” he said. “We’ve found a few stumbling blocks, too. Trying to get sign guys in Miami to work with sign guys up here was a nightmare.”