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Dr. Bruce Irwin – The Pioneer of Urgent Care

Every story has a beginning. American Family Care’s starts with its founder and CEO, Dr. D. Bruce Irwin, in an emergency room.

Dr. Irwin’s story, however, begins several months before he was born. In October of 1949, his father, Bruce Irwin, was injured in a railroad accident near Atmore, Alabama. A locomotive cut off both of his legs. Irwin would survive the accident and live another 17 years, but the tragedy would overshadow the rest of his life.

His son, Donald Bruce Irwin, grew up in Center Point, Alabama, helping to take care of his father, who learned a new trade that he could do from his wheelchair — shoemaking. Young Bruce Irwin would accompany his father on many doctor’s visits over the years. Irwin no longer remembers it, but it became family lore that after the elder Irwin became allergic to penicillin and reacted badly, the young boy seemed agitated and very upset. When he was calmed down, Bruce told his family that he was fine — but he was going to become a doctor.

He wanted to help people like his dad.

American Family Care’s origins. Flash forward to 1980. Irwin attended the University of Alabama School of Medicine. One day, working in an emergency room at Brookwood Medical Center, Irwin couldn’t help but be struck by how many people came in for non-emergencies. They were sick all right — adults and children would come in with aggressive, nasty coughs, for instance — and often they were hurt. Fracturing a bone or skinning your knee is not pleasant and needs to be tended to before the injury worsens and becomes an emergency.

But much of what the emergency room doctors were treating weren’t really true emergencies, and because of ER rooms becoming increasingly overcrowded, the people who were truly in a life-or-death situation weren’t able to get the best care. In fact, nobody was really getting the prompt care they needed.

Irwin had an idea.

Irwin hadn’t taken any business classes at medical school, but he did have an entrepreneurial mindset. He had worked in his father’s shoe shop. He mowed lawns for money and turned it into a thriving revenue generator, and later, he even started a janitorial service as a teenager. When he was a resident in medical school, he began an emergency room staffing company.
And so, it isn’t surprising, really, that in his downtime during his emergency room stint, he started hatching a business idea. What if he opened some clinics to handle the non-emergency cases in Birmingham, the cases for the people who were sick or injured and needed immediate care but didn’t have life-threatening emergencies?

In 1982, Irwin opened his first clinic — American Family Care.

The beginning of something special. Irwin wasn’t the only person around this time thinking that an urgent care clinic was needed, but he was on the front lines of a trend. For instance, a December New York Times article mentions that “more than 130 hospitals have opened satellite emergency centers since 1979.”

When Irwin had his epiphany, doctors had long stopped making house calls, and there were times, especially weekends and evenings, when it was next to impossible to get care without going into a crowded emergency room and waiting for hours to be seen — and then being handed an astronomical bill.

Of course, it doesn’t sound like things have changed all that much, a fact Irwin ruefully noted in 2017 when he was interviewed by The Birmingham News.

“I’ve got 19 clinics in the Birmingham area, and Birmingham ERs are still overloaded,” Irwin said. “It’s not a question of people not having insurance. That’s what everybody used to think. I think some of it is people not knowing how many things we can treat. But it’s something that’s still going on.”

The American Family Care story continues. American Family Care slowly but surely grew into a respected regional presence throughout the 1980s and 1990s and early 2000s. It didn’t actually begin franchising until 2008. In 2013, when it purchased the urgent care chain, Doctors Express, it suddenly went from a 37-clinic operation in Alabama, Georgia and Tennessee to one of the largest privately-held urgent care operators in the country.

Today, there are 215 American Family Care facilities across 28 states. Tomorrow, there will be 500 clinics across 50 states.

Well, maybe not tomorrow, because to do this right takes time, but the plan is to eventually more than double the current number of AFC clinics.

The AFC clinics, staffed with physicians, nurses, support staff, and housing state-of-the-art equipment, are designed to provide quick and high-quality primary care, urgent care, minor emergency treatment and occupational medicine. Most patients come and leave within an hour.

And Dr. D. Bruce Irwin? He continues to lead the charge for better, more efficient and more affordable healthcare — and making sure that people, such as his father, and like all of the patients he has treated over the years, continue to get the best medical care available, and in a warm and inviting environment. He doesn’t think anybody should have to go into an urgent care or any medical establishment and be treated like a number.

Until that happens, and until ERs start seeing a reduction in overcrowding, Dr. Irwin will keep writing the story of healthcare.

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