The case study includes the foundation history and two vignettes about different urgent care facilities (UCC) under the label of ConvenientMD in New Hampshire. Gareth Dickens and Max Puyanic, the co-founders of Convenient MD, met while working together in the investment banking company William Blair in 2002, during the economic recession. The firm’s limited budget and reduced staff numbers lead to both consistently working overtime and without weekends. Such experience allowed Dickens and Puyanic to study each other’s work ethic and lead to their decision to start a business together. Having M&A experience in the healthcare field, Dickens and Puyanic set up a search fund and started looking for a UCC to buy. As there were none available for purchase, the entrepreneurs decided to open a UCC company themselves.
UCC’s main distinction from a large-scale hospital lies in its opportunity to provide healthcare services for a lower price due to having fewer overhead costs and a simpler organizational system. Dickens and Puyanic developed a business plan for ConvenientMD, outlining their plans for launching six UCCs in New Hampshire by 2017. Their first UCC facility opened its doors on December 7, 2012, in Windham and performed right at the top of the industry standard.
However, as Dickens and Puyanic moved to the launch of their second UCC, this time positioned in Hampton, complications arose. They chose the area based on its high demand for medical care, which local Hampton Hospital could not satisfy in full. Its emergency rooms were overcrowded, and residents struggled with long waitlist times and inaccessible prices. ConvenientMD aimed for a cooperative relationship, as the UCC could focus on lower acuity patients and help the hospital to provide a better experience for higher acuity ones. While being correct in the demand assessment and successfully attracting the target market they aimed for, ConvenientMD received negative comments in local newspapers from Hampton Hospital physicians. Upon arranging a meeting with the hospital’s CEO, Dickens and Puyanic understood that for him, cooperation was not on the table, as competitors accused them of “picking his pocket”.
As ConvenientMD moved on to the launch of its third facility, in Pelham, Dickens and Puyanic were faced with new challenges. The co-founders picked a building on the road to the Pelham hospital: a decision that would require everyone to drive past ConvenientMD on their way to the emergency room. Once their plans became public, a local zoning board director informed Dickens and Puyanic that she would not support a medical office located in the building. Later, the hospital’s executive director stated that having two medical facilities in the Northern part of the city would not be beneficial for the population of its Southern part. Puyanic and Dickens were approached by another member of the zoning board, who mentioned an available building in the Southern part to their attention. He also provided them with contacts of a local lawyer, who suggested representing ConvenientMD for a steep fee of $40,000.
ConvenientMD case highlights the stressful uncertainty entrepreneurs deal with on a regular basis. It depicts the challenges Puyanic and Dickens have to overcome while launching the UCC of their franchise, which continues to be a difficult endeavor despite the success of the first center. The entrepreneurs consistently navigate ambiguous professional conversations and deal with instances of their strategic planning, while largely correct, not being fully applicable to reality. In this way, the case is illustrative of the volatility of the business environment.