Five days a week, nurse practitioner Patricia Smith sees her patients in a small building in the corner of the parking lot of a Strawberry Plains truck stop.
But she's motivated to think what she does there could make a big difference — to her patients, and to the trucking industry.
Smith works in an Urgent Care Travel clinic at the Pilot Travel Center at 7210 Strawberry Plains Pike. The clinic, which opened about four years ago, was the first of seven Pilot Flying J and Urgent Care Travel have opened together.
The clinic functions as a walk-in and will take all comers: RVers, business and vacationing travelers, guests from the nearby hotels and even permanent members of the community. But its primary targets — who make up 80 percent of Smith's patients — are truck drivers.
Long hours, a sedentary lifestyle and rigors of the job lead to a higher incidence of chronic health problems among truckers. More than half are obese, the government says, compared to 26 percent of all Americans. Truckers are 50 percent more likely to have diabetes, and 87 percent have high blood pressure, according to a study in the Journal of Occupational and Environmental Medicine. They're more than twice as likely to smoke, yet only 8 percent report regularly exercising — compared to nearly half of the general population.
This affects not only their health and their life expectancy, which is considerably shorter, but also their livelihood — more than half of drivers have one or more chronic health condition that leads the Department of Transportation to certify them for a commercial driver's license for less than the two-year maximum: one year, six months, or even three months.
Smith hopes to manage those conditions first, then point truckers toward a healthier lifestyle. She estimates, once they become established patients, around 60 percent make those lifestyle changes: better eating, more physical activity and taking medications and getting regular care to manage their chronic health conditions.
"I think they're motivated to stay healthy, and I also think it's because they realize someone cares about them," Smith said.
Mitch Strobin, vice president of service management for Urgen tCare Travel, said getting to a medical facility to manage those conditions is sometimes challenging for drivers, who have to find somewhere to park their trucks, find transportation to a provider sometimes 20-30 minutes away, wait for care and then get transportation back to their trucks.
"That's four hours off the road," Strobin said. "This is on the road, on their normal truck route. They can park their trucks right here and be here often, because they need care for these conditions. It isn't just a one-time visit — they need ongoing medical care."
The clinics share electronic records, so truckers could go to any one of them, he said.
Urgent Care Travel contracts with trucking companies to provide the mandatory physicals required by DOT, as well as drug and alcohol testing as needed, Strobin said. Four years ago, when DOT began requiring medical providers to have special certification in order to provide commercial driver's license physicals, some providers who did few didn't bother to put the time and money in to be certified. But all Urgent Care Travel clinics provide the physicals and take self-pay patients as well as commercial insurance and Medicare/Medicaid.
Urgent Care Travel also offers an in-house "health network" that gives unlimited visits including physicals, drug/alcohol screening, care plans for chronic illnesses, treatment of work-related injuries, "sick visits" for viruses or infections, prescriptions written for refills, flu and tetanus shots and some labwork, for a flat monthly fee of $100 for an individual or $150 for a family of up to five.
Strobin said some trucking companies offer the plan as a retention or recruitment benefit. It also targets self-employed drivers who own their own trucks and might have no insurance or a high-deductible policy.
"If a driver is sick, they'll look in their wallet to determine if they're sick or not," Strobin said. "What happens is, something that should maybe only take you off of the road for an hour becomes a week because they didn't take care of it. They'll struggle through it, struggle through it, then it becomes pneumonia or something and they miss five days of work" or more, if they end up hospitalized.
The plan removes that barrier, he said: "If you know you don't have to reach in your wallet, you can come in every day — that's fine. Get a blood pressure check. If you have diabetes, get your monitoring. You're here anyway; just come on in."
Scott Klepper, senior manager of facility revenue at Pilot Flying J, said the urgent-care clinic "was obviously something we were missing" in the company's quest to serve truckers and trucking companies, as well as other travelers.
Healthier drivers could lead to less turnover. The American Trucking Associations puts driver turnover at more than 80 percent.
"The average cost for a trucking company to replace a driver is around $5,000," Klepper said. "Obviously, anything we can do to help trucking companies grow helps our business."
"What we're trying to do is act as a preventive agency where they can keep their job, we can keep them healthy, we can create care plans for them and teach them how to stay healthy," she said. "They want to stay healthy. This is their bread and butter; this is how they pay their bills. And a lot of them want to stay healthy for their children and grandchildren."
Current Urgent Care Travel clinics:
Knoxville, Tenn.: I-40, Exit 398
Cartersville, Ga.: I-75, Exit 296
Ruther Glen, Va.: I-95, Exit 104
Oklahoma City, Okla.: I-40, Exit 140
Dallas, Texas: I-20, Exit 472
Baytown, Texas: I-10, Exit 789
Fontana, Calif.: I-10, Exit 64
Planned 2018 clinics:
Carlisle, Penn.: I-81, Exit 52
Phoenix, Ariz.: I-10, Exit 137
West Memphis, Ark.: I-55, Exit 4, or I-40, Exit 280
Toledo, Ohio: I-280, Exit 1B
Joplin, Mo.: I-49, Exit 39A
Laredo, Texas: I-35, Exits 12 or 13
Spiceland, Ind.: I-70, Exit 123
Hubbard, Ohio: I-80, Exit 234