Few businesses can be classified as unique these days, but Princeton Medical Answering Service qualifies. Its president, Gretchen Godwin, is the only registered nurse in the country who owns a medical answering service. Which means she can do something few in her field can do: send you to the emergency room.

Godwin’s direct voice in the matter comes only after several attempts to reach an on-call doctor prove unsuccessful. If the first page to a doctor fails, her company calls the doctor directly. If that fails, it calls the doctor’s home. If that fails, it calls the doctor’s partner. And if that fails, someone calls Godwin.

“Because I’m a registered nurse I have the legal authority to send people to the hospital,” she says. “It’s kind of a free nurse triage.” She is not allowed to give out medical advice (although she is working on a plan to change that), but unlike most other people answering the phone at on-call services, she can say more than “He’ll call you back.”

Lest you get the idea that Godwin is running a one-woman business, taking calls for a couple doctors at one medical office, know that Godwin — who owns Princeton Medical Answering Service (PMAS) at 345 Witherspoon Street and Corridor Medical Answering Service in Kendall Park — employs 26 operators here and another 19 around the country who handle calls made to roughly 2,500 physicians.

To give you an idea of how many actual calls that adds up to, Godwin’s firms also act as the switchboard operator at John Theurer Cancer Center at Hackensack, taking all non-code (read: ambulance dispatch) calls for the center’s 32 staff doctors. From this alone, Godwin’s operators field about 1,200 calls a day.

Godwin’s enterprise is considered “small to mid-size” by the industry, she says. “The big boys have more than 5,000 employees. Collectively we have 45.” PMAS has 25 medical accounts in Princeton, but Godwin is talking with the University Medical Center at Princeton to set up PMAS as the switchboard operator for the coming medical center in Plainsboro.

Godwin got into the industry by buying into Corridor in 2000. The company was owned by the Robertshaw family, which owns 16 call centers across the United States. The family also owns the building at 345 Witherspoon Street, where Godwin has set up shop and uses the conference room to meet out-of-town guests.

Godwin had owned about 40 percent of Corridor until she bought it out fully in February from Robertshaw Communications. Princeton Medical Answering Service is an entirely independent enteprise for Godwin, who started the company from scratch in January.

When Godwin got into medical answering a decade ago things were much different. Even as late as 2000 the business model for an answering service was mom-and-pop with a corkboard and paper schedules.

At times, say on a snow day, when everyone might call out, Godwin would be in the office by herself, completely swamped. The logistical need to clock in at one dedicated office (where records were kept and all calls were routed) also caused no end of turnover. “My first years were like a revolving door,” Godwin says. “I must have gone through 60 people that first year.”

But as more robust computer technology took over the industry, Godwin was able to expand the geographic limits. Her son, Andrew Donato, helped a lot. He figured a way to work remotely when he went away to college, she says, and paved the way to setting up a network that does not tie employees down in one office building. Godwin’s employees these days can work from anywhere, on camera, in uniform, and connected to the complex network of doctors and hospitals PMAS serves.

The cameras and the uniforms are part of a quality-control effort that ensures that even a remote, at-home work station is a dedicated workspace. Operators are monitored on video and someone in Kendall Park monitors at least five calls per shift from each operator, Godwin says. The operators (all of whom must have some kind of background in the medical industry, be bilingual, and be able to type at least 80 words per minute) are set up with special phones and keyboards. Every operator’s workplace has to be behind a closed door, in a place free from distracting sounds.

“We listen in, and if we hear a dog barking in the background, we suspend you for three days without pay,” Godwin says. “First offense. But we’ve never had to suspend anybody yet. I find that if you set the rules and explain them, people are fine.” Since moving to a looser network of operators — one lives in Michigan, another in Florida — Godwin says her retention rate has been 100 percent. “I haven’t had to hire any new employees in five years,” she says.

If the discipline sounds militaristic, it could have a lot to do with Godwin’s upbringing. A self-described Air Force brat, Godwin spent her youth moving from base to base with her father, Ira, an Air Force pilot and colonel. Her mother was a nurse in Boston before she met Godwin’s father. Godwin is one of nine children, all of whom grew up poor but happy, she says.

In 1975 the 19-year-old Godwin was living in Colorado, where she went to nursing school at the University of Colorado and became a registered medical assistant. There she met her husband, Joseph, who got a scholarship to attend Princeton University. Joseph returned to Colorado to open his optometry practice, but he never wanted to be a doctor, Godwin says. He left the profession to be a writer, but “had trouble putting food on the table.”

The couple came back east, where Godwin finished her bachelor’s in nursing at SUNY-Albany. The couple settled in Princeton in order to give their two children (a daughter, 30, and Andrew, now 25) a more diverse upbringing near the arts and culture hub of New York. Joseph became a teacher in the Hopewell Valley School District and later went to work for ETS.

Godwin worked as a clinical office manager at Princeton Eye Group, and when Wayne Grabowski, a retinal specialist, left to start his own firm, she moved with him. She had always thought of running her own business, though. Then one day, one of Grabowski’s patients (who owned 500 small medical answering services) told her that since she did such a good job running the office, she should consider buying Corridor.

Three years after she bought Corridor, Godwin expanded the practice to 12 operators. Corridor still operates in Kendall Park, where the company’s large, powerful, and expensive computers (one worth about $200,000) remain. Princeton Medical Answering Service is a satellite of Corridor.

“It made practical business sense to leave the equipment at the Kendall Park location and have both companies run off the same equipment, because we are 40 feet from the Verizon central office in Kendall Park,” Godwin says.

Godwin says she is seizing the answering service mantel in Princeton that began in earnest with Winifred Donahue’s Answering Service. Donahue opened her company in 1970s as a typing business before converting it in 1982 to an answering service that served numerous Princeton doctors. After Donahue died, the firm was taken over by her daughter, Maureen Donahue-Bircks, who moved the company to Hamilton. That firm now handles calls for 350 clients, many of which are medical practices .

Godwin is looking to nail down the bulk of the Princeton market, and she sees a lot of growth potential as the immediate region gears up to become a major medical practice hub. There has been a concerted effort to transform Princeton Forrestal Village into a complex of medical suites to complement the new hospital in Plainsboro, and Godwin says she is ready for the change.

The future of the medical answering service industry is already headed in the direction that hardware stores and office supply outlets went a decade or two ago. Ten years ago, Godwin says, there were 30,000 answering service firms in the United States. Today there are around 1,500. The once-mom-and-pop industry has succumbed to buyouts and mergers that have reduced the industry to 5 percent of its former size.

As the industry realigns itself, Godwin sees an increasing value that qualified answering services offer doctors. In addition to its round-the-clock office calls after hours, PMAS handles overflow calls when all the lines at a doctor’s office are busy.

Patients can make appointments with a PMAS operator without knowing that they are talking to someone outside the office. PMAS’s computer system is linked into client networks, allowing the company to take appointment information and give it directly to the doctor.

PMAS also handles pharmacy refill calls, which Godwin says saves no end of time (not to mention money) for a doctor’s office. When she worked for doctors’ offices years ago, she says, she would have to cull phone messages left on the answering machine, many of which came from elderly and ill people who did not always speak clearly into the tape.

“We talk to people, get their full name, spelled out, and all their information,” Godwin says. The information is then forwarded for authorization, and the doctor’s staff does not need to worry about tracking patients down.

Godwin maintains her RN license and works part time as a nurse with SJ Nurses, a home healthcare firm based in Jersey City. She also volunteers with Seniors Helping Seniors, an agency with an office in Lawrenceville.

Godwin is also in talks with Night Nurse, an after-hours pediatric triage service by which qualified nurses are able to offer suggestions to callers over the phone. One call to Night Nurse costs $15, but, Godwin says, “that’s a lot cheaper than going to the emergency room.” Godwin wants to link Corridor and PMAS with Night Nurse as a way to lessen the costs of medical care on families and keep doctors from having to always be on call.

On the family side, Godwin says, a hefty portion of the calls her companies field relate to children, and most of those are new-parent worries that Godwin knows she could handle but is not allowed to. “I have to smile at some of them,” she says of parents worried that their babies are crying or that they feel a little warm. “But I have to say, ‘We’ll let the doctor know.’”

On the physician side, Godwin says she is willing to try anything that takes the after-hours burden from doctors. “They’re like everybody else,” she says. “They want to go home at 5 and not be bothered too.”

So with all these phone calls, all day, every day, does Godwin ever get on the phone when she’s off the clock? “It’s funny,” she says. “I just looked at my last statement. I logged 5,000 minutes on my cell phone last month.”

#b#Princeton Medical Answering Service#/b#, 345 Witherspoon Street, Princeton 08542; 609-658-8845; fax, 609-921-1496. Gretchen Godwin, president. www.princetonanswering.com.

#b#Corridor Medical Answering Service#/b#, 3088 Route 27, Kendall Park 08824; 732-821-2377; fax, 732-422-6566. Gretchen Godwin RN, general manager. www.corridoranswering.net.

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