HOLLY SPRINGS - In ones and pairs, patients trudged, hobbled and sometimes just walked out of the oppressive fog and into Rex Healthcare’s atrium-like lobby last Wednesday morning.

Some were first-time visitors, driven in by the nasty flu that’s spreading this season. Others have been coming since the 30,000-square-foot medical building opened a year ago.

So far, Rex has found burgeoning Holly Springs to be just the market it expected. The building’s general physician, pediatric office and urgent care center all are seeing at least 20 patients daily.

“Why venture out when the services rendered here are just the same?” asked Patrick Worthy, a 50-year-old Holly Springs resident, as he waited for an appointment in David Tsai’s practice on the second floor.

That simple logic has led hospital groups, like any chain, to chase demand into Holly Springs and other towns on the suburban fringe.

While Rex has a much-more visible presence with its glass-and-brick building, WakeMed’s also reaching for the local market with its smaller Holly Springs Medical Center, which was created from a formerly independent practice.

Rex’s early success, including 750 monthly visits to its urgent care, has bolstered the health-care system’s expansion plans for the area. Rex already has won state approval to build a full-fledged hospital on the site and plans to add a second medical office.

The Holly Springs hospital plan, however, is tied up by the ongoing certificate-of-need fight between Rex and WakeMed, which likely won’t be heard by the N.C. Court of Appeals until early next year.

That doesn’t mean medical companies are frozen in place here, though. Rex may soon bring on a second full-time general physician, and it’s finalizing plans to open a cardiology practice in Holly Springs.

The company also bought about two acres to prepare for future construction at its site on Avent Ferry Road.

Shifting industry

Large hospitals’ localized expansions are also a sign of the consolidation of medical practices.

David Tsai, for example, ran his own practice in Austin before joining Rex and eventually becoming the hospital system’s full-time general physician in Holly Springs.

“It was the administrative part of medicine that made it very challenging,” Tsai said.

While he thinks he could have made it on his own for a few more years, “it’s more manageable to be with a large group,” he said.

Like quite a few doctors, he finds himself wishing he’d gone to business school so that could keep up with an ever-complicating health-care business.

Hospitals’ increasing presence on the edge of suburbia also has an effect in more rural areas. While many of Rex’s regular patients in Holly Springs are local, the urgent care facility draws injured and sick people from as far as Lillington, according to Sara Martin, a practice manager for Rex in Holly Springs.

“We’re drawing from two or three counties,” she said.

Of course, that may not last long: Harnett Health System was scheduled to open its own hospital in Lillington, 30 miles south, last Friday.