Urgent Care Centers

‘Emergency medicine light, or family practice fast’

The United States faces a potential physician shortage in the coming decade, and some members of the healthcare community believe urgent care centers may help ease the deficit. These clinics, which typically offer drop-in care for non-life threatening ailments, tend to speed up patient visits, thus allowing more patients to be seen.

The American Academy of Urgent Care Medicine estimates the United States has 9,300 urgent care centers. Furthermore, as patient demand increases and hospital systems enter the urgent care business, that number is expected to grow.

From ‘doc-in-a-box’ to now
Urgent care centers date back to the 1970s, when clinics began offering outpatient care without appointments, says Franz Ritucci, M.D., a member of the American Board of Urgent Care Medicine. Because these clinics were informally known as “doc-in-a-box,” the physicians who staffed them felt that their legitimacy was questioned, when in reality many of them were also family practitioners.

With evolving technology, the doc-in-a-box clinics eventually transformed into today’s urgent care centers, organized primarily through the American Academy of Urgent Care Medicine (AAUCM), says Ritucci. Established in 1997, the organization serves as a “rallying call” for urgent care practitioners, similar to the way other organizations, such as the American Academy of Family Physicians, serve as a unifying body for their members, he says.

Urgent care medicine shares similarities with both family practice and emergency care, according to the AAUCM website. Ritucci describes urgent care medicine as a hybrid: “emergency medicine light or family practice fast.” Urgent care centers are “not doing life and limb treatments” or long-term cardiac care, he says, nor do they replace the primary care physician. But most urgent care centers have capabilities such as radiology and X-ray, and can manage acute medical problems and certain injuries, such as simple fractures.

Ritucci explains that one benefit of urgent care centers is the expediency with which they can care for patients. They tend to be able to process more patients per hour than a traditional family practice, through what he calls “fast tracking”: evaluating and treating the patient first, and doing the paperwork once they are taken care of.

From now into the future
AAUCM notes a surge in the presence of urgent care centers in the U.S. since 2008, which it attributes to the “public’s desire for immediate access to medical care.” Similarly, Ritucci describes a modern “McDonald’s Society” as the driver in growth: “We want what we want, when we want it.”

Because urgent care centers usually operate outside of normal business hours – and, therefore, outside of traditional doctor’s office hours – they can meet that demand. With a societal workforce that operates 24 hours a day, Ritucci says, people will come at any and every hour to seek care. “It’s just a response to the marketplace.”

Hospital systems have also entered the urgent care scene. For example, Phoenix, Ariz.-based Banner Health completed its acquisition of Urgent Care Extra’s Arizona locations in November 2016, bringing 32 urgent care centers throughout the greater Phoenix and Tucson metropolitan areas into the Banner network.

Ritucci says such acquisitions have a twofold benefit for hospital systems. The first perk is publicity: Hospital systems “get their name out there.” The second benefit, he says, is the ability to “downstream” care. In other words, once a patient enters a Banner Urgent Care facility, they can be referred to other Banner facilities for additional needed care.

In the way that small family physician practices have been acquired by larger hospital networks, he believes independent urgent care centers will continue to be acquired by hospitals.

Finally, urgent care centers could serve as a “reliever” for the predicted deficit of primary care physicians in the U.S. in the coming decade, says Ritucci. Though patients sometimes choose to bypass primary care and go straight to the emergency room, he notes that the ER is not designed for the sort of acute ailments that urgent care centers treat.

On top of that, insurance co-pays tend to be cheaper for patients at urgent care centers, and insurers pay more for hospital visits than they do for urgent care center visits. “Insurance carriers obviously want [patients] to go to the urgent care center as opposed to the hospital” because hospital costs are triple or quadruple those of urgent care centers, Ritucci says.

He believes these savings provide an incentive for urgent care centers to increase their presence in the United States. And no matter what direction American health insurance takes, he predicts that presence to grow.


Urgent care association reports patient increase
The vast majority of urgent care centers across the country met demands of an increased patient load and kept wait times very low in 2015, according to the annual Benchmarking Report from the Urgent Care Association of America (UCAOA). The report shows that 96 percent of centers saw more patients in 2015 than 2014, and 92 percent kept wait times to 30 minutes or less. The total number of urgent care centers in the U.S. jumped to 7,357 in 2016, which is a 10 percent increase over 2015. (The American Academy of Urgent Care Medicine estimates 9,300 urgent care centers in the U.S. Different research methods and definition standards between UCAOA and AAUCM account for the difference in estimates.)

“The number of urgent care centers continues to increase, and patient visits at each center are climbing, as patients seek out convenient and affordable options for their on-demand healthcare needs,” said Steve Sellars, president of UCAOA board of directors. “Nine out of 10 centers expect continued growth, and many are broadening their scope of services beyond the x-rays and strep tests they are known for, to provide patients with an increasing array of treatment options.”

The study showed that many urgent care centers now offer healthcare services such as physical therapy, travel medicine, telemedicine, in-house pharmaceutical dispensing and concussion screening. In addition, others are also extending their reach into their communities through flu immunization clinics, employer-based worksite services and health fairs.

The study validated the value of urgent care centers in caring for acute episodic illnesses and injuries. According to the survey, the most common diagnoses at urgent care centers in 2015 were acute upper respiratory infection, acute sinusitis, acute pharyngitis, cough and acute bronchitis. Eighty-five percent of surveyed centers also reported that they have implemented mechanisms to secure a primary care physician for presenting patients who are not yet affiliated with one.

(Source: PRWeb. To read the full press release, visit http://www.prweb.com/releases/2017/01/prweb13987046.htm. To learn more about UCAOA, visit http://www.ucaoa.org.)

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