Again, when something is needed, we see the primary care
physicians (PCPs) lining up against them and in states with strong
medical boards, they are being prevented from coming into existence.
I am talking about
urgent care centers (UCCs). With the shortage of
primary care physicians, the strain on most hospital emergency
departments (ED), and rising health care costs, these urgent care
centers operate as a great convenience to non-emergency cases.
Since PCPs do not have evening office hours, this only
seems reasonable that UCCs can fill a great need in caring for people not needing the
services of the ED. In addition, costs are less than the ED. The
PCPs are claiming that this is hurting their people and safety is an
issue. Some providers believe urgent care centers disrupt
coordination and continuity of care. I say to these providers, then
have practices that are open 16 hours per day, 7 days a week and
there would not be the need for UCCs.
Others believe the concerns of PCPs may be overstated, given
urgent care’s focus on episodic and simple conditions rather than
chronic and complex cases. In the future, health coverage expansions
under the national health reform may lead to greater capacity strains
on both primary and emergency care, causing even more growth of
urgent care centers. Hospitals view urgent care centers as a way to
gain patients, while health plans see opportunities of containing
costs by steering patients away from costly emergency department
visits.
UCCs are not designed to handle car accidents or resuscitate
patients at death's door, but they do treat minor injuries such as
cuts and minor fractures, as well as the ear infections and strep
throats of primary care. The Urgent Care Association of America puts
the number of UCCs at 9000, with physicians or physician groups
owning 35% of them. In addition, corporations own 30%, hospitals own
25%, and non-physician individuals or franchisors own 7%.
Rapid expansion of UCCs is often attributed to such factors as
long wait times for primary care appointments, crowded emergency
departments and patient demand for more accessible care, including
after-hours appointments. UCCs provide care on a walk-in basis,
typically during regular business hours, as well as evenings and
weekends, though not 24 hours a day. UCCs commonly treat conditions
seen in primary care practices and retail clinics, including ear
infections, strep throat and the flu, as well some minor injuries,
such as lacerations and simple fractures.
UCCs generally are not equipped to deal with trauma, provide
resuscitation or admit patients to a hospital, all reasons for
seeking ED care. UCCs are typically staffed by physicians, generally
with backgrounds in primary care or emergency medicine, and some have
nurse practitioners or physician assistants working under physician
supervision.
Patient demand for more convenient access to care reportedly has
increased, prompting renewed growth in urgent care centers.
According to a recent study, approximately 60 percent of patients
with a usual primary care physician (PCP) reported that their PCP
practices do not offer extended hours, suggesting a niche for urgent
care centers to fill.