Services Provided by Urgent Care Centers vs. Emergency Rooms

If you need medical care, the first decision you have to make centers on urgency: how quickly is a doctor needed? If a situation is life-threatening, the decision is clear cut: someone calls 911 and provides immediate first aid. However, most of time you won’t have a life-or-death situation to consider, so the process of deciding which type of medical provider to approach requires some deliberation. Urgent care centers offer a useful option, giving you immediate access to medical care, but without the massive life-saving infrastructure that constitutes hospital emergency care. Learn about urgent care centers so that you can take advantage of the full range of medical care options available to you.

How Did Urgent Care Centers Get Started?
Back in the 1970s, physicians began to respond to a gap that had developed in healthcare delivery. Medical practices had entered the modern era, and family doctors no longer made after-hours house calls. Emergency rooms were becoming overcrowded with non-emergency problems, simply because some patients needed immediate attention. A baby with an ear infection on a Friday night, for example, could not safely wait for treatment until the pediatrician’s office opened the following Monday morning. On the other hand, it was inefficient to use the massive life-saving resources of a hospital emergency room for common-place situations that simply required an antibiotic prescription.
A number of free-standing acute care clinics were opened during the 1970s and 1980s, but they encountered resistance from established health care systems. Nick-named “doc in a box,” these independent centers flourished for a few years and then decreased in number. Hospitals responded by expanding their emergency room services, and it appeared for a time that the urgent care concept was not sustainable.
The essential efficiency of urgent care centers eventually won the day, as the health care delivery landscape underwent revolutionary change in the 21st century. Employers became stakeholders in the drive to develop cost-effective health care options, and urgent care centers were soon firmly established as a valuable channel for health care delivery. “That number [of urgent care centers] is rapidly growing. There really has been an explosion,” states Margaret Simat, secretary of the Northeast Regional Urgent Care Association.

What Services Do Urgent Care Centers Offer?
Ninety percent of all services provided by urgent care centers are “episodic and acute,” according to the National Association for Ambulatory Care (NAFAC). This statistic aligns with the definition of urgent care medicine, which NAFAC states as “the treatment of any disease, illness, and injury, which is presented by otherwise healthy consumers.”
Healthy people have episodes of acute medical need, which do not constitute life-threatening emergencies. NAFAC characterizes these as typically consisting of “minor lacerations, fractures, bumps, sore throats, ear infections, and other ‘just don’t feel good’ conditions.” All urgent care centers include basic radiology services, providing chest exams and identification of fractures. Ninety-eight percent of these centers also have a laboratory, which conducts routine blood tests and other basic lab procedures. In addition to providing care for acute medical conditions, urgent care centers have also stepped in to fill another gap: employment-related examinations. Most urgent care centers offer pre-employment physical exams and physical therapy related to Workmen’s Compensation case management.

A Matter of Timing
In many cases, deciding whether to go to an urgent care center is simply a question of timing. Since these centers nearly all stay open seven days a week, some for up to 20 hours a day, they are usually accessible when regular doctors’ offices are closed. Urgent care centers see patients on a walk-in basis, making them a faster option than physicians’ offices even during weekdays. The rapid growth of urgent care centers nationwide is partly due to the long waits for appointments at the offices of primary care providers, according to the National Institutes for Health (NIH).

Decreasing Unnecessary Emergency Room Use
For true trauma care, there is no substitute for an emergency room. If you try to use an urgent care center for a complex or dangerous condition, they will immediately transfer you to the nearest emergency room and you will simply delay treatment. However, the capability of urgent care centers to handle minor wounds and fractures has resulted in a decrease of non-essential uses of hospital emergency rooms, according to the NIH report. This shift in resource usage has numerous benefits:

• Patients with simple medical problems don’t end up waiting for many hours in a hospital emergency room.

• Patient bills from an urgent care center average about one-third to one-tenth the cost of an emergency room visit.

• Emergency room staff members are freed up to provide care to patients with serious trauma.

• Primary care physicians receive full medical reports from the urgent care center, and they are able to follow up as needed with the patient.

• Insurers are receptive to billing urgent care centers because of the efficiency of care provided by them. Ninety-five percent of urgent care centers accept patients from managed care programs and private insurers.

As new certification and training standards for urgent care medicine are established, this new specialty is becoming “more of a career choice” for many family practitioners. Clearly the continued growth in urgent care centers represents a real step forward toward better health care access for every medical consumer.

SOURCES: 
1. Sean McNeeley, MD. “Urgent Care Centers: An Overview.” American Journal of Clinical Medicine. Summer 2012. Volume 9. Number 2. https://www.aapsus.org/wp-content/uploads/ucc80.pdf
2. Ridgely Ochs. “Urgent Care Centers Booming on LI.” Newsday. September 27, 2014. https://www.newsday.com/news/health/urgent-care-centers-booming-on-li-1.9425769
3. “About NAFAC.” National Association for Ambulatory Care. n.d. https://www.urgentcare.org/aboutNAFAC/tabid/131/default.aspx
4. Robin M. Weinick, Steffanie J. Bristol, Catherine M. DesRoches. “Urgent Care Centers in the U.S.: Findings From a National Survey.” BioMed Central Health Services Research. May 15, 2009. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2685126/