Emergency vs. Urgent Care

 

Overcrowded ERs, along with lengthy waits and the perception that the cost of the care received is not commensurate with the services rendered, is forcing the market to reconfigure the distribution and delivery of these and other services. Examples include the development of ambulatory care facilities, imaging centers, “surgicenters,” and – more recently – urgent care centers. The latter is now said to be the fasted growing healthcare sector.

 

Dissatisfaction with the status quo is creating opportunities for Physicians, entrepreneurs, and other entities that are now entering this market that was previously controlled almost exclusively by hospitals. And the expediency, convenience, and cost containment afforded by urgent care centers have led to increased support from the public, the medical community, and third party payers.

 

The overall cost of an urgent care visit is one-third to one fourth that of a similar service provided in the ER setting where a facility charge and an expensive cost structure exist.

 

The National Association for Ambulatory Urgent Care (NAFAC) defines urgent care medicine as a growing discipline specializing in the treatment of diseases, illnesses, or injuries that occur in otherwise healthy populations; resolve within 10-14 days; and can be safely and definitively treated in an ambulatory care setting.

 

Urgent care facilities should not be confused with traditional primary care practices that open a few hours in the morning, a few hours in the evening, and a few hours on Saturday and Sunday. These facilities offer extended office hours for the convenience of their patients but continue to provide primary care, albeit “fragmented”. They continue to practice traditional office-based medicine and compete with primary care physicians for the same patients. Furthermore, since most offer no specialized services, they provide no real alternative to the hospital emergency room.

 

Urgent care facilities, in contrast, routinely provide in-house x-ray, laboratory services, and procedure rooms equipped to monitor patients undergoing a variety of treatments such as laceration repair, line placement, fracture care, and/or conscious sedation. Among other services within the scope of urgent care are industrial medicine, workers compensation and pre-placement services. 

 

Unlike office-based practices, urgent care facilities provide services 365 days per year, 10-13 hours per day including weekends and holidays.

 

True urgent care facilities are walk-in centers where appointments are not required, and care is rendered without the long waits characteristic of hospital emergency rooms. The conditions, illnesses, and injuries encountered in urgent care centers are seldom incapacitating and can be classified as minor, but these patients require immediate treatment. In the hospital emergency room these patients must compete with those afflicted by more severe injuries or illnesses, and during the peak hours, may be forced to wait in excess of four to five hours to be seen. Like hospital emergency rooms, however, urgent care facilities triage patients and may provide care out of sequence with presentation, based on the acuity of their problems.

 

By definition urgent care requires only limited follow-up and excludes the longitudinal care of patients’ problems. The laws governing these practices vary from state to state. Also, because urgent care centers seldom have established primary care patients, they use an abbreviated event record that identifies the specific problem and the focused care provided instead of the traditional medical record. 

 

Urgent Care facilities do not compete, but complement the services provided by primary care Physicians whom ultimately remain in charge of the longitudinal care given their patients.