Can the urgent care business model survive?

Urgent Care isn’t really taking business away from Emergency Rooms, they’re actually helping Emergency Departments run more efficiently — Dr. Nicole Berwald

If you suffered from the flu this winter or recently sprained an ankle, odds are you’ve visited one of dozens of Urgent Care Centers that have recently cropped up in almost every corner of our borough. The rapidly expanding segment of the healthcare industry, which has become an integral facet of medicine over the past five years nationally, accounting for more than $18 billion of the U.S.’s medical expenses, has changed the face of healthcare delivery and alleviated a lot of undue pressure from overcrowded Emergency Rooms.

But one question still remains: Is there enough demand for this business model to successfully exist?

“In recent years, Urgent Care Centers have been popping up almost everywhere,” reported Dr. Nicole Berwald, chair of the Emergency Department at Staten Island University Hospital who said that primary care doctors are most affected by this change. “They serve as another venue for patients to receive care but mostly appear to be giving competition to primary care physicians, not the ER.”

That’s because there’s only so much an Urgi Care Center can handle, Dr. Berwald explained.

Have a sore throat or an earache? An asthma attack or minor cut? An Urgent Care facility, which is usually staffed by one doctor and several physician’s assistants, can handle it. Severe bleeding, burns, head injury or suspected poisoning? Head directly to the ER.

“It really depends on the patient’s needs,” Dr. Berwald said. “But Urgent Care isn’t really taking business away from Emergency Rooms, they’re actually helping Emergency Departments run more efficiently. Primary physicians are really the ones who may be feeling a little opposition.” The Emergency Room alternative does have its benefits: Convenient hours, almost zero waiting time and a no-appointment- necessary policy. All reasons why many patients are opting to bypass their traditional primary care office visits in favor of this newer, quicker method.

“Urgicare is basically a model of primary care,” Dr. Berwald said. “And because of their walk-in policies and wide range of availability – there are several in almost every neighborhood – patients are opting to pay a higher co-pay simply out of convenience.” Northwell Health, of which SIUH is a member hospital, is a participant in the Urgent Care surge: The Healthcare system partnered with GoHealth in 2014 and currently operates five Urgent Care Facilities on the Island.

“We partner with leading health systems that have the finest networks of physicians and clinicians,” GoHealth said in a statement. “From general wellness visits to lab services and x-rays, we offer a wide range of healthcare services. And if you do need to see a specialist, we’re happy to refer you to providers we trust. With so many services available, there are few reasons you’ll need to go anywhere else.”

Richmond University Medical Center also maintains three primary walk-in/immediate care centers in the borough, one on Forest Avenue and two other locations on Hylan and Victory Boulevards. Each site is open six days a week and offers services such as bloodwork, vaccinations, wellness visits and x-rays.

CityMD, a chain of walk-in medical clinics founded by four ER doctors in 2010 as an alternative to “primary care physicians booked weeks in advance and expensive, crowded emergency rooms with long wait times,” has over 100 locations throughout the country, two of which are in Staten Island. ProHEALTH Circle Urgent Care, which, according to its website was “designed to address the lack of access to convenient, efficient, high quality healthcare for people in Staten Island,” has three locations in the borough and there are several privately owned Urgent Care centers on both the North and South shores.

And the Urgent Care Association of America, which recently published a white paper on the essential role of Urgent Care in society, says the industry is only predicted to grow.

Citing a $4.4 billion annual cost savings for hospitals that no longer have to deal with non-life-threatening injuries, and an opportunity to improve the population’s health with more screening opportunities and appropriate care in appropriate settings, the organization says the Urgent Care model is basically smart business.

“Access to healthcare is a key contributor to the growth and success of urgent care medicine in our communities,” the report said. “One of the important consumer- centric values is convenience for patients. Convenience in locations of urgent care centers, convenience in hours of availability and convenience in breadth of services offered. Most urgent care centers offer a one-stop-shop environment from the scope of practice, offering pediatric to geriatric evaluations, to on-site diagnostics including imaging and laboratory.

Many also dispense pre-packaged medications, allowing patients immediate access to dozens of routine medications without having to visit a 24-hour off-site pharmacy or wait for the next day to receive necessary medical treatment. Urgent care centers are structured, staffed and equipped for optimal efficiency and patient flow – very different from the typical primary care, specialty care, retail care and emergency care services.”

The Association also reported that urgent care medicine will continue to play a key role in accessing healthcare as the delivery system evolves.

“There is increasing focus and pressure to reduce hospital re-admissions and now primary care clinicians can partner with Urgent Care Centers to evaluate discharged patients before emergent issues arise which would require readmission,” the report concluded. “Patients no longer having to wait over nights, weekends and holidays to connect with medical providers that will evaluate and recommend treatment after communicating with busy, overburdened or physically unavailable primary care clinicians.”— SIBT