Care centers

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Overview

The initial urgent care centers opened in the 1970s. Since then this sector of the healthcare industry has rapidly expanded to an approximately 17,000 centers. Many of these centers have been started by entrepreneurial physicians who have responded to the public need for convenient access to unscheduled medical care. Other centers have been opened by hospital systems, seeking to attract patients. Much of the growth of these centers has been fueled by the significant savings that urgent care centers provide over the care in a hospital emergency department.

Many managed care organizations (MCOs) now encourage their customers to utilize the urgent care option.

Other ambulatory healthcare facilities

Urgent care centers are distinguished from other similar types of ambulatory healthcare centers.

Emergency departments

Emergency departments are located within hospitals and are prepared to care for patients suffering true emergencies, such as myocardial infarctions ("heart attacks"), serious motor vehicle accidents, suicide attempts, and other such life-threatening conditions. Being located within a hospital, these centers are positioned to provide ready access to major surgeries and critical care units. Emergency departments are usually staffed by physicians with specialized training or board certification in emergency medicine. Most states in the USA require all hospitals to house an emergency department within the hospital building. A few states in the USA allow freestanding emergency departments to be built outside of a hospital building. Many authorities would consider this type of facility to be a high-acuity urgent care center, rather than a true emergency department.

Primary care offices with extended hours

Many primary care offices are open for some hours in the evenings and weekends. However, unless these centers are open for walk-in patients at all times when open for patients, offer on-site x-ray facilities, and care for most simple fractures and lacerations--these primary care physician offices are not considered to be true urgent care centers.

Walk-in primary care offices

Allowing walk-in patients is not a sufficient criterion to define a physician office as an urgent care. If the office does not offer the expanded services and significant after-hours care, then the physician office would not fit the definition of an urgent care center.

Mid-level provider offices in retail stores

In 2000, medical treatment began to be offered at small offices in retail stores with onsite pharmacies. These centers are generally staffed with nurse practitioners or physician assistants. Prices are generally posted in public view and patients can do shopping while waiting. Some experts consider these medical treatment sites to be the wave of the future in light of consumer driven health plans such as Health Savings Accounts. These retail clinics are not true urgent care centers, because of the limited level of care that can be provided without a physician nor x-ray facilities on site. Concerns about conflict of interest and incentives to over-prescribe medications in a facility rented from a pharmacy have yet to be fully addressed by organized medicine or governmental agencies.

Organized medicine and urgent care

The Urgent Care Association of America (UCAOA) holds an annual spring convention and, also, offers an annual fall conference. The American Academy of Urgent Care Medicine (AAUCM), also, holds an annual convention. Many leaders in organized urgent care medicine anticipate the full establishment of urgent care as a fully-recognized specialty.

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