Are Urgent Care Centers the Future of Primary Care?

This week the Chicago Tribune examined the growing trend of urgent care centers and concluded that, for many, they are preferred over primary care physicians. According to the Tribune:

Urgent care centers have been gaining ground in Illinois and across the country recently as an attractive medical option for time-pressed families trying to avoid spending hours in a hospital ER or days waiting for a doctor's appointment.

Sometimes known as “docs in a box,” the centers offer walk-in medical services and extended hours to customers with sore throats, ear infections, sprained or fractured limbs, simple wounds and other non-life-threatening medical problems. Doctors provide the care, assisted by nurses, and generally X-ray and laboratory services are available. Most centers are open 365 days a year, and insurance policies cover most services.

This convenience-oriented format, started more than 20 years ago, is getting a boost as hospitals and private firms build new centers, responding in part to new competition from retail clinics in Walgreens, CVS and Wal-Mart stores.

For patients, the centers offer easy access and affordable care, charging a fraction of what services would cost in an emergency room. Many insurers, keen to keep costs down, have begun encouraging people to use urgent care as an alternative to ERs in the evenings or weekends when their doctors' offices are closed.

That puts the onus on patients to evaluate their symptoms and recognize what level of care they need, said Dr. Sandra Schneider, an emergency-department physician at the University of Rochester Medical Center in New York and a vice president of the American College of Emergency Physicians.
…

For some consumers, urgent-care centers are usurping primary care physicians -- a trend some medical experts view with alarm. Pina Lobraco, a mother of two young girls who lives in Addison, said she finds it easier to pop into a nearby Alexian Brothers Hospital Network immediate-care center than to call her doctor and wait to get an appointment.

On Mother's Day, Lobraco was at the center with Daniella, 4, who had started crying and holding her ear earlier in the day. “I don't know why it is, but a lot of times it seems [the girls] get sick in the evening or early in the morning or on the weekends,” she said.

“My regular doctor doesn't know who I am,” Lobraco said later in an interview. “But these people [at the center] know me -- they see me all the time.”

Granted, this anecdote from Ms. Lobraco and others in the Tribune article don’t constitute quantitative evidence, but they do represent the preferences of busy people who aren’t being adequately served by traditional care delivery models. Especially alarming is that Ms. Lobraco has a better relationship with the staff at the urgent care center than with her regular doctor.

With shortages of primary care physicians throughout the country and appointment wait times increasing, will urgent care centers and other walk-in clinics replace primary care physicians as consumers’ first choice for care? And how will this impact the continuum of care? Can primary care doctors tailor their services and hours to offer comparable convenience? In fact, several newspapers, including Minneapolis Star-Tribune and the Washington Post, have been reporting recently that there is a growing number of doctors performing house calls in cities across the nation.

Comments

[Daminen]

The fact is primary care physicians (family practice) are underpaid and overworked. Many people think these physicians make alot of money, yet they are at the bottom pole when it comes to physicians. After you figure their malpractice insurance, reinbursments from medicare/medicaid, and overhead expenses it's generally less than 20 bucks an hour. With that said - every year less MD's are entering the "family practice" field and usually choosing a specialty field.

What many patients don't know is that an Internist is a grade higher than a Family Practice physician and are also considered primary care providers.

Daminen

[Chris the Medical Instrument Sales Guy]

Simply stated - Urgent Care Centers offer convenience and that is what Americans want...

I'll never forget the pricing study that they used to teach in business class about "popcorn".

At Big Box grocery store - $0.99 per lb
At small grocery in microwave bag - $2.99 box
At gas station in microwave bag - $4.95 box
At movie theater - $8.00 a bag

Each time you dropped the volume of popcorn that you purchased but the price jumped drastically.

Why do people do it even if it is so obvious - convenience and service!

The medical industry is no different - convenience and service will always win...