Urgent Care Centers Thrive As Potential Solution to Physician Crunch

Urgent Care Centers Thrive As Potential Solution to Physician Crunch

UCCs as Alternatives to Primary Care 

Across the U.S. shortages of both general practice and specialist physicians are resulting in patients waiting long times to receive the treatment they need. Only about 30% of all physicians practice primary care, compared to the 70% practicing in most other developed countries and the 70% that practiced in the U.S. 50 years ago. A booming global population means such shortages will only increase, and are likely to reach 90,000 by 2025, according to the Association of American Medical Colleges. Solutions to the problem are complex, but multi-pronged answers are being developed so as to allow for an urgent care center (UCC) expansion.

It is for this reason that the urgent care market is expected to prosper near-term.  How many UCCs are in the U.S.? Nearly 10,000 as of 2017.  Patients may walk into urgent care centers during  extended hours if their illness or injury is acute, and are given treatment beyond the scope of most primary care practices. While strong support continues to drive UCC expansion in the U.S., delays to treatment and long waiting times are increasing as the supply of general practice and specialist physicians in the U.S. dwindles. In its recently published report, The U.S. Market for Urgent Care Centers (Clinic Locations and Growth, Revenues by Procedure, Diagnostic and vaccine Sales to Clinics, Operator Profiles), Kalorama Information analyzes how urgent care centers address physician labor shortages in the health care industry.

UCCs' history dates back before many modern health care facilities. Emerging in the 1970s, urgent care centers met the needs of rising health care costs and consumers seeking a more convenient health care experience. Some hospital systems began endorsing UCCs to reduce demand on emergency rooms. And while on occasion entrepreneurial physicians will start up a UCC as a means to expand their income and meet the market need, overall UCCs are an established segment of the public health care industry. Most UCC users have a physician, but according to a recent Kalorama survey of urgent care customers, many are likely (70%) to visit a UCC location more than once in a given year. There remains overall a very high rate of customer satisfaction with urgent care centers; according to the same Kalorama survey of UCC customers, almost all (94%) of patients said they were satisfied with urgent care service. Among the reasons for urgent care center success is the decline in primary care physicians and specialists.  Standalone emergency rooms, or Standalone ERs, an attempt of the hospital industry to mimic urgent care business model, but at higher fees, are also a challenge.

Innovations to delivery and technology in the urgent care industry will be crucial to the efficiency of treatment urgent care centers offer, making it easier for them to provide dedicated services in a centralized location. Also important will be increased federal support for residency training and more efficient use of a UCC’s health care professionals, which is the urgent care center’s primary answer to the dwindling physician population. As they grow more sophisticated and better-funded, urgent care centers hope to draw in physicians who see UCCs as attractive alternatives to working in primary care.   

Challenges to the UCC Business Model

The UCC's business model is not without its problems. Tech innovations, increased federal funding, and improving a team’s health professionals are only parts of a complex plan, and they will take time to implement. It will also take time for urgent care centers to build their team base, because of a likely limited supply of physicians in the near future. Physician education encompasses four years of undergraduate education, another four years of medical school, and finally another three to five years of residency. Quickly producing more physicians with six to ten years of after-college training is not an option.

 Urgent care centers’ qualified medical teams include nurse practitioners, physician assistants, and other non-physician staff besides just physicians. While physicians’ education is more complex, most nurse practitioners have completed extensive medical training and are adept at addressing even complicated medical concerns, and sometimes find treating minor illnesses in the urgent care setting intellectually unrewarding.

Sleep schedules often challenge urgent care center workers -- the Urgent Care Association reports 71% of UCC clinicians average only 6 to 7 hours of sleep a night. Of these urgent care center workers, almost 90% believe there should be sleep or work-hour guidelines for UCC staff to promote team performance and as compulsory to well-being.

 Possibly the biggest grievance voiced by UCC workers is their comparatively low compensation, as UCC chains need to contain costs after charging low prices for their health care services. Some urgent care centers attempt to recruit nurse practitioners and physician assistants at lower salary levels in exchange for various benefits like flexible working schedules, but this often proves unsuccessful since professionals increasingly consider themselves deserving of higher compensation rates closer to those offered to physicians. Many UCCs provide much lower rates, and according to a recent survey from the Urgent Care Association of America, pay on average just $70-80 per hour for physicians, $51-$60, per hour for physician assistants, and $56-60 for nurse practitioners.   

 Challenges to UCC expansion notwithstanding, the health care industry is taking steps to showcase urgent care centers as attractive career options for budding physicians. As UCC infrastructure advances, physicians will hopefully see in urgent care centers compelling reasons to offer their health care services. In 2006 The Urgent Care Association of America (UCAOA) sponsored the first fellowship training program in urgent care medicine. The program is in collaboration between the department of Family Medicine University Hospitals of Cleveland/ Case School of Medicine, the UCAOA, and University Primary and Specialty Care practices, Inc. and is partially funded by a grant from the UCAOA. Physicians receive training in many disciplines and learn urgent care center procedures and business operations. A second fellowship opportunity through the University of Illinois was sponsored in 2007, open to graduates of accredited Family Medicine and Med/Peds residences. Other promotional and lobbying efforts, like Urgent Care Awareness Month wherein many UCCs hold health fairs and issue news releases, help raise public awareness of urgent care centers and, ultimately, draw back in badly needed physicians.

  Kalorama Information’s detailed report - The U.S. Market for Urgent Care Centers (Clinic Locations and Growth, Revenues by Procedure, Diagnostic and vaccine Sales to Clinics, Operator Profiles) contains market segment breakouts, supplier sales estimates and other statistics.