The rise of Fast Medicine: Urgent care clinics offer benefits for patients and physicians, and some drawbacks.

Dawn Ouellette Nixon//November 1, 2019

The rise of Fast Medicine: Urgent care clinics offer benefits for patients and physicians, and some drawbacks.

Dawn Ouellette Nixon//November 1, 2019

Two years ago my daughter Annabelle, then 10, came down with a high fever and sore throat. She was fading in and out of sleep, and I was getting worried. Because she was so sick, I chose to take her to the walk-in urgent care center near our home, rather than her pediatrician, which was further away.

I just wanted Belle to be seen as fast as possible.

Sure enough, right after signing in at the urgent care, Annabelle was ushered in to see a doctor. She was quickly given tests on-site that determined she was dealing with both the flu and strep throat. A double whammy for my poor girl.

After a speedy visit, we were sent on our way with the doctor’s sympathies, a prescription for antibiotics and a note for school. I promptly brought Annabelle back home to bed where she spent a two weeks recovering.

I was glad to be able to take advantage of the convenience of the urgent care clinic. We didn’t have to spend hours in an emergency room waiting room, and we didn’t have to wait for her primary care doctor to call back with test results.

We got quality care, quickly, as advertised.

My daughter and I are reflective of the growing number of health care consumers who are turning to urgent care centers rather than traditional primary care offices in recent years.

Patients are rushing to these urgent care centers, which offer medical care for minor emergencies and illnesses at a fraction of the cost of the traditional emergency room. In addition, these walk-in clinics often offer convenient access to tests and services not available at most primary care offices.

In fact, the utilization of non-emergency acute-care centers increased 140 percent between 2008 and 2015, according to research published in the Oct. 2018 issue of the Journal of the American Medical Association for Internal Medicine.

There are many reasons for this increase, including changing attitudes about primary care and primary care physicians, and new strategies put in place by the big health care networks.

“Many Americans, particularly millennials, don’t have a primary care physician anymore,” says Robert McDonald, professor of health care systems engineering at Lehigh University.  “They don’t have any on-going relationship with any physician. They just want on-demand health care. They look for convenience and efficiency, and that’s what urgent care offers.”

‘Culturally intolerable’

For millennials, certain trademarks of care at a traditional primary care physician’s office, such as filling out pages of forms and waiting for appointments or test results, are “culturally intolerable,” he said.

Robert McDonald, professor of health care systems engineering, Lehigh University – submitted

Millennials have grown up in a world of on-demand convenience and they want the same from their health care.

Today’s primary-care physicians have changing needs too, Mcdonald said. They don’t want to be bogged down with the demands of running a business. And as an employee with an urgent care network, a doctor can concentrate solely on practicing medicine.

“They didn’t go to medical school to run a business,” McDonald says. “For a physician, working for an urgent care can be a nice employment alternative.”

The big health care networks are responding by opening their own walk-in centers in multiple locations.

“It’s become part of the horizontal integration strategy of the health networks,” McDonald said. “It is a way to integrate into the market, so that their urgent care docs can refer patients to the health care network’s specialists in a form of system integration. It’s a business relationship.”

Despite the many reasons behind the trend, McDonald doesn’t see traditional primary care offices disappearing completely, not for a while anyway.

“Some physicians simply like the independence of their own practice,” he says. “These tend to be older physicians however. The doctors coming out of medical school today are very different. The new graduates are the ones more likely to join up with a network.”

Work/life balance

One such physician is Dr. Olga Vinshtok, regional medical director for Patient First, an urgent care network with offices throughout the Lehigh Valley. She chose to work at an urgent care center because for her, it offered a better work/life balance than other employment options.

Vinshtok is able to have select weekends and weekdays off, she says, allowing her to take care of her family’s needs, like going to the bank, the dentist, or on a field trip with a child.

“There is a great deal of flexibility,” she says. “The other major benefit to working at Patient First is that you do not have to take work home with you. Once your shift is over, your work is over.”

Vinshtok also values the compensation, benefits, and fast-paced atmosphere.

“I have the opportunity to treat a variety of conditions on a daily basis,” she says. “You never know what might walk through the door.”

Vinshtok attributes the growth in urgent care facilities to the gap the centers fill between a traditional doctor’s office and the ER. She also thinks patients appreciate the convenience of extended hours, walk-in access and the wide range of on-site services, such as on-site prescriptions, which can save a patient an extra trip to the pharmacy. And with a range of services and staff under one roof, patients can often receive complete care in one visit, she says.

Not for everyone

Urgent care centers aren’t a good match for every doctor or health care consumer, though. For physicians like Dr. Jeffrey Zlotnick, a family medicine physician based in Reading who once worked for an urgent care center, urgent care practices are a “mixed bag for physicians.”

Dr. Jeffrey Zlotnick, doctor of family medicine, based in Reading, Pa – submitted

“I sort of felt like I was losing my skills when I was working there,” he says. “It’s all about quickness, in/out. Some people like that. I don’t. …A doctor who values spending time with patients could feel stressed and like he or she is falling behind.”

Zlotnick sees the same mixed bag for consumers. Urgent care offices do a good job with what they are designed for, which is providing quick medical care for minor emergencies and illnesses, but they aren’t designed for building a relationship between doctor and patient.

“Complex problems can be missed,” he says. “I’ve seen it happen.”

Consumers need to understand what urgent cares can and cannot do, he said. In his opinion, if the diagnosis is complicated it’s best to sit down with someone who has the time to go over everything.

In time traditional primary care offices will regain popularity when patients, once again, desire a personal relationship with their physician, Zlotnick said.

“Patients are going to search for that connection again,” he says. “Health care trends may wax and wane but personal connection will never go out of style.”