Urgent Care Boom Changing Health System
By that time, her doctor's office had closed for the weekend. Rather than visit a hospital emergency room, they went to Wentworth-Douglass Express Care in
"We took her down there because (her injuries) didn't warrant sitting in an ER for an entire day," said Steere, 27, of
Without insurance or a primary care doctor, she wanted to be treated quickly without racking up a huge bill.
"All I needed was an antibiotic and did not wish to spend my morning in the ER getting several tests done for a simple infection," she said in an e-mail.
Walk-in health centers centers have existed in one form or another for decades, including in
But the number of urgent care centers in
There are 44 licensed urgent care centers operating across much of the Granite State, and almost one third of those have opened within the past 15 months, according to state records. These include new facilities in
More are on the way.
Most urgent care centers are open later than a typical doctor's office and are open on weekends. They can treat many serious but non-life-threatening medical conditions. The cost of going to one of these centers is usually much less than an emergency room visit.
"Generally speaking, (urgent care) is a more cost effective way to get safe care that is a middle ground between the emergency room and the primary care doctor," said Dr.
CHANGING LANDSCAPE
One is the relative shortage of primary care doctors across the U.S. and parts of
"We're seeing an increase in demand for primary care services and an inadequate supply of people doing it, and the marketplace is responding," Helms said.
"A lot of places are now opening up, and they understand there are people with medical needs who have resources they didn't have before."
Cost is another factor.
While more people are now insured, many plans require consumers to pay a larger share of medical costs. The average health insurance deductable in
With some high-deductable plans, an ER visit for something minor, such as strep throat, could cost about
"Urgent care centers are providing a good solution for people that are looking for quality, convenient care at an affordable price," said Puyanic, whose company operates five centers in
Changing consumer preferences are also a factor.
Not everyone can leave work early to take a sick child to the doctor or seek treatment for a nagging cough. Most urgent care centers stay open late six or seven days a week. They also try to register, treat and release patients within an hour.
OUTSIDE MONEY
It's not a coincidence that a few large urgent care companies are expanding rapidly across the state. According to
"The urgent care centers that have historically been in
"Like any entrepreneur, these private operators look at factors like demographics, traffic count, population density and very much use retail decision making in determining where they place centers," he said.
In other words, locations that make sense for a
Urgent care centers are a low-margin business that need a lot of patients to cover rent, marketing, employee pay and supplies. But once that threshold is met, every patient that walks in the door contributes to the bottom line.
With so much expansion and a fixed number of potential patients, some urgent care centers won't survive. As a result, customer service is just as important as quick service at the facilities.
"The truth is that all facilities will not be successful," Puyanic said. "Some facilities that open will not make it. We think ultimately the facilities that provide the highest quality care and the best experiences at the lowest cost will survive and others won't."
HIGH STANDARDS
Urgent care centers are not intended to replace primary care doctors for sickness prevention, general well-being or regular treatment of serious illnesses. But for "episodic" injuries that require treatment within a day or two, there is no evidence urgent care centers provide lower quality care than a doctor's office or emergency room.
"I have not seen anything that says if you hit your thumb with a hammer and want to get seen and taken care of ... that the care is going to suffer because of the nature of the organization you are walking into," said Helms of the UNH health policy center.
Steere was pleased with the care received during her family's recent visit to the
"We weren't just stuck in a room and someone came running in and running out," she said, adding that they were in and out in about 90 minutes.
Hewitt, who has used local urgent care centers several times, has had nothing but positive experiences. Her most recent visit in December, for a sinus infection, typified that.
She was seen within 10 minutes and treated by a doctor who confirmed the diagnosis and wrote her a prescription.
"I was in and out within a half-hour," she said, "and my bill only came to
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