Physicians Find Opportunities in Growth of Urgent Care Centers

“I’m not sure if a lot of the phenomenality of [the growth] is due to recognition more than explosive, exponential growth,” says Lou Ellen Horwitz, executive director of the Chicago-based Urgent Care Association of America. “Definitely, there is growth. We probably see a new one opening up every week. But prior to people paying attention, there may have been one opening every other week, but it wasn’t on the radar.”

There’s no denying the growth of urgent care centers. A more appropriate consideration might be, just how explosive has that growth been?

“I’m not sure if a lot of the phenomenality of [the growth] is due to recognition more than explosive, exponential growth,” says Lou Ellen Horwitz, executive director of the Chicago-based Urgent Care Association of America. “Definitely, there is growth. We probably see a new one opening up every week. But prior to people paying attention, there may have been one opening every other week, but it wasn’t on the radar.”

Well, it’s on the radar now, with estimates in early 2008 of some 8,000 urgent care centers operating in the United States. Physicians—as owners, investors or employees—are taking notice.

The growth spurt

Horwitz says the reason for the growth of urgent care centers is three-fold. The first is patient-driven, with healthcare consumers more aware of urgent care as a viable option. Second is the attention being drawn to the overcrowding of emergency departments, which is prompting payors to incentivize their members to use urgent care instead. And third, perhaps as a domino effect from the first two scenarios, physicians are either switching their practice to urgent care or purchasing urgent care centers.

“The biggest aspect of urgent care is accessibility to care on a broad scope,” says Horwitz.

John Frana, president of The Frana Group, a healthcare consulting company that works with clinics and community health centers nationwide, echoes those thoughts. He points out that in 2006, emergency room visits increased by 5 million. “And that’s in the face of emergency rooms closing,” says Frana, adding that about 14 percent of emergency room visits are essentially routine primary care visits. “It’s clear that these urgent care clinics are going to continue to grow and become an increasing access point. So, for physicians in private practice, from the standpoint of a potential way to improve your bottom line, particularly if you’re having trouble getting patients into your own practice, there are opportunities.”

Relationship building

One of the negative connotations being attached to urgent care centers is that they don’t foster the kind of doctor-patient relationship that a primary care physician practice would. Horwitz agrees, saying, “They’re not intended to do so.” But she adds that urgent care centers are building relationships on a different level.

“The primary care physician is in touch with your medical history from day one, and monitors all of your health issues that are integrated in every aspect of your care,” says Horwitz. “The urgent care center is not going to do that. But, they definitely want to build a relationship with the patient who’s there because they stepped on a nail, or their child has a sore throat on Saturday night, so that the next time that patient steps on a nail, they’ll come back to the center. They also believe the patient should have a medical home to go to for their regular care.”

Michigan-based St. Joseph Mercy Oakland Hospital, which has opened several urgent care facilities in the last 6 months, understands the importance of the doctor-patient relationship and the relationship between physicians and urgent care centers. The hospital’s focus is collaboration, not competition.

“We have a large cadre of private practice physicians in the communities where we’ve opened urgent care centers,” explains hospital CEO Jack Weiner. “We want those physicians to be secure in the knowledge that if they phone and refer a patient to us at 10 p.m., that they will get a report first thing in the morning so that they can follow up with that patient. They’re not going to lose that patient.”

Urgent care opportunities

Weiner says that many private practice physicians are taking shifts after hours in some of the hospital’s urgent care centers, and he understands why independent physician groups would open or invest in urgent care facilities. “As you extend hours, it becomes attractive for a different group of patients than [the physicians] might have been seeing in their offices. It allows them to balance their patient mix.”

Echoes Frana, “Most physicians practice out of a single geographic site. If the physician’s office is 30 minutes or more from a patient’s home, and there’s an urgent care clinic 10 minutes away, [the patient is] going to go to the clinic. So, if you don’t have a way to offer care to your patients at a reasonable cost to keep them in your system, you’re going to lose a lot of patients.”

Before you run and invest in or open an urgent care center, keep Horwitz’s words of caution in mind. “[Opening an urgent care center is] not unlike opening a practice. You need to be a good business person as well.” The same way a physician’s practice is like a small business, so is an urgent care center. “And probably more complex,” Horwitz adds.

Ed Rabinowitz is a veteran healthcare reporter and writer. He welcomes comments at edwardr@frontiernet.net.