Urgent Care

Definition of Urgent Care: Urgent care is defined as the delivery of ambulatory medical care outside of a hospital emergency department on a walk-in basis without a scheduled appointment.

Scope of Urgent Care: Urgent care centers treat many problems that can be seen in a primary care physician's office, but urgent care centers offer some services that are generally not available in primary care physician offices, for example: X-Ray facilities allow for treatment of minor fractures and foreign bodies, such as nail gun injuries.

Minor trauma rooms facilitate repair of minor and moderate-severity lacerations so they can be treated in an urgent care center.

Value of Urgent Care: Urgent care centers provide significant savings to patients and insurers over the alternative of hospital emergency departments for episodic care that can not be delayed until an appointment at a physician office is available.

Convenience of Urgent Care: According to the Centers for Disease Control (CDC), patient visits to hospital emergency departments currently average 3.2 hours (emergency department overcrowding). Many of the problems currently treated in hospital emergency departments, however, can receive timely treatment in less than one hour in an urgent care center.

Urgent Care Hours: Most urgent care centers offer extended hours in evenings and on weekends for patients to receive treatment when their personal physician is not available.

Appropriateness: The CDC has reported that approximately 40% of visits to hospital emergency departments are for non-urgent or semi-urgent problems (many ED visits more appropriate to urgent care). These problems aggravate the overcrowded emergency departments of the country, and many would be better treated in an urgent care center.

Industry Growth: With the first urgent care centers opening about 20 years ago the industry has seen rapid growth, with multiple urgent care centers serving most communities in America.

Compliment to Primary Care: By definition urgent care centers function as overflow valves for the public, when timely appointments to a primary care physician office are not available or after regular office hours when patients needing immediate attention would otherwise be diverted to a hospital emergency department.

Future Developments

Training: Fellowship and residency training is much needed for the rapidly growing specialty of urgent care medicine. The Urgent Care Association sponsors the development of university-sponsored fellowships for physicians who are board-certified or board-eligible in a primary care specialty. To learn more, visit our Fellowship section.

Urgent Care Board Exam Certification: The Urgent Care Association of America is committed to developing urgent care medicine as the twenty-fifth ABMS-recognized specialty in America with a full-fledged board certification process.

Coding: Urgent care centers do not "establish" patients as do primary care physicians with complete intake history and physical exams. In hospital emergency departments new and established patients are not differentiated, because patients are seen on an episodic basis rather "established" as ongoing patients. Coding that distinguishes between new and established patients is artificial and forced in the urgent care setting. Thus, a separate set of evaluation and management codes is needed for urgent care. In the interim physicians may negotiate use of problem-based coding for urgent care services. Urgent care coding is an ongoing issue and soon we will devote some web pages to this topic. In the interim, please visit our Forums.

Retail Clinics: Several states are starting to see the creation of "express care" or similar services provided in retail stores like budget department stores and drugstores. This appears to be a growing phenomenon but is still in the fledgling stages.

In summary, urgent care is a rapidly-growing sector of the health care industry. It offers timely, convenient and appropriate care to members of the public who have illnesses or injuries that are of an acute nature. Urgent care is appropriate for injuries of an acuity higher than generally seen in a primary care physician office but yet of lower acuity than requiring care in a hospital emergency department. Urgent care also offers an overflow outlet for the public when an appointment is not available at a primary care physician office.