Should I Go To The Emergency Room or Urgent Care
Choosing an Urgent Care Center That’s Right for You
These healthcare providers may be an option when you don’t need to go to the ER and your doctor isn’t available.
By Shari Roan
Medically Reviewed by Ross Radusky, MD
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Urgent care centers play a growing role in healthcare nationwide as a treatment option for non-emergency illnesses and injuries. But what factors should consumers weigh when choosing an urgent care center?
Urgent care centers now account for 18.2 percent of all primary care visits and 9.7 percent of outpatient visits in the United States, according to the Urgent Care Association of America (UCAOA). “In a short amount of time, urgent care centers have experienced rapid growth,” says Laurel Stoimenoff, the chief executive officer of the UCAOA, which is one of several urgent care membership and accreditation groups in the country.
Why Urgent Care?
These centers offer an alternative to the long waits and high costs of an emergency room visit when urgent care is needed for a non-life-threatening condition, and provide walk-in access to medical care after hours or on weekends when a primary care physician may be unavailable. They typically provide a range of services, treating everything from strains, sprains, and minor fractures to cold or flu symptoms, mild asthma, rashes, and minor burns.
The UCAOA estimates that there are more than 7,500 centers across the country, with as many as 500 new centers opening each year. “In my own experience, there are probably three or four urgent care centers within a five-mile radius,” Stoimenoff says. “It can be confusing to a patient to know where to go.”
Choosing the right urgent care center begins with considering quality and safety, says David Shih, MD, the executive vice president of strategy on health and innovation at CityMD, a network of more than 75 urgent care centers in New York, New Jersey, and the state of Washington.
“The urgent care industry has evolved over the past few years, so there is a wide spectrum of urgent care practices to choose from,” Dr. Shih says. “Some practices label themselves as urgent care centers but do not fit all the criteria needed, so it’s important for patients to understand where to go in order to receive high-quality care and proper follow-up as needed.”
Check for Accreditation or Certification
Shih recommends looking for a center that is accredited. The UCAOA offers two levels of membership, Stoimenoff says.
Centers can be certified by meeting certain requirements, such as extended hours, laboratory and X-ray services, and having a medical director on staff. They can also apply for UCAOA accreditation, a higher level of scrutiny that involves a site visit. Accredited centers have to show the highest levels of quality and safety, such as having certain infection control practices.
Other organizations — such as the independent, not-for-profit Joint Commission — also certify or accredit urgent care centers. Most centers will list accreditation or certification on their websites.
“Accreditation is a way for consumers to look for a gold standard,” Stoimenoff says. “You don’t have to be accredited. But we’re seeing now that some health insurance payers are requiring accreditation.”
Paying for Urgent Care
How you will pay for an urgent care visit is an important factor to consider before you receive any services.
Most urgent care centers accept private insurance, according to Stoimenoff. About 58 percent of UCAOA-member centers accept Medicare. Many accept worker’s compensation.
People who do not have health insurance can ask about cash discounts. “Discount programs vary by state because of state regulations,” Stoimenoff says.
Questions to Ask About Urgent Care
If you’re considering a visit to an urgent care center, there are several things you can determine in advance:
Is the urgent care center affiliated with a particular hospital or physicians’ network?“It’s important to ensure you find an urgent care center that is in-network with your health insurance so that your cost of care is under control,” Shih says. “Ideally, the urgent care of choice is affiliated with your health system and communicates closely with your primary care doctor to optimize your care.”
Can I make an appointment?Most urgent care centers accept walk-in patients, but you may be able to make an appointment. Some centers offer online check-in so patients can complete paperwork before coming in.
Does the urgent care center accept children or specialize in any particular health services?Most urgent care centers treat children, but they may not accept patients younger than 6 months. While centers typically provide a wide variety of services, some specialize in areas such as orthopedics or mental health.
Does the center provide laboratory services and X-rays? Does the center dispense prescription medication?Not all centers offer imaging and lab services. Blood tests are sometimes processed in a separate laboratory, which means results may take longer. Many centers, but not all, have on-site pharmacies.
Who is on staff?Most urgent care centers will have a medical doctor or doctor of osteopathic medicine (DO) available at all times. Certain services may be provided by physician's assistants, nurse practitioners, or registered nurses.
“Some urgent care centers, like CityMD, are staffed with board-certified emergency medicine physicians and licensed physician's assistants (PAs), so they can handle more complex clinical problems that require a higher-level of skill and care and save you a trip to the ER,” Shih says. “Others are staffed with pediatric specialists who are experts in dealing with pediatric emergencies and common neonatal issues.”
Does the urgent care center offer primary care services?Your local urgent care center may offer primary care services, in addition to walk-in treatment for a sudden illness or injury. “There are some that have the dual model and provide more comprehensive primary care,” Stoimenoff says. However, she adds, “most urgent cares shy away from that.”
Shih recommends that you research local urgent care centers before you actually need medical care. Most centers’ websites provide details about certification or accreditation, staffing, services offered, hours of operation, and types of insurance accepted.
“Consumers today are savvy,” Stoimenoff says.
Video: What all Nurses Wish Patients Knew About Urgent Care
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