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Defining Urgent Care as Convenient Care

by John Kulin, DO, FACEP

About a month ago I had the opportunity to talk to an insurer about a potential new urgent care location. They seemed excited until one point when the conversation turned to the topic of rates. That’s when they made this statement: “Most of what you do is convenient care anyway."

The cynic in me realized this was just a negotiating ploy to keep me from asking for a rate increase. But their comment did get me thinking.

Probably the toughest question about urgent care is, well, "What is urgent care?" Ask a gathering of 10 urgent care professionals and you’ll probably get 10 different answers. Why? We have certification and accreditation programs all defining urgent care. We have a national organization that represents our field, and a recently formed College of Urgent Care Physicians. Surely this stands for something.

But the assertion that we are just "convenient care" providers struck a nerve.

When I opened our first urgent care facility, I thought we were ahead of the curve. With our background in emergency medicine, I thought we offered better care than “family practices billing themselves as urgent care.” Yes, I was an urgent care snob.

Then, I went to my first urgent care conference. Confusion set in as I realized that urgent care ran the gamut from small, single-site family practice/urgent cares trying to survive in a tough market, to urgent cares that seemed like mini Emergency Departments, with immediate access to on-site ultrasound and CT scans. Wow. I was more confused than ever. Where did we fit in? Were we doing urgent care "right”? All these people said they had an urgent care center, but with different models, in all sorts of communities across the nation.

Over the next few years, our center continued to grow and I continued to ask those two lingering questions: “What is urgent care?” and “Are we doing urgent care correctly?” I think I started driving my partners nuts. We got our certification from the Urgent Care Association of America (UCAOA) and have begun pursuing accreditation from the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO). Surely we must be on the right track.

Now, whether she knew it or not, this insurance company rep had gotten to me. How would I respond—how should I respond—the next time I was accused of providing "convenient care" instead of urgent care? After a full month of contemplation, I had my answer.

The comment that the insurance rep may have intended as a putdown is actually an honor. Yes, a part of any urgent care’s activity is convenient care. From those small, single-site centers to the large corporations, we all provide a convenience to patients: timely effective medical care they may not otherwise be able to get. We prevent people from becoming sicker and ending up as an ED admission. We enable patients to receive care without taking a day off from work. We allow families to get care on their schedule, not just weekdays from 9 a.m. to 5 p.m., like the rest of the nation.

With this reflection, I realized that there are so many different urgent care models because each urgent care provider has found the best way to deliver care in their community. The key is providing access to care. Who has it right? We all do.

To survive in these tough times, we have to know our customers’ needs. So the next time I am accused of providing "convenient care," I will proudly answer "Yes." All of us together provide convenient medical care when we provide our community access to quality care. As urgent care centers, our diversity is truly our strength.

Dr. John Kulin is an athenahealth client who practices emergency medicine at Occupational Medicine South in Manahawkin, New Jersey.

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