Here in the Hudson Valley urgent-care centers have become part of the medical landscape. “When we opened, we were trying to meet a need for people who were going to the emergency room but getting triaged and having to wait,” said Todd Martin, executive vice president of Emergency One, an urgent-care and occupational health center with offices in Kingston and Hyde Park. “Treatment for them was episodic, and they often felt they were lost in the shuffle. There was a need to relieve emergency rooms of non-emergencies and also deliver an increased level of customer service and hands-on care.”
Recently designated a certified urgent-care center by the Urgent Care Association of America, Emergency One is joined in the Hudson Valley by Health Quest immediate care centers in Dutchess and Orange counties and the West Coxsackie-based EmUrgentCare, which recently announced that it would be opening a facility in Saugerties.
The three Health Quest immediate-care centers (Health Quicc), located in Wappingers Falls, Lagrangeville and Newburgh, are operated independently of the Health Quest hospitals and medical practices, said David Ping, vice president of strategic planning and business development for Health Quest. They are, however, connected to Health Quest’s electronic medical records system, which means that the Health Quicc facilities have access to the same medical histories and knowledge of medical conditions that the organization’s primary-care physicians do.
“The Health Quicc sites were the first locations in the Health Quest system to have access to our electronic record system,” said Ping. “We want to continue to offer more access points and make it easier for people to obtain services through the Health Quest network.”
New model of care
Urgent-care clinics are facilities designed to provide a level of immediate medical care just below that offered by hospital emergency rooms. They’re for patients who can’t wait for an appointment with a primary-care physician but don’t have a life-threatening health situation. Clinics are equipped with x-ray machines, lab services, and physicians who can cast broken bones, suture wounds and perform other relatively routine medical tasks.
Emergency One opened in Kingston in 1995, founded by Dr. Ferdinand Anderson, former emergency-room director at all the Ulster County-affiliated hospitals (Benedictine, Kingston, Ellenville and Margaretville) and past chairman of the Hudson Valley EMS Medical Advisory Committee. “He realized then that there was a need in the community for urgent-care services,” explained Martin.
Emergency One has grown from six employees at its start to a roster of 45 currently. It opened its Hyde Park facility in 2007 to handle what Martin called an ever-increasing desire for convenient, fast medical services.
“The whole concept of centers like ours is to provide prompt care,” he noted. “People have busy lives and limited time. Our main focus is to make sure wait time is short. That’s what drives our model.”
“Urgent-care centers are an essential component to the health of a community, especially now given the strain on our hospitals’ emergency departments and availability of primary-care doctors,” said Dr. Stephen Hassett, EmUrgentCare principal and chief medical officer.
Ping agreed. “We’d like people who have minor injuries to go the immediate-care centers and not the emergency room,” said Ping. “It’s a lot less expensive to treat patients in that setting, and it’s typically a much shorter wait time to be seen by a doctor than in a traditional emergency room.”
The growth of urgent care is about a change in how people access health care, said Martin. “They’ve become better stewards of their own health,” he said, comparing urgent care to online shopping in that it exists outside the traditional industry model and reflects a desire for more convenient options. “We’re trying to meet community expectations and give people the care they expect,” Martin noted.
Urgent-care centers began opening in the 1970s. It is estimated there are now more than 15,000 such facilities nationwide. They’ve evolved into a quicker — and due to insurance, less expensive — option for emergencies.
Ping sees the urgent-care model as an important emergent force in the health-care industry, one meeting a growing need for quicker, more cost-effective care for minor emergencies. Expanded hours (the Wappingers Falls site is open seven days a week until 10 p.m.) and the convenience of not requiring an appointment or waiting to be treated make the centers a better fit for patients and the organization, Ping said.
There is an important distinction between the urgent care needed for minor ailments and medical attention for major accidents. Martin was quick to point out that serious emergencies still demand a trip to the emergency room.
“When an individual needs immediate care, if it’s a matter of life or limb, they belong in the emergency room,” he said. “But anything below that can usually be treated effectively in urgent care.”
The American College of Emergency Physicians cautions that people suffering chest pain, stroke symptoms or any kind of life-threatening trauma constitute true emergencies, and need to be treated in a conventional emergency room.
Why the switch?
The reason that treatment at urgent-care facilities is also usually less costly than emergency room visits is that patients treated at urgent centers typically pay insurance co-pays rated for office visits rather than trips to the emergency room. The trend in insurance over the past decade to increase the cost of emergency room co-pays has shifted the financial impact of visiting the emergency room onto the patient, said Martin. “Communities have recognized that urgent care is more convenient and costs a lot less, and when they can utilize it they’re starting to more and more,” he pointed out.
According to a study by the federal Centers for Disease Control, up to 40 percent of emergency room patients who are triaged (meaning that they wait for care while other, more serious cases are treated) could be handled in an urgent-care setting. The American Medical Association predicts a growing shortage of primary-care physicians over the next decade, making insurance-driven models more difficult to open and private individual practices more difficult to operate.
That shortage, said Martin, will make urgent care all the more important. “We’ve positioned ourselves as partners, or adjuncts, with our community primary-care physicians,” he said. “The community in general has become better stewards of their own health care and making better decisions in how they want to access health care.”
Are facilities like Emergency One competitors with hospital emergency rooms? Martin says that urgent-care clinics actually function as partners with ERs.
Ping echoed Martin’s assertion that a looming shortage of primary-care physicians in the Hudson Valley will reinforce the urgent-care model as a vital component of the continuing reform of health care. “We see urgent care as a growth area for our industry,” he said. “As reform continues, you’ll start to see an increase in volume, and these centers will become really important ways for patients to see doctors and be treated.”
Martin denied that urgent-care centers were in a competitive relationship with community hospitals and doctors. “We don’t provide primary care,” he said. “We treat people, and they follow up with them. We try to provide immediate care to augment primary-care physician services and hospital treatment.”
Though urgent-care centers aren’t a replacement for emergency rooms, their growing numbers indicate that their popularity as quick-treatment facilities will continue to grow. “You’re seeing a shift in use that we think is going to continue,” said Martin. “People have a need for prompt medical attention in a setting that’s comfortable for them.”++