Don’t call them “doc in a box.” In recent years, urgent care facilities have blossomed into booming business. According to the Urgent Care Association of America, it’s become a $11.28 billion annual business.
Sure, we know they’re practically sitting on every corner. But what’s the anatomy of an urgent care practice? Who’s working there, how does it operate and what are the advantages of working in that environment?
In order to find out, we consulted a pair of urgent care professionals in the Atlanta area.
Dr. Raul Rodon
North Atlanta Urgent Care
On how his business is structured:
“We got together four certified ER doctors, with the idea of getting into urgent care. The structure is pretty easy. It’s not like an ER, because the things you’re going to provide are going to be very straightforward. We have front desk people, receptionists. And we have what we call medical assistants. They basically take patients to the back and check vital signs, blood pressure, that sort of thing. We staff our practice with physicians, in our case ER doctors.There are places that have nurse practitioners and physician’s assistants as part of the staff. We’re looking into that, too. Licensed practical nurses and registered nurses are more expensive. While that’s cost effective in the emergency room, it makes more sense for us to hire medical assistants.”
On the advantages of working in urgent care:
“There are no night shifts, unlike an ER that’s open 24 hours. Most of the urgent cares here in Atlanta aren’t open 24 hours. Most of our doctors are part-time and have the flexibility to still work in the hospital. They look at this as five to seven shifts a month. And also the convenient part is the level of acuity we see here. I trained at Grady and Emory, and then I was working in the Piedmont ER. In those places, we were seeing everything: chest pains, strokes, stab wounds. In the urgent care, it definitely drops. It’s not a high level stress patient. For [the staff] that’s good. It decreases the burnout rate and makes life easier.”
On the growth of urgent care:
“Urgent care has been rapidly growing in past five to 10 years. There are a lot of consumers demanding high quality care, and urgent care is affordable. It’s like a perfect storm for urgent care. One thing is the Affordable Care Act. We’re seeing more patients getting insured and having access to health care. And getting into your primary care doctor or family physician can be a hassle. Sometimes they don’t have appointments next day or same day. So the patient has a decision to make. They can wait for their primary care doctor to be available, go to the emergency room or find something in between. And that’s where urgent care comes in. It’s not expensive compared to the emergency room. A pneumonia diagnosis at an emergency room can usually cost you $2,000. If you don’t have insurance, you’re responsible for that. At urgent care, we do the same thing they’re doing, but you’ll get charged $150, $175. So it’s a big difference for people. We’re not competing with emergency rooms. They have their place in health care. But we don’t want patients who are easily treated going to the ER.”
Kelly Inoue, Manager of Clinical Operations
Children’s Healthcare of Atlanta at Hudson Bridge and Town Center
On how her urgent care facilities are staffed:
“We work with nurses, medical assistants, registration coordinators, nurse practitioners, physician’s assistants and physicians. Typically the way we staff is one nurse per provider and one extra nurse. We’re open during regular doctors’ hours and then after hours for people who couldn’t make it to the pediatrician. So we’re open until 9 p.m., and during that time we basically have two to three providers available and one nurse per provider. We also have a nurse who does screening up front, and usually two medical assistants to help us with tasks and to keep things running with procedures.”
On the advantages of urgent care nursing:
“This kind of nursing really lends itself to a less-than 12-hour shift than you’d have in a hospital, which works for well for people. We have several people who work part time and occasional part time on an as-needed basis. There’s a lot of flexibility in urgent care that’s not available in the hospital nursing arena.”
On what to expect on a typical day:
“We see between 80 and 100 kids per day. It’s pretty fast paced, and you have to be ready for anything that comes through the door. Depending on the center, the needs vary. We have several patients that have your general strep throat, ear infection and those kind of problems. I would say once or twice a day we send children to the hospital who need additional support or monitoring. We have some centers where a helicopter transport is required about once a week.”
