Dr Cooper: I know you have done studies on retail medicine to ascertain whether it helps to divert the load of non-acute patient conditions from the ER, thereby saving our healthcare system money. What did you and your coauthors find?
Dr Mehrotra: We found that, in the vast majority of cases, retail clinic visits represented new utilization of care rather than substituting for, and thereby reducing, more costly ER visits. Net, there were no savings to the healthcare system as a whole. Of course, our studies focused solely on retail clinics.
To the best of my knowledge, this same line of inquiry has never been conducted specifically with urgent care centers. But it makes sense that the greater convenience of care offered by urgent care would drive new utilization patterns — thereby increasing overall US healthcare costs.
And at the present time, there is no evidence to say the quality of care offered by urgent care clinics is better or worse than more traditional care options.
Dr Cooper: Why haven’t urgent care clinics been studied more?
Dr Mehrotra: It boils down to the fact that there is no one universal definition of “urgent care.”
For instance, when your doctor’s office offers you extended hours in the evening or no-wait appointments on a Saturday morning for acute illness, is this urgent care?
Is urgent care limited to freestanding enterprises in shopping centers or on street corners only, or does it include “step-down” emergency-care clinics located right next to traditional hospital ERs?
Are clinics for acutely-injured employees considered “urgent care,” or are they occupational medicine? You can quickly see the difficulty involved in precisely defining the term.
To further complicate things, estimates vary widely on how many urgent care centers there are in the US. The Urgent Care Association of America says that there were 7357 such centers in 2016. But I’ve seen other estimates that are considerably lower. Urgent care is a tough nut to crack, research-wise, for these and other reasons.