Letter to my OB: 1st draft

PRESCRIPTION FOR GROWTH: URGENT CARE CENTERS SEE BOOM.

States News Service March 7, 2011 ORLANDO, FL -- The following information was released by the American Academy of Urgent Care Medicine (AAUCM):

This is peak season for the dozen or so urgent care centers across the Pikes Peak region.

Colds, flu and respiratory syncytial virus bring in sick children and worried parents who can't wait for an appointment with their primary care physician. On weekends and after work, the urgent care centers fill a need that is sometimes acute, sometimes merely convenient.

It's not tied to the season, but urgent cares themselves have been seeing a boom in the region in recent years. Last month, Memorial Health System moved its south urgent care to a new location on Janitell Road near Circle Drive and I-25. Colorado Springs Health Partners last year moved its urgent care to a bigger facility at Union and Fillmore boulevards. When Penrose-St. Francis Health Services replaced Penrose Community Hospital with St. Francis Medical Center in 2008, it opened Penrose Community Urgent Care in what had been the old hospital's emergency room. And half a dozen privately owned urgent cares have opened in recent years.

Nationally, there are about 8,700 urgent cares, a number that grew by more than 300 in 2009-2010, according to the Urgent Care Association of America.

The boom in business doesn't mean more Colorado Springs residents are stubbing their toes or catching colds, local providers say. Rather, the growth reflects larger trends in health care. Primary care doctors are in short supply, meaning appointments can be tough to find, too. Insurers are raising co-pays and deductibles for emergency room visits. Young people don't see the need to have a primary care physician until something goes wrong. All of it adds up to an urgent need for urgent cares.

Dr. John Torres is one face of modern urgent care. A former emergency room doctor, Torres opened Premier Urgent Care three years ago in Monument. In November, he opened a second location on Voyager Parkway in Colorado Springs.

"I did ER for the last 12 years," Torres said. "One of the things that I noticed is, with patient after patient, they were frustrated. If they came in with anything other than a heart attack or a stroke, they were waiting 12 hours." For nonlife-threatening conditions, a typical urgent care wait is under half an hour and costs far less than a visit to the ER. Local urgent cares can treat anything from sniffles to a bone fracture. web site concentra urgent care

It's not uncommon, however, for patients with more serious conditions to walk through the door. Dr. John Torrent, medical director for Memorial Health System's urgent cares, said one or two patients a day are taken by ambulance from the new Urgent Care at Circle Square, near Circle Drive and I-25, to Memorial Hospital Central. Sometimes, those patients aren't sure what's wrong; other times, they're just crossing their fingers. site concentra urgent care

"Insurance companies have dramatically increased co-pays for the emergency room, so there's an incentive for people to go to the urgent care," Torrent said. "Even the patients will say, 'I guess I should have gone to the emergency room.'" Since Penrose Community is housed in a former ER, many patients come in expecting that level of capability.

"We've had gunshot wounds, we've had chest pains," said Gail Decker, who manages the business operations for Penrose-St. Francis' urgent cares. Those cases, she said, get stabilized and sent to the hospital.

It might seem like the city’s two hospitals would be better off financially if patients went to the higher-cost ERs than to urgent cares, but Decker said the hospital’s costs are so much higher in the ER that it tends to balance out. As many as 40 percent of patients in an ER have conditions that could be treated in a less-intensive setting, according to the American Academy of Urgent Care Medicine.

If it’s not a life-threatening condition, Decker said, coming to an urgent care makes sense for everyone.

“These rooms are equipped for just about anything that walks through the door,” Decker said. “You’re going to get the same quality care (as in an ER), at a much better price.” Memorial’s two urgent care centers see a combined 60,000 patients a year — half the volume of Memorial’s emergency room, despite being open only 12 hours a day, 9 a.m. to 9 p.m. If all of those patients didn’t have urgent care as an option, Torrent said, the ER would be overwhelmed.

“Most emergency rooms are overloaded across the country,” Torrent said. “Urgent care helps be an alternative.” Many private urgent cares also provide occupational medicine such as treating on-the-job injuries, performing drug tests and physical therapy, plus immunizations and physicals. Concentra Urgent Care, a national company with two local locations, began as an occupational medicine provider, but branched into urgent care three years ago.

“So much of what we were doing was, in essence, urgent care,” said Dr. Matt Miller, Concentra’s regional medical director. “We do feel that it’s an area that will grow.” Despite their range of services, urgent care operators say they’re not out to compete with private practices.

“We’re not here to take other PCPs’ (primary care physicians’) patients,” said Mary Sanchez, urgent care manager for Colorado Springs Health Partners. “We want to be able to take care of their patients when they can’t.” Concentra’s Miller said urgent cares aren’t suited for providing extended care the way primary care physicians can.

“If it’s going to go beyond one visit, then we are certainly pushing them toward finding a primary care provider,” he said. “We really are that stopgap between primary care, but not having to go to the emergency room.” And there may be more business on the way for urgent cares. Most urgent care practitioners believe health care reform will increase the need for urgent care clinics, since more people will have insurance but not a primary care physician.

“I’ve talked about this with some of my urgent care buddies,” Torres said. “Most of us think it’s only going to make us more busy.” By ANDREW WINEKE The Gazette

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