Urgent care clinics: What they do and why there are so many of them

The proliferation of urgent care clinics across America has made a significant mark on the South Sound, where dozens of the walk-in medical centers have popped up over the past two decades.

The region’s hospital chains are heavily invested in them and encourage people with minor-to-moderate medical issues to consider heading for the nearest clinic instead of a hospital.

The logic is direct: Emergency room treatment of minor issues is more expensive than at clinics, comes with longer wait times and diverts resources from more serious medical problems.

The growth in the number of the clinics also opens up more complex questions of when a patient should choose an urgent care clinic and whether that’s happening as often as it should.

We’ll attempt to provide some answers to give a basic understanding of this evolution in medical care.

Q: How many urgent care centers are there around here?

A: State regulators don’t have an accurate count.

Urgent care clinics have popped up throughout Washington since the facilities began their spread in the late-1990s. Because the state Department of Healths requires the similar permits for clinics as doctors’ offices, the agency does not track the number of clinics, a spokeswoman said.

The Urgent Care Association of America lists 185 Washington clinics on its website.

The South Sound’s largest medical providers operate a sizable number of the clinics, and that’s on the rise.

MultiCare has 35 urgent care clinics under three brand names and plans to open more. This summer, its purchase of the Rockwood clinic system will add six clinics east of the Cascades to that total, along with a fourth name. No consolidation of names is planned, MultiCare spokewoman Marce Edwards said.

CHI Franciscan lists 14 urgent care centers on its website and has partnered up with New York-based CityMD on a public campaign to get more patients into urgent cares. Also in the South Sound, Community Health Care, Providence Health and the Madigan Army Medical Center, among others, operate their own clinics.

Q: Why should I go to an urgent care clinic?

A: If visiting your regular doctor requires weeks or longer in lead time, or if you don’t need care for a traumatic injury, perhaps a visit to an urgent care clinic would be better.

Representatives from MultiCare and CHI Franciscan said the average trip to an urgent care clinic runs in the neighborhood of 30 minutes, door to door. An uneventful emergency room visit often can takes a couple of hours, or more, of waiting around, especially if it’s a busy time for high-priority cases.

Q: When is — and isn’t — a clinic a good idea?

A: CHI Franciscan and CityMD issued a rule-of-thumb guide this month.

The most basic one: If the situation doesn’t threaten to take a life or a limb, skip the ER and see urgent care.

Urgent care is recommended in the guide for situations that include a child’s 104 degree fever, a cut from a fall that keeps bleeding, or an injured ankle that might be broken.

A possible heart attack or a loss of consciousness after a wreck? To the hospital.

“If you’re even concerned about staying alive, that’s the emergency room,” said Dr. Joseph Passanante, senior vice president of medical operations with CityMD.

Q: What happens if I get into a clinic and the problem is worse than they can handle?

A: The doctor will send you to a hospital. If it’s a bad situation, the clinic will call an ambulance and attend you while you wait.

In many cases, doctors seeing patients in the urgent care clinics are the same doctors who work other shifts in a hospital’s emergency room, Passanante said.

Q: How do I find one of these clinics when I need one?

A: That’s one of the trickier aspects to navigate.

Each competing chain has a website where you can look up the facility closest to you. Choosing among MultiCare, CHI Franciscan, Community, Providence or another provider will, for many people, come down to what’s closest and what one’s insurance covers.

Because answering those questions isn’t easy in the throes of a tough medical situation — say, a child’s high fever — it’s good to do some advance scouting of a clinic or two near one’s home.

That includes knowing its operating hours and the exact location of the office. The clinic addresses on the website often lead to obscure locations in a strip mall or office complex, which can make them hard to find.

“If you’re in an emergency room mindset, the location in the strip mall or in the community might sometimes not be what the patient has in mind,” Passanante said, “but once they make it in, they can see the kind of care available.”

This story was originally published April 14, 2017 at 8:00 AM with the headline "Urgent care clinics: What they do and why there are so many of them."