Urgent care facilities have become more widely available in recent years, popping up in urban cores, strip malls and small towns across America. According to a June 2021 report from the National Center for Health Statistics, urgent care and retail health clinic users were more likely to be women, younger (under age 44), non-Hispanic Whites and have either some college or a college degree or higher.
Patients turn to urgent care and retail clinics for many reasons, including more scheduling flexibility and easy access, limited access to or confidence in primary care, or because they faced an urgent situation.
Urgent care facilities are excellent when you need them, says Dr. Dustin Cotliar, a New Orleans ER physician who has worked in both urgent care and ER settings. Rashes, cuts and burns are excellent reasons to head to urgent care. But all in all, urgent care can’t replace preventive healthcare. We dig into why.
What is preventive healthcare?
Some patients are scheduling urgent care visits for issues best addressed in primary care provider settings, such as immunizations, musculoskeletal and dermatologic conditions, lab and diagnostic tests and blood pressure checks, according to a review published in the Journal of the American Association of Nurse Practitioners.
But relying on urgent care for preventive medicine can cause issues down the line, the review noted, including reduced continuity of care, trouble accessing preventive services and difficulty managing chronic conditions. Those repeatedly seeking urgent care may not understand how to navigate the healthcare system and deflect care.
Part of routine care includes preventive healthcare. A preventive health visit typically includes updating vaccines and screening for diseases such as diabetes, osteoporosis, cancer and high blood pressure. Physicians may discuss any new changes you’ve noticed and encourage a healthy lifestyle, while observing potential future risks from alcohol, cigarettes or diet.
During a normal annual exam, your provider takes your blood pressure, listens to your heart and lungs, and sends you to a lab for bloodwork. Women may get a Pap smear in a clinic from a primary care provider, and men could undergo a prostate exam. After a certain age, you may be referred out for a routine mammogram or colonoscopy, or for genetic cancer testing or other special concerns.
Where urgent care falls short
A PCP office and an urgent care facility are structured differently, explains Dr. Suryadutt Venkat. When he worked at a University of Massachusetts primary healthcare center with extended hours, Venkat often treated urgent cases. He sees some limited overlap between his work then and his work now in private practice in Pawtucket, Rhode Island — primarily where acute issues are concerned, such as removing foreign bodies, examining concussions or draining abscesses.
Urgent care is geared toward acute and episodic illness that can be diagnosed and treated quickly, within 15 to 10 minutes. “Most urgent cares do not have access to previous patient records for the treating provider to know the full story,” Venkat says.
While an urgent care facility may provide some limited preventive care testing, it’s typically only in response to a more immediate symptom, not prevention. Urgent care physicians don’t routinely screen for, identify or help manage chronic issues such as high blood pressure, diabetes or high cholesterol. “I can’t imagine a scenario where I’d order a cholesterol test for someone who came to urgent care,” Cotliar says. If patients repeatedly visit an urgent care, they may be subject to unnecessarily repeated tests and procedures.
“It drives costs up and adds a layer of chaos, without the continuity of care,” Venkat says. “Primary care is geared toward keeping the overall cost of healthcare down and helping patients manage the complex healthcare system with ease.”
Skipping annual preventive screening tests can lead to serious issues. If an older smoker comes in with a cough, pneumonia might be found and treated after an X-ray. But a small mass, potentially early-stage lung cancer, could be overlooked or mentioned in passing to a patient. “There’s a window of opportunity lost that could’ve been addressed by a primary care provider, earlier and better, and leading to a better health outcome for the patient,” Venkat says.
The benefits of primary care providers
“You want to see someone who knows you, who you’ve seen a long time and is familiar with your ongoing issues,” Cotliar says, as you build two-way rapport and trust. If a treatment plan doesn’t work, your PCP can tweak the regimen or refer you to a specialist
Preventive care from a PCP also affords more consumer choice. You can browse recommendations and reviews, ask friends and family for suggestions or choose a provider by gender, training or background. In an urgent care facility, you’ll be assigned to one of many providers working that shift, perhaps never seeing the same physician twice.
With a PCP, you benefit from continuity of care and consistent record keeping, as all your tests and results are in the same place. In contrast, there usually isn’t a relay of information between an urgent care visit and your primary care physician, unless they’re part of the same health system.
“It’s important to go to the primary care doctor and plan to take your chronic issues seriously,” Cotliar says, through making appointments. If you’re older or have several issues at once (e.g., hypertension, diabetes, prior heart attack or cancer treatment), you’ll have a PCP working “quarterback” while tracking your overall care between a cancer specialist, endocrinologist and heart doctor.
But the advantages extend to all ages. “Even young people get better care in primary care,” Cotliar says.