OPINION: Urgent care centers: what is their place?

January 27, 2014 By Raanan Geberer Brooklyn Daily Eagle

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One of the charges against the various plans for Long Island College Hospital (LICH) by supporters of the hospital is that they would be just a “glorified urgent care center.” Even the planned standalone emergency rooms, which I wrote about last week, are often derided as being more similar to urgent care centers than to “true” emergency department.

I’ve been to an urgent care center, and there is an important place for these centers, although they’re not a substitute for a hospital, or even for a full-fledged emergency room.

Within a block from where I live, there is combination clinic and urgent care center that is affiliated with a major hospital. It was once open 24 hours a day; now, it’s open 12 hours a day, but it’s still open Saturdays and Sundays as well as weekdays.

My wife sees her regular primary-care doctor there, but also has used the place as an urgent care center on occasion. She’s gone there for stomach problems, for a bladder infection and when she misplaced one of her prescriptions and needed a new one as soon as possible. She also went there when she had a cut and needed stitches. In each case, the doctor (in one case, a physician’s assistant) helped her. Since the most recent occasion was around 7:30 at night, the urgent care center filled a vital niche that a “regular” doctor’s office was unable to do.

Yet, such an urgent care center has its limitations. What it doesn’t do is take care of patients who have serious emergencies that might require admission to a hospital. Thus, if I came in with one of my asthma attacks, the nurse would almost certainly tell me to go to an emergency room immediately – she would likely call one and then have someone stay with me until the ambulance arrived. That’s why I would know better than to go there if I ever have another serious asthma attack (knock on wood). And the ambulance drivers know better, too.

Now, there’s nothing wrong with an urgent care center. It fills an important niche in medical care, a niche that went unfilled until fairly recently. The doctors, nurses and physician’s assistants I saw there were professional and competent. Having one in a neighborhood that has been starved for medical services is a big, big step forward.

But, conversely, residents of a neighborhood that has had a full-scale hospital for years, i.e., the area near LICH, would understandably think of such a facility as a step down. To those who have availed themselves of LICH’s services for years, the idea of having an urgent care center as a quasi-replacement might seem like an insult. And from what I understand, there’s already an urgent care center in the neighborhood, which is part of the Mount Sinai network.

Not being a medical professional, and indeed, being someone who never got more than a B-minus in biology, I can’t offer a qualified opinion about whether an urgent care center would help fill the void caused by the (presumed) shutdown of LICH. It seems to me that an urgent care center and similar walk-in facilities, such as endoscopy and dialysis centers, are an important part of a neighborhood’s healthcare mix. The problem is that they’re not the whole thing, and shouldn’t be.