In a recent note, I discussed how primary care practices and hospital-based ambulatory care are now being forced to compete with both walk-in clinics in retail drug stores and urgent care centers (see: Physicians Are Disappearing from the Front Line of Healthcare). I have just learned about another type of first-line competition for physician and physical medicine practices: walk-in, orthopedic urgent care centers (see: Orthopedic urgent care centers to expand). Below is an excerpt from the relevant article:
A new orthopedic urgent care center operator is expected to start opening centers in Michigan later this year under the Miami-based OrthoNOW franchise as demand for convenience and lower prices sweeps the health care industry....Over the past decade, the number of urgent care centers has exploded in Michigan and nationally as patients seek to avoid a steep emergency room bill or visit more convenient health care settings. Data show there are more than 350 urgent care or walk-in clinics in Michigan, including more than 45 within 20 miles of Detroit, according to Urgent Care Locations LLC.....Most health insurers in Southeast Michigan contract with urgent centers because of their lower cost relative to emergency departments. That steady and reliable reimbursement has helped push the expansion of urgent care. Now, a new breed of urgent cares hopes to convince patients with bumps, bruises, sprains, and even simple broken bones to go to the urgent care rather than the emergency room....[T]he Michigan centers will assess and treat an array of musculoskeletal orthopedic and sports injuries and chronic conditions without appointments. Injuries could affect the foot, ankle, knee, hip, wrist, hand, elbow, shoulder and spine. OrthoNOW also will offer radiology, physical therapy and sports medicine and wellness care.....[The] owner and operator of 1st Choice Urgent Care said his three centers have direct referral relationships with 10 orthopedic surgeons for more serious cases.
To summarize, a new type of walk-in, urgent care facility is emerging to attend to orthopedic problems including sports injuries and even sinple broken bones. Similar to walk-in retail drug store clinics but unlike many urgent care facilities, these orthopedic centers are staffed by a physician assistant and a medical technician who can also take X-rays but not by a physician. Such orthopedic walk-in facilities represent an expansion of first line health services and one more reason to avoid hospital ERs and primary physician offices. Note also the referral relationship of these centers to orthopedic surgeons for more complex cases.
Health insurance companies are encouraging the use of walk-in urgent care and drug store clinics because they are generally less expensive than hospital ER visits or perhaps even physician office visits. Heres the discussion on the Humana web site pertaining to urgent care center visits by its members (see: Urgent Care FAQs):
When should I visit an urgent care center?
If you have a non-life threatening illness or injury needing immediate treatment, urgent care is a great choice. You’ll receive direct attention from trained clinicians. There are reasons why using an ER for minor and moderate conditions may not be advisable. An ER can be expensive and you may experience long waits for treatment. A primary care physician can be another option. However, your doctor’s office may not be open daily with extended hours, or offer on-site diagnostic tests.