Urgent care centers are a common sight these days in the Wilmington area, and have become an increasingly popular option for those looking to avoid painful waiting times in hospital emergency rooms.
The types of local urgent care centers vary in terms of services offered, staffing and hours of operation. Some are certified by the

Urgent Care Association of America, a trade organization with a stated goal “to be the catalyst for the recognition of urgent care as an essential part of the health care system.”

There are more than 20 urgent care facilities in the three-county area surrounding Wilmington. There are about 430 locations in North Carolina, with at least 25 urgent care facilities opening since 2008, according to UCAOA executive director Lou Ellen Horwitz. Nationwide, there are more than 8,500 urgent care centers in operation.

In general, such facilities provide walk-in service, evening and weekend hours, are staffed by physician assistants with at least one doctor on premises or on-call and have basic lab facilities and X-ray machines.

ERs still popular

People made 119.2 million visits to hospital emergency rooms in 2008, according to the Centers for Disease Control and Prevention. The CDC found the median time spent in the ER is 2.6 hours.

Both major area hospitals and Wilmington Health Associates, a large medical group, have entered the urgent care arena. New Hanover Regional Medical Center operates Urgent Care of Wilmington at 1135 Military Cutoff Road.

New Hanover Regional Medical Center spokeswoman Erin Balzotti said the use of urgent care centers is growing nationally “as people find they’re a convenient and less expensive way to get unscheduled treatment of injuries and illnesses that aren’t serious enough to warrant a trip to the emergency department.”

She said urgent care centers are less costly to operate than a hospital ER because they require fewer intensive services, surgical services and access to specialists typically found in an emergency department, particularly a trauma center like New Hanover Regional Medical Center.

The hospital affiliated urgent-care center offers routine forms of medical treatment that are more immediate in nature, “but not complex enough to require hospital treatment,” Balzotti said.

That can include treatment for colds and flu, infections, various injuries and routine physicals.

Novant Health, which operates Brunswick Community Hospital, also has a local urgent care center – Novant Urgent Care, which is on Main Street in Shallotte. System-wide, Novant operates 20 urgent care centers.

The Shallotte facility is staffed by nationally board-certified physicians, said Novant spokeswoman Amy Myers.

“Urgent care centers allow us to improve access to our patients who need same-day service, and in the coastal area, they also provide care for the many vacationers who visit the area,” Myers said.

A ‘good alternative’

“As more and more businesses across the country transition their employees to consumer-driven health care plans, it is likely that patients will consider the cost of care being sought at (urgent) care facilities more than they have in the past,” Myers said.

Wilmington Health Associates, a multi-specialty medical group practice that has operated in southeastern North Carolina for 30 years, recently acquired two urgent care clinics. The Med Care clinics are on 5245 S. College Road in Wilmington and in Jacksonville.

Some urgent care centers in Wilmington are run by small physician groups. Wrightsville Family Practice & Urgent Care combines a traditional medical practice with urgent care availability on the weekends. The business, at 1414 39th St. in Wilmington, is run by two doctors. The medical practice opened in 2001 and the urgent care component opened in 2003, said office manager Sharon Williams.

Williams said one doctor and a registered nurse work on weekends. Patients “come from all over,” she said.

Some urgent care facilities don’t accept patients without insurance or who have Medicare or Medicaid. Some patients must pay out-of-pocket or are given other treatment options that may include a trip to a hospital emergency room.
‘Quality and safety’

A N.C. Medical Society spokesman said all urgent care facilities are not created equal.

“Quality and safety, of course, are always paramount,” said Mike Edwards, N.C. Medical Society spokesman. “We oppose the existence of store-based clinics unless they embrace certain principles.”

The first principle states that the clinics “must have a well-defined and limited scope of clinical services, consistent with state scope of practice laws.”

The second calls for “standardized medical protocols derived from evidence-based practice guidelines” to ensure patient safety and quality care.

Others state that health care practitioners have direct access to and supervision by those with medical degrees.

Public perception of urgent care centers as “doc in a box” facilities has changed, Horwitz said.

“That is a largely outdated perception, in my opinion. Urgent care has either evolved or people have become more aware that they really don’t have limited services,” she said. The majority of doctors working at urgent care centers are either family medicine or emergency room physicians, Horwitz said, “so obviously they think it’s great.”
Good local relationships

When urgent care centers become well integrated into the primary and specialty care communities in an area, “there is a very good relationship because it gives the primary care physicians someone known and trusted to send their patients to when they cannot see them,” Horwitz said.

Urgent care centers are also a good referral source for specialists in the community for conditions that need additional treatment, she said.

The urgent care concept has obviously caught on. Medac Health Services operates three urgent care centers in Wilmington.

NextCare Urgent Care, with clinics in six states, has 16 locations in North Carolina and one in Wilmington.
And local hospitals are on board along with medical groups like Wilmington Health Associates, indicating that competition is heating up for the urgent care dollar.