Urgent care and emergency care clinics are quickly beginning to dot the Dallas-Fort Worth area landscape. As the number of stand-alone clinics continues to grow, patients are faced with understanding the difference between primary care physicians, urgent care centers, freestanding emergency care centers and hospital emergency rooms.
"The simple distinction is that an urgent care is a doctor's office without hours," said John McGee, owner of ER Centers of America. "From a consumer's perspective, under Texas state law, only a freestanding ER can display the words 'emergency' in their branding."
While McGee said it is easier to point out the differences between urgent care clinics and freestanding emergency rooms, he also said each treats patients with all kinds of symptoms.
Urgent care clinics are not intended to be used for the treatment of chronic illness or serious conditions, such as a heart attack or stroke," said Joanna Ray, CEO of the Urgent Care Association of America.
"Urgent care is really intended more for episodic concerns, such as cold symptoms, sunburn, sprains and fractures," Ray said.
Urgent care clinics often have extended hours past normal doctor office operating hours, although they are generally not open 24 hours a day. Walk-in appointments are available and the wait time is usually short. Clinics may be staffed by physician assistants rather than a physician, said Dr. Kirk Mahon, one of the owners of Legacy ER & Urgent Care. Urgent care facilities also generally require payment at the time of service, although most accept insurance. Unlike an emergency room, urgent care facilities are not mandated by the state to treat patients regardless of their ability to pay. Dr. David Weitzman, chair of the executive council for the American Academy of Urgent Care Medicine, said urgent care clinics do not take the place of a primary care physician, and urgent care centers should encourage the patient to set a follow-up appointment with their primary care physician within a few days of visiting an urgent care clinic.
"In the integration model, urgent care centers work with primary care physicians," Weitzman said.
By Texas law, freestanding emergency clinics are required to be open 24 hours a day, be staffed by a physician and have on-site laboratory equipment, radiology services, as well as X-ray, CT scan and ultrasound capabilities. Mahon said a freestanding ER should be able to handle any initial emergency a hospital can, although patients with massive trauma, such as a gunshot or knife wound to the chest would probably be better off at a hospital ER.
"However, the freestanding ER facilities are also able to take care of those patients and stabilize them and get them to the operating room in a similar manner," Mahon said. "They have the same physicians and stabilizing equipment. The kind of cases that typically a patient would be better off in a hospital ER would almost certainly arrive via [emergency medical service] system. If they are able to get here on their own and they are not coming by 911, then a freestanding ER is able to take care of them. We take care of heart attacks, we take care of major car accidents and situations like that."
Mahon said freestanding emergency clinics generally charge similar rates to what a hospital emergency room would charge, which is higher than the cost for urgent care.
