Although the rise in urgent care clinics may not yet be posing a threat to the existence of traditional doctors' offices, family practices are addressing challenges to stay in business while facing increasing costs for equipment and lower reimbursements for Medicaid and Medicare patients.

Northwest Austin family practitioner Dr. Neal Johnson said it has become almost cost-ineffective to sustain X-ray machines and in-house labs at his practice with the decrease in insurance reimbursements. His office no longer has an X-ray machine.

"You could do it if you were being reimbursed by the insurance companies, but they cut back on their reimbursements so drastically that you were actually losing money in most cases," he said.

While some traditional small practices are struggling, the number of urgent care clinics in Central Texas and throughout the nation has been on the rise since 2008, according to the Urgent Care Association of America.

Urgent care clinics are defined as facilities that offer walk-in, extended-hour medical service for children and adults, UCAOA CEO Joanna Ray said. Typically clinics offer a larger scope of treatment than a primary care physician, including treatment of fractures, suturing cuts, providing intravenous drips and X-ray and laboratory processing on-site.

Urgent care clinics do not, however, provide treatment for chronic conditions such as diabetes or heart disease, which are better handled by a primary physician, Ray said. They also do not cover emergency situations such as labor, heart attacks or strokes.

"Urgent care does work with primary care physicians in identifying and referring patients who have conditions that require ongoing care and make the referrals to the appropriate providers in the community," Ray said. "Urgent care is really intended more for episodic concerns, such as cold symptoms, sunburn, sprains and fractures."

UCAOA projections estimate that 300 urgent care facilities were built per year in the U.S. between 2008–10, with the number doubling to 600 per year in 2011. Some doctors credit the increasing numbers to urgent care clinics' efficiency and to a growing demand for health care as more people enroll in insurance plans.

"It's a very clean and simple business model in a very complex industry," said Dr. Norman Chenven, Austin Regional Clinic founder and CEO. "Certainly if there's a lot of demand because of additional people coming into insurance and into the payment system, then this would be an ideal time to build urgent care centers."

To keep traditional medical practices afloat in an industry flooded with urgent care–type facilities, the Texas Medical Association is working to develop programs to ease operating costs, and incorporating elements of urgent care treatment may be part of the approach.

Another idea includes developing a software system that would allow doctors throughout the nation to share and look up medical records of patients. Any solution will be carefully examined by the TMA, and it may be years before a full plan is put into effect.

"The TMA is doing a fabulous job methodically exploring these issues," Chenven said. "This is not a quick process; it will take a number of years to grow and mature."