The absolute need for Board Certification in the field of Urgent Care Medicine is increasing rapidly. Board certification demonstrates a physician’s exceptional expertise in a particular specialty of medical practice. Board certification in Urgent Care Medicine signals a physician’s commitment and expertise in consistently achieving superior clinical outcomes in a responsive, patient-focused setting. Patients, fellow physicians, healthcare providers, insurers and quality organizations look for to Board Certification as the best measure of a physician’s knowledge, experience and skills to provide quality healthcare within their specialty. As patients and insurers are increasingly finding that Urgent Care Medicine is a viable and economical option versus care in the emergency department, so will the need for physician certification in this specialty.

In 2003 the American Academy of Urgent Care Medicine (AAUCM) was admitted into the Specialty and Service Society (SSS) of the American Medical Association (AMA). The Specialty and Service Society (SSS) is the largest caucus in the American Medical Association (AMA) House of Delegates (HOD). For more information about the Specialty and Service Society of the AMA, please click here. In addition, in cooperation with the AMA, the AAUCM was successful in having Urgent Care Medicine, (UCM) established as a Self-Designated/Practice Specialty (SDPS) code. To change your SDPS to UCM, please download a Change Form from the Document Center.

The American Board of Medical Specialties (ABMS) is an umbrella organization that currently has 24 member Boards representing 25 specialties. According to our latest data, there are approximately 150 non-ABMS affiliated Boards. These Boards are not unified by an umbrella organization such as the ABMS. There are a number of non-ABMS Boards that provide a valid specialty certification process. The American Board of Urgent Care Medicine (ABUCM) is a non-ABMS Board that from its inception has emulated ABMS-member Boards. The ABUCM follows rigorous standards for determining Board Certification, scrutinizing each applicant’s training, licensure, practice experience, and actual medical care. The certification process culminates in a written examination, which has been psychometrically validated. It is both medically and legally defensible.

Many third party payers are now cognizant of the vital role ABUCM physicians play in our healthcare system. The ABUCM is interfacing with insurance company providers to enlighten them on the benefits of Board Certification in Urgent Care Medicine, and hundreds of organizations and facilities have requested verification of the Board Certification in Urgent Care Medicine of our Diplomates. For a complete list of the organizations/facilities who have requested verification of certification of our Diplomates, go to http://www.aaucm.org/Professionals/BoardCertifications/CertificationVerification.

Insurance carries both globally and locally have not yet made a universal decision. In many local markets the carrier will accept Board Certification in Urgent Care Medicine, depending on the concentration and penetration of their market. When communicating with any carrier, we encourage our Diplomates to communicate to the carrier that the ABUCM is the only organization in the U.S. functioning to certify properly qualified candidates in the specialty of Urgent Care Medicine, and therefore are the leading experts in this field. If the carrier has different rates/levels of reimbursements for Primary Care, ED Care and Urgent Care, then they too recognize that there is a distinction in the level of care that is provided and the physicians who render such care.

At this time to AAUCM does not have a designated residency in Urgent Care Medicine. We are looking to develop such a program and are seeking a university to host a residency program for urgent care.

Yes, the AAUCM has a template Operations Manual available for purchase. To purchase, use the Operations Manual Order Form: http://aaucm.org/Resources/370/FileRepository/Operations%20Manual%20Template%20Order%20Form.pdf

RNs: 6%
PAs/NPs: 32%
LPNs: 4%
MAs: 96%

The AAUCM has noted a trend that hospital entities are changing their staffing models from employment of RNs & LPNs to the utilization of MAs, RTs and EMTs who are all crossed trained (for cost-reduction purposes).

The average income for Urgent Care PAs/NPs is $55/hour.

New patient visits used to be easy to distinguish from those with established patients. A new patient was someone you had not previously seen or perhaps someone for whom you did not have a current medical record. Today, like so many other aspects of health care delivery, differentiating between new and established patients and coding your services accordingly has become more complex. By CPT definition, a new patient is "one who has not received any professional services from the physician, or another physician of the same specialty who belongs to the same group practice, within the past three years." By contrast, an established patient has received professional services from the physician or another physician in the same group and the same specialty within the prior three years.

The average is 2-5%; it all depends on the size of the billing company, the type of ARs reporting produced, and if the company will be scrubbing the charts for optimal billing.

Unfortunately, there are no formal training programs in Urgent Care for Nurse Practitioners at this time. Most get their experience from working in the ED. An alternative option is to spend some time at an Urgent Care center shadowing someone for a few weeks to get a sense of the skill sets required. As a member benefit, the AAUCM can assist in finding a center for NPs to shadow someone.

A quarterly medical chart review for each provider conducted by the Medical Director can be used to measure quality in an Urgent Care center.

Yes, as insurance companies continue to narrow the margins of profitability and patients expectations of convenience and cost, self -dispensing is becoming more of the norm, with the exceptions of states that do not permit dispensing. A full list of dispensing regulations by state is available at http://aaucm.org/Professionals/MedicalClinicalNews/DispensingRegulations/default.aspx.

Yes, the AAUCM has an Urgent Care Center Quality Assurance Checklist available for purchase. To purchase , please use the Urgent Care Center Quality Assurance Checklist Order Form: http://aaucm.org/Resources/370/FileRepository/Urgent%20Care%20Center%20Quality%20Assurance%20Checklist%20Order%20Form.pdf

SUGGESTED MAJOR MEDICAL EQUIPMENT

X-ray (digital preferred)
For: Diagnostics - Chest, head, body, extremities

Developer - 90 second
For: Wet process chemical development of x-rays

Controller
For: Digital system to control x-ray unit

Hematology unit (optional)
For: Blood samples, WBC, RBC, Platelets, Differentials

ECG (EKG)
For: Cardiac diagnostics

MCG Ultrasound (optional) (from Cardiac Analytics)
For: Diagnosis CAD in office (for carotid/cardiac, abdominal, DVT) along with cart

Spirometer
For: Measures lung capacity

Hyfrecator
For: Electric device to remove skin lesions, also used for cauterization of veins

Cryogenics
For: Used to freeze off dermatological occurrences

Microscope
For: Used to look at serum, stools, urine, sputum

Centrifuge
For: Used to produce lab samples for study

Autoclave
For: Sterilizes instruments

Surgical lights (2)
For: High intensity light for minor procedures

Exam lights
For: High intensity, small lights for examinations

Audiometer
For: Tests hearing (workman comp contracts require)

Crash cart (Banyan kit or similar)

Oxygen Regulator & Tanks
For: Emergencies

IV poles
For: Administering D5W/NS etc. & meds

Kick bucket (stainless steel with 4 wheels)

Baum Meters (10) (wall mounted & portable blood pressure units)

Electronic thermometers (4)
For: Ear canal readings

Surgical Instruments, Assorted

Assorted Misc. Lab and Clinical minor equipment & supplies

Scales (one adult, one pediatric)

Otoscopes/Ophal. (wall mounted, cordless halogen)

Power table
For: minor surgery and specific exams (obese pt./handicap )

Exam tables (with electric and drawers)

Exam stools
For: Physicians to examine patients

Staff seating (mix of ergonomic seats)

Staff desks (all executive style)

Patient seating (ergonomic modern)

Patient furniture (mix of tables and lamps)

Telephone system (console with speakerphones)

Security system (full alarm with security camera and recording capabilities)

Televisions (13” cable ready – in exam rooms)

DVD player (to interface with TVs)

Cabinets
For: drugs and supplies

Fax machine (plain paper, dry toner or ink jet)

Photocopier (15 page per minute, reduction, auto-feeder)

Photocopier (8 page per minute for clinical use)

Postal meter & scale Calculators (with paper tape)

File cabinets (standard 2 drawer lateral)

Misc. Equipment (small office supplies & equipment)

Signs – Internal (various required signs and placards)

Signs – External (one or two signs, lighted or back lit - plastic or wood)

Safe (standard with .5 cubic meters of storage)

Safe (with 4 drawers and suitable for data)

Computer system

Scanners (2)
For: Scanning of documents; capable of scanning health insurance cards and insert into EHR

EHR (Electronic Health Records)

Digital Camera (2)
For: To insert picture of patients into medical records; To document patient dermatology or other conditions

For the most part Urgent Care centers no longer utilize nurses in their clinics because of cost/reimbursement issues. Urgent care centers operate on very thin margins, given the high operational costs of running a center and the reimbursements from insurance companies. An MA or nurse would be expected to take vital signs, administer medications or injections under the supervision of a physician, start an IV, provide nebulizer treatments, assist or apply casting/ortho hardware, provide gait training, infection/ wound management, do urine drug screens, do pulmonary functions, BATs (Blood Alcohol Test), supply management, re-ordering, and lift capacity testing to name a few.

Board certification requires rigorous review of a doctor’s knowledge, experience and skill in a medical specialty. Board certification also means that a doctor is actively improving his or her practice of medicine through continuing education. A board-certified doctor is more likely to have the most current skills and knowledge about how to treat medical conditions.