Urgent Care Medicine (UCM) is the provision of immediate medical service offering outpatient care for the treatment of acute and chronic illness and injury. It requires a broad and comprehensive fund of knowledge to provide such care. Excellence in care for patients with complex and or unusual conditions is founded on the close communication and collaboration between the urgent care medicine physician, the specialists and the primary physicians.
Urgent care does not replace your primary care physician. An urgent care center is a convenient option when someone's regular physician is on vacation or unable to offer a timely appointment. Or, when illness strikes outside of regular office hours, urgent care offers an alternative to waiting for hours in a hospital Emergency Room.
Because urgent care practitioners are on the “front lines” of medicine, they need to be proficient in evaluating and caring for – at least initially – any patient who walks into an urgent care medicine center or urgent care clinic. For this reason, there is some overlap in the scope of practice between UCM and all existing medical specialties that involve direct patient care. Because of the convenience of UCM centers, patients choose these facilities when they are unable to see their usual doctor in a timely fashion or choose not to go to a hospital emergency department.
For most patients seen in an ambulatory medicine setting, the UCM specialist can fully care for the presenting problem, either independently or in consultation with another specialist. Sometimes patients will require follow-up with or referral to another specialist, transfer to an emergency department, or direct hospitalization (with inpatient care by the consultant). UCM specialists do not perform surgery (other than wound repair and skin lesion removal), do not care for inpatients, and typically do not engage in the continuing medical care of chronic medical problems.
Of all of the existing specialties, UCM shares the most in common with family practice and emergency medicine, though there is enough uniqueness of practice that UCM, in reality, is a separate specialty with a distinct knowledge base, skill set, and required breadth of experience. UCM shares with family practice (FP) its broad scope: caring for both male and female patients of any age with any complaint. UCM differs from FP in that its primary focus is on acute medical problems.
Because specialization is the result of focused attention and having experience in a particular area, acute care represent the majority of what UCM specialists do – versus FP practitioners who divide their time caring for some acute, but predominately chronic health issues. Because of this, their experience and expertise in acute care is more extensive than that of FP practitioners. The FP’s area of practice that is distinct from UCM involves continuity of medical care and, for some FP practitioners, inpatient care and obstetrics.
As with FP, UCM shares a broad scope with Emergency Medicine (EM) as well: caring for both male and female patients of any age with any complaint. UCM differs from EM in that its primary focus is on acute medical problems at the lower end of the severity spectrum. UCM specialists have expertise evaluating and treating these patients with only simple office-based laboratory tests (e.g., urinalysis, pregnancy test, rapid strep assay) and X-ray. There is no immediate access to extensive laboratory testing or advanced imaging (e.g., CT scanning and ultrasound). Those who present to an urgent care center who, in the judgment of the UCM specialist, require this, are transferred to a hospital emergency department. Due to the simpler administrative procedures and costs associated with office-based versus hospital-based practice, similar care in an UCM setting can generally be provided more quickly and economically than in an EM setting. The area of EM’s practice that is distinctive from UCM involves the definitive care of critically ill patients and the ability to observe patients for an extended period of time.
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