You can’t pretend urgent care centers aren’t here, and you can’t help but notice when a board-certified emergency physician colleague goes to work for one.

What should ACEP do about it?

The first step to answering that is a mission of ACEP’s newest fact-finding group, the Urgent Care Task Force, which met for the first time on Sept. 30 during ACEP24 in Las Vegas.

Created by Immediate Past President Aisha T. Terry, MD, MPH, FACEP, co-chaired by Ohio emergency physician and ACEP Past President (2008–09) Nicholas Jouriles, MD, FACEP, and California emergency physician and urgent care physician Joe Toscano, MD, and supported by current ACEP President Alison J. Haddock, MD, FACEP, the Urgent Care Task Force is a proactive step toward identifying where ACEP and emergency physicians fit in the urgent care center practice setting and how engagement might benefit members—both in and out of these facilities.

The creation of the Task Force comes at a time when urgent care centers continue to establish themselves as a growing part of the health care system.

Some say they bridge a gap between primary care physicians and emergency departments (EDs). Others say they provide substandard patient care, particularly if they lack board-certified emergency physicians as part of the staffing model.

“One of the key objectives is to figure out what is the landscape today and how it might change,” said Dr. Terry, who stopped by the first Task Force meeting to provide direction. “Physicians are taking a greater role in urgent care centers, so we need to think about the skill set necessary to do that well and how it differs from our skill set that we currently have. What new skills might we need to ensure that we’re prepared to do it? And I don’t think we can have this conversation without some recognition of the role of nurse practitioners and physician assistants in that space, as well.”

The urgent care industry has seen exponential growth in recent years.

According to the College of Urgent Care Medicine, the United States is home to approximately 14,000 urgent care centers and 27,000 practicing clinicians. The association was established in 2004 and now serves as the leading organization for the industry, representing more than 3,500 member centers and providers. This industry, though still in its relative infancy compared to EDs, has become an alternative for patients seeking immediate care for non–life-threatening conditions.

One ACEP Task Force member compared the current urgent care landscape to EDs when they were first incorporated into hospitals, setting the stage for the creation of ACEP 56 years ago.

The Task Force meeting at ACEP24 brought together 15 emergency physicians, including some who participated remotely.

The focus was to define the objectives, explore the differences between urgent care and other health care models, and establish a roadmap for the Task Force’s work. A significant part of their discussion was to investigate how ACEP could provide resources for emergency physicians transitioning to urgent care settings, as well as develop an understanding of how urgent care centers are regulated and managed.

The Task Force’s objectives range from analyzing the current landscape of urgent care to the creation of an Urgent Care Section of Membership for those who practice in this setting or might move in that direction. One of the key objectives is to distinguish urgent care from similar models, like freestanding EDs. Task Force members agreed that this distinction is crucial, as the two models operate differently and cater to distinct patient needs. Urgent care centers focus on providing immediate but non-emergency care, while freestanding EDs are designed to offer the full range of emergency services, albeit outside of a traditional hospital setting.

The College of Urgent Care Medicine reports more than 205 million patient visits in 2022 compared to 131 million in EDs, according to CDC statistics. The workforce in urgent care, according to the association, is primarily made up of health care professionals trained in family medicine at 45 percent. Thirty-five percent are trained in emergency medicine, eight percent in pediatrics, and three percent in internal medicine.

“We know that traditional brick-and-mortar practice and ED emergency medicine alone will likely not suffice long term,” said Dr. Terry. “It’s time to get the building blocks of knowledge that we need to understand this space, and then, more specifically, understand how to ideally insert ourselves into that space in a meaningful way.”

The Task Force identified several challenges that need to be addressed. One key issue is the lack of standardized regulations across the urgent care industry. Unlike hospitals and EDs, which are heavily regulated, urgent care centers operate under a patchwork of state-level regulations, making it difficult to ensure consistent quality of care. Another challenge is the relationship between urgent care centers and hospitals. In some cases, hospitals may see urgent care centers as competitors, which can lead to tension and potentially hinder collaboration.

Meeting attendees also highlighted the role of private equity in urgent care operations. While private equity investments have contributed to growth of the industry, there are concerns about how this business model might affect patient care. They agreed that any urgent care initiative undertaken by ACEP must prioritize patient safety and quality of care over financial considerations.

Key action items of the Task Force include organizing a list of objectives, assigning volunteers to work on specific areas, and developing a survey to gauge ACEP member interest and participation in urgent care medicine. The Task Force will also engage with the Urgent Care Association of America (UCA) to ensure that all relevant stakeholders are involved in the process.

The Task Force’s goal is to finalize its report by ACEP25 in Salt Lake City in early September.

Urgent Care Task Force Objectives

• Determine the current landscape of urgent care centers, including quantity, locations, volumes, and capabilities, as well as associated physician and non-physician provision of care.
• Make the distinction between urgent care centers, retail clinics, minute clinics, and freestanding EDs.
• Assess the current prevalence of clinical partnerships between emergency medicine and urgent care centers. Make recommendations on a future role in this space, particularly related to collaboration.
• Explore credentialing opportunities for physicians practicing in urgent care centers, including possible ABEM subspecialization, focus practice designation, or board certification.
• Describe the business and financial models of urgent care reimbursement, including the process for when a patient is transferred between an ED and an urgent care center.
• Determine what additional skills might equip and prepare emergency physicians to practice urgent care medicine that are not currently taught in emergency medicine residency.
• Identify resources currently needed by emergency physicians who primarily work in urgent care centers.
• Make recommendations for how to enhance the body of scholarly work related to urgent care practice, and how ACEP might be instrumental in such efforts.
• Generate a list of quality metrics for urgent care centers.

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Urgent Care Task Force Survey

Should ACEP Develop an Urgent Care Section? What’s the main outcome you would like to see from the Urgent Care Task Force?