The Debate on Westchester Walk-in Medical-Care

They’re fast and convenient, but are urgent-care centers good for our healthcare system?

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Lee bluntly adds, “There is discontinuity of care. People, many times, don’t pass on information to their physicians or primary-care providers. In a healthcare environment where we’re trying to consolidate and integrate care, this is actually a massive disintegration of the communication chain.”

The effects of urgent care on the business of medicine in Westchester aren’t being felt very strongly—yet. Sole practitioner Michael Fusco, MD, says, “Even though I’m within a couple of miles of urgent-care centers, I’m busier than I ever have been. Generally, the way my office works, I cover my patients, myself, 24 hours a day anyway. But I’m the exception, not the rule.” He says he doesn’t hesitate to send a patient to an emergency room or urgent-care center if they call him and he feels they need immediate assistance that he can’t provide right at that moment. 

Westchester hospital emergency rooms are also busier than ever. From 2005 to 2010 (the latest year with available data from the New York State Department of Health), ER visits jumped nearly 25 percent at County hospitals. St. John’s Riverside Hospital Emergency Department currently sees 38,000 patients annually in a space built to serve 25,000, and its volume is continuing to grow at more than 3 percent per year. The new Flanzer Center for Emergencies and Critical Care at White Plains Hospital provides emergency and critical care for more than 48,000 patients annually.

While urgent-care centers may be relieving some of that pressure, it’s probably going to get worse before it gets better when the Affordable Care Act takes full effect next year. As Fusco points out, “The Affordable Care Act is insuring millions of new people, but it doesn’t say who’s going to take care of them.”

Urgent-care providers are hoping to fill that gap, but even they know there’s more to the opportunity than meets the eye. “People without insurance today are reluctant to go to doctors because of the expense. They wait until the last minute,” explains Dan Purugganan, director of operations at Doctors Express, an urgent-care franchise that opened in Hartsdale in 2011 and is actively seeking more locations.