NEJM Catalyst: Urgent Care is a Key ‘Disruptor’ of Primary Care

Starting with the premise that “primary care is at the vortex of massive changes driven by cost-control pressures and reimbursement transformation,” an article in NEJM Catalyst proceeds to explain that urgent care is a key disrupter of primary care as we know it. In essence, the authors argue that the requirements imposed on primary care practices are in conflict with patient preferences, leaving the primary care field in a no-win situation. In regard to the pressures on primary care, clinicians are “accountable for managing and documenting high-quality care, reducing medical expenses, and ensuring outstanding patient experiences. However, the technical and practice-related systems that are required to provide comprehensive and proactive care reliably, effectively, and efficiently are not commonplace.” Further, the article goes on to say, without streamlined systems, providers are forced “to spend increasingly more time on administrative tasks rather [than] on actual care.” Increasingly dissatisfied patients, they say, are being driven to seek care in settings that are more dynamic and readily accessible—urgent care being prominent among them. The article also puts telemedicine, medical apps, and mobile paramedic programs in the “disruptors” category. It’s not necessarily a negative term, however; the authors reason that the only way for primary care to reverse the trend of patients going elsewhere is to move forward and adopt some of the practices now becoming common in other settings.