By Jane Ehrhardt
“Children don’t get sick on a schedule, and it’s unreasonable to expect pediatricians to be open 24/7. That’s where we come in. We serve as an extension to their team,” says Allury Arora-Lal, MD, the founder and Chief Medical Officer of Urgent Care for Children.
Urgent care clinics fill a gap in America’s healthcare system by providing convenient, on-demand care without the high cost of an emergency room visit. Started in the U.S. in the 1970s, many were opened by emergency medicine doctors responding to the need for walk-in care for minor illnesses, fractures, sprains, and wounds during the off-hours of traditional primary care practices. The centers, most of which cater to all ages, have taken off in the last decade, especially in suburban areas, growing to almost 10,000 throughout the country.
More recently, pediatric urgent cares have sprung up to focus only on children. Urgent Care for Children, which started in 2017 on Highway 280 was designed with children in mind. Waiting areas offer coloring books, cartoons, and QR codes for parents to download books for contactless reading. “We offer snacks, popsicles, and drinks to our patients because most come after school or right after evening activities. They’re hungry. And hungry kids can get cranky,” Arora-Lal says.
Serving patients from newborns to young adults up to 21 years old, the centers are open evenings, holidays, and weekends every day of the year and are staffed with pediatric-trained healthcare staff. “It can take a special heart and specific training to know how to handle children.” Arora-Lal says. “They are coming into a new, overwhelming environment feeling sick. Our staff is trained to not just support the children, but also the guardians and parents who accompany them.”
Some traditional urgent care centers will not treat very young children or infants, automatically sending them on to ERs. “Pediatric physiology and the way children’s bodies process pharmacology is unique, and you need to be proficient to safely treat children, even with such common medications as steroids and antibiotics,” Arora-Lal says.
Everything is offered under one roof at the clinics, including labs and x-rays. “We also have a pharmacy so parents don’t have to run around town to pick up prescriptions,” Arora-Lal says. About 45 percent fill their prescriptions at the centers.
Around 50 percent of their patients return for treatment at some point, but the clinics do not serve as a source for primary care. “I see pediatric urgent care as a partner to our patients’ primary care, which is their medical home,” Arora-Lal says. “With strong communications, we can create a seamless process of care.”
To keep the patients tied into their primary care physician, the urgent care sends detailed notes of the patient’s visit to their PCP by the next day. The centers also do not offer any well-child visits, such as immunizations (except Covid), vision and hearing testing, milestone visits, and growth plotting. “They go to their family care doctor for that,” Arora-Lal says.
About 10 percent of the almost 100,000 Alabama children and young adults seen annually by their centers arrive with no primary care provider connection. “In that case, we act as the entry point into the medical care system for them,” Arora-Lal says, and refer them to area pediatricians for continued care.
Urgent care also brings a unique value proposition to the healthcare industry. “Getting patients into the appropriate setting has the potential to save billions of dollars,” Arora-Lal says. The average urgent care visit runs about $160. For the same treatment, the patient would spend $2,000 at the emergency room, according to a 2016 study in the Annals of Emergency Medicine. “We are the option for these families who don’t have pay the expensive ER copay for reasons like rashes, urinary infections, sore throats, and fevers.”
Besides lower out-of-pocket costs, urgent cares tend to be more accessible than hospitals, with twice the expansion in suburban areas than in urban ones. They also see patients very quickly. Almost 97 percent of urgent care patient interactions lasted an hour or less, and 92 percent saw a provider within 30 minutes, according to the Urgent Care Association 2019 benchmarking report.
This convenience of walk-in appointments, cost savings, and accessibility to quality care is why urgent care centers continue to sprout up. As of this year, 78 percent of the U.S. population is within a 10-minute drive to an urgent care center, according to the Urgent Care Association. Urgent Care for Children has quickly expanded in the last five years to 11 locations in Alabama with nine more in Tennessee and Louisiana.
Arora-Lal foresees pediatric urgent care experiencing growth, not only because of consumer demand, but also to fill the shortage of primary care physicians, making same-day visits even harder to obtain. “When you have a sick child, you don’t have time to wait for another day,” she says. “We are the solution to many issues in healthcare continuity.”