Expert Spotlight: 5 Questions with the Urgent Care Association

You’ve probably been to an urgent care clinic. It’s a rapidly growing segment of the healthcare industry that sees 65-80 million patient visits each year. ARAC formed a partnership with the Urgent Care Association (UCA) in 2016 to promote antibiotic stewardship in the sector — action that could help slow the growing threat of antibiotic resistance. In announcing our partnership, UCA said: “We want to do more than just our part in helping achieve this goal. We want to lead the way.” We talked to Laurel Stoimenoff, CEO of the Urgent Care Association to learn more about antibiotic stewardship in urgent care.

1. We're excited to have formed a partnership with you! Can you tell our followers more about UCA and its work?

UCA supports a collaboration between the Association, the Urgent Care Foundation and the College of Urgent Care Medicine. Each play a key role in supporting the work we do representing the urgent care industry, its providers, research and philanthropy. UCA’s mission states, “We advance our industry and support success through advocacy, education, research, collaboration and high standards of excellence.”

UCA recognizes the value of urgent care in the communities they serve. One objective is to advocate on behalf of our members. As a trade association, our members include individuals and organizations directly providing care and many vendors who serve them. UCA currently puts on the largest convening of the industry through its Annual Convention & Expo that takes place in the spring of every year as well as a Fall Conference. In our quest to advance the industry, UCA has also established certification which is largely about scope of services, and accreditation programs, which address quality and safety. We are proud that UCA now accredits more urgent care centers than any other accrediting body.

2. The urgent care industry is a rapidly growing sector in healthcare. How fast is your industry growing and what do you attribute this to?

The industry is consumer-centric and consumers were ready for cost-effective, accessible same-day medical care for non-emergent illnesses and injuries. In addition to easy access, urgent care centers are often a one-stop destination for care with access to a provider, x-ray and laboratory services under one roof. Convenience coupled with shortages of primary care physicians, investor interest, and hospitals shifting their focus to an ambulatory care strategy created an almost unprecedented growth trajectory. Our database now reflects over 8,200 U.S. based urgent care centers, growing from 6,400 in 2014 and 7,200 in 2016. Urgent care costs a fraction of an emergency department visit in a fraction of the time. As consumers bear greater responsibility for payment, they are seeking lower cost, high quality alternatives.

3. We love that you have prioritized tackling antibiotic stewardship as one of your top priorities. At what point did you realize that this issue needed to be addressed more urgently?

UCA joined with ARAC in 2016. Prior to that we had provided education at events to our members at our conference and conventions and through other means; however, there was significant literature being produced on the dangers associated with antimicrobial resistance and the agricultural and medical industries both had a role to play in addressing it for the future health of our communities. Urgent care centers are destinations for patients who are suffering from both illnesses and injuries that may or may not require an antibiotic.

We produce an annual Benchmarking Report where we seek the top five to 10 diagnoses. Since urgent care centers aren’t typically providing many of the wellness and follow-up visits that a provider might encounter in a traditional family medicine practice, the percentage of acute illness presentations to the urgent care center naturally exceed most ambulatory care settings.

4. What is UCA doing to make the urgent care industry a leader in antibiotic stewardship?

As I mentioned, we teamed up with ARAC in 2016 in an effort to create awareness, provide education, better understand the perspective of the consumer, and determine how best UCA and the College of Urgent Care Medicine (CUCM) can be a voice for antibiotic stewardship within the industry. This month (July 2018) we meet with ARAC, the CDC and industry leaders for an antibiotic stewardship in urgent care summit with a follow-up already planned in conjunction with our Fall Conference in October 2018. CUCM has made Antibiotic Stewardship one of its 2018 Strategic Objectives, submitted its Commitment to Stewardship to the CDC and is drafting an industry specific Antibiotic Stewardship Toolkit. Additionally, UCA’s Accreditation Standards Committee reviews its standards on an annual basis. The Committee added antibiotic stewardship as a component of an organization’s overarching quality plan in its 2019 Standards. There are a number of medical providers who are champions for stewardship within the industry and we are pleased to have their voices within UCA.

5. What do you want patients who visit urgent care centers to know about antibiotic resistance and antibiotic stewardship?

I speak to a multitude of urgent care providers across the country. They care about their patients and their patient’s future. We all want the patients to understand the ramifications of antimicrobial resistance and the impact it has now and, if unchecked, how it will have devastating results in the future. They need to place their trust in their medical providers to evaluate them and determine the best course of treatment, which may simply be non-prescription symptomatic relief because their provider is protecting their future and the health of future generations.

The consumer is an integral component of the success of any stewardship program. I believe that many now understand that antibiotics are not always indicated despite how badly they may feel, but there is much to be done to ensure that all patients have the same understanding. And I’d want them to know it’s just not about the visit to their physician but also to the grocery store. Data shows that millions of pounds of antibiotics are used in food animal production each year, much of it unnecessary. As a result, antibiotic stewardship is necessary in animal agriculture as well. Consumers and patients should look for meat labeled "organic," "raised without antibiotics" or "no antibiotics ever.” We all play an important role in antibiotic stewardship, for the future health of our communities.