Crain’s Health Pulse
July 7, 2016
As the growth of urgent care centers has accelerated over the past several years, more emergency department clinicians are making the leap to these companies that stress convenience and accessibility for patients and offer a quieter lifestyle for medical professionals. About 70% of clinicians currently working at CityMD, and about 75% of the clinicians at GoHealth Urgent Care, previously worked in emergency departments. As New York incentivizes the move away from hospitals and toward outpatient care, more practitioners may have to make a similar transition.
Crain’s chatted with a physician and a licensed nurse practitioner, who both left hospital emergency departments to work at walk-in clinics to find out why they defected, and whether it was worth it.
Dr. Kenneth Weinberg, who now works at ProHEALTH Urgent Care, said he chose to leave emergency department work after more than 20 years because he grew frustrated by his inability to provide continuing care to his patients with chronic diseases. While the episodic nature of his work continues in the world of urgent care, the level of tragedy Weinberg sees is “dialed down significantly,” he said.
“I used to dread going to work as my career went on,” said Weinberg. “It was just really onerous.”
But the pay was good. Weinberg said he made $200 per hour in the emergency department at Holy Name Medical Center in New Jersey. Since leaving in 2011, he has accepted hourly pay cuts of $50 to $80 in his subsequent urgent care positions. The employee benefits in urgent care are also less robust, Weinberg said.
Weinberg has worked at several urgent care chains and in most cases the pay cut has been worth it for him.
“A very well-run urgent care can be a really pleasurable place to work,” he said, recalling a positive relationship with his colleagues at CityMD, where he worked from October 2012 to June 2014.
The hours could be long, if a lot of people came just before closing, because there was no one to relieve him from his shift, as there would be in a hospital. Still, Weinberg appreciated that the office was well-organized and less hectic than an emergency department.
He said he ultimately quit because he didn’t like the organization’s corporate culture.
For nurse practitioners, the move to urgent care also has its pros and cons. Nancy Marrazzo, 51, previously worked as a nurse practitioner at Beth Israel and Long Island College Hospital before taking a position at GoHealth Urgent Care, which is affiliated with Northwell Health.
Marrazzo said she now gets to spend more time with patients. But while working at a hospital-affiliated urgent care center appealed to her, she said it still doesn’t offer the same level of access to resources like medical tests.
Weinberg said the limited opportunity for career growth in urgent care continues to be a major drawback. But urgent care operators say they are working to create career trajectories and incentives that will attract the best medical practitioners. “We have examples in our organization of providers who took on medical director roles and now run an entire market,” Todd Latz, chief executive of Atlanta-based GoHealth Urgent Care, which is partnered in New York with Northwell Health, said during a Crain's health summit panel on urgent care last week.
While a spokeswoman for CityMD said the chain prefers to recruit from emergency departments rather than medical schools, GoHealth said it is starting to hire new graduates from primary care programs at schools including Duke University, Nassau University Medical Center, Northwell Health-Glen Cove and Northwell Health-Plainview.
“If you went back in time and looked at urgent care five, seven, 10 years ago, it was physicians who were running from something,” said Latz during the panel. “I think what we’re seeing today is they’re really running to this model now because it allows them to be caregivers full-time.”
New York medical schools contacted about the destinations of their recent graduates were unable to provide specific data on how many ended up in urgent care.