If you’ve needed a COVID-19 test or broken a bone recently, you’ve seen it. Access to urgent care is strained statewide. Urgent care tends to be a standalone center that offers immediate outpatient services. Think minor injuries and infections.
In a weekly update to state agencies, the Oklahoma State Department of Health warned that strain has led to cutbacks. It reads, in part, “Urgent care centers are reporting decreased hours or are shutting down due to inability to serve patient volume or redirect staff to other facilities to support an increase in patients.”
Dr. Jaime Zengotita is the clinical director of operations for Mercy GoHealth, a collection of urgent cares under the Mercy hospital system. He said that the late-summer surge hit that system hard.
“For the month of June, we did about 4,000 tests,” he said. “In the month of July, we did about 5,000 tests. In the month of August, we reach almost 10,000 tests just in Oklahoma City.”
The strain on Mercy’s urgent care centers took a while. At the beginning of the pandemic — March and April 2020 — Zengotita says demand bottomed out. Some centers were seeing no patients. With mask mandates, closed restaurants, only essential workers going to work in person, there were just fewer people getting sick and getting hurt. And testing hadn’t really started yet.
Then, last summer, the centers got their hands on some rapid test equipment.
“We decided we were not going to advertise, that we’re not going to do any marketing — just to sort of see what the workflow is going to look like,” he said. “And literally by the end of that first day, I don’t know, the word ran through town, and people were standing in line to get tested.”
That rampant demand has held steady. Flu season is always busy for all urgent cares, but Mercy GoHealth was seeing numbers that dwarfed flu season records for most of the pandemic.
Like all other health providers, the centers are seeing staff shortages. But it’s not just nurses and doctors. They’re in dire need of radiology technicians and medical assistants. Those workers have more extensive training than that of a certified nursing assistant, also called a CNA, but less extensive than a nurse. They provide administrative support as well as medical support.
"As we’ve gone out there and try to recruit and hire more MAs to be able to meet that increasing capacity, the pool is very shallow right now," said Lou Ellen Horwitz, the chief executive officer of the Urgent Care Association, a national trade group. "ERs are trying to get more staff. Hospitals are trying to get more staff. [Doctor's] offices are trying to get more staff."
Horwitz said the medical assistant shortage — like the nursing shortage — isn't new, but severely exacerbated.
“I think what it comes down to is that the growth in urgent care has outpaced the labor pool and the ability of schools to, you know, graduate enough students to fill the roles, particularly as medical assistants become more and more in demand,” she said. “They’ve always been a key part of the urgent care model, but a lot of other health care organizations are starting to add them. And so that just makes it even more competitive.”
And staffing issues don’t end at procurement. Dr. Paul Wright, the vice president of medical practice at SSM Health St. Anthony, said that on top of not having enough staff, some can get sick themselves.
“There’s the concentric circles around someone who is sick,” he said. “And even if you’re feeling fine, there are different times you have to limit your exposure because of ongoing exposures at home, especially for our single parents or ones that have little kids.”
Wright said because the urgent care is part of a larger system, workers can get shifted over. But even that has gotten harder.
“It's unlike last summer and last spring when everything shut down, we had furloughs. We had people that were allowed to go home and be off because we just had that decreased demand," he said. "It’s full steam ahead plus for the outpatient arena. And the hospital, of course.”
Over the past few weeks, Oklahoma’s COVID hospitalizations have decreased, and so have case counts. State officials are hopeful that without a new variant, the situation will continue to improve somewhat in the near future.
