Younger Americans are increasingly turning to urgent care centres rather than establishing relationships with a primary care physician, according to newly released federal data that underscores a seismic shift in how a generation accesses healthcare. In 2024, 27.6 per cent of people had at least one visit to an urgent care centre, with adults aged 18–64 and children aged 0–17 both significantly more likely to attend than those over 65, the National Health Interview Survey found. The trend, also visible in 2021 data from the U.S. Centers for Disease Control and Prevention, reflects a decade-long pattern that has seen the number of urgent care centres in the United States double.
Younger adults drive urgent care surge
The expansion of the sector has been explosive. Between 2014 and 2023, the number of urgent care centres nearly doubled, rising by 99.2 per cent from 7,220 to 14,382, according to industry data from the Urgent Care Association. Projections suggest further growth is expected. In 2023 these centres treated an estimated 206 million people. Excluding Covid-related visits, utilisation increased by 18.9 per cent from the second quarter of 2019 to the second quarter of 2023, while the number of centres rose by 25.2 per cent over the same period, suggesting supply may be outpacing demand. Spending on urgent care grew by more than 50 per cent between 2018 and 2022, driven primarily by a sharp increase in visits, with average per-person spending rising from $18 to $27.
The demographic profile of urgent care users is unmistakable. In the 12 months to June 2025, 29 per cent of urgent care patients were children and young adults aged 21 or younger. Among adults, the proportion who said an urgent care centre or a clinic in a drug store or grocery store was their usual source of healthcare was 12.2 per cent for those aged 18–34, falling to 3.8 per cent among those 65 and older. Overall, 8.6 per cent of adults reported such a clinic as their usual source of care in 2024. Geographic differences also emerged: among adults aged 18–64, urgent care visits were less common in large central metropolitan areas (26.6 per cent) and non-metropolitan areas (26.1 per cent) than in large fringe metropolitan areas (31.5 per cent) and medium or small metropolitan areas (30.6 per cent).
This shift towards urgent care is happening against a backdrop of a severe shortage of primary care physicians. A 2024 analysis projects a shortfall of 87,150 full-time equivalent primary care doctors by 2037, while the Association of American Medical Colleges estimates a shortage of 86,000 physicians by 2036. Only 24.4 per cent of U.S. physicians currently practise in primary care specialties, well below the benchmark of 50 per cent. Some 76 million people live in primary care deserts, and the average wait for a new patient appointment with a family medicine doctor in major metropolitan areas has stretched to 26 days, up from 18 days in 2014. For established patients the average wait for a non-urgent appointment is 22 days. Meanwhile, patient volume at urgent care centres has risen by 67 per cent since 2020, while primary care office visits have declined by 12 per cent over the same period. More than 40 per cent of adults aged 18–29 do not have a primary care physician, according to a 2019 poll from the Kaiser Family Foundation, and a survey by Aflac insurance last year found that over half of Gen Z and Millennial Americans primarily use urgent care and the emergency room for their health needs. Among millennials, 62 per cent lack a regular primary care doctor, compared with 28 per cent of baby boomers.
Convenience and access trump continuity
Several factors explain why younger adults are gravitating towards urgent care. Many in good health do not believe they need long-term or preventative care until they are older or develop an obvious condition. Going to an urgent care centre is convenient and often less costly than an emergency room visit: a study in the Annals of Emergency Medicine found that treatment at an urgent care centre costs approximately one-tenth of an ER visit, with copays averaging $30–$50 compared with $20–$30 for primary care. The medical publication Physician’s Weekly notes that cost, location and complacency are barriers to accessing primary care. An inability to secure timely appointments is another key reason. As family physician Natasha Bhuyan told the American Academy of Family Physicians, “Convenience and access, for patients, trump continuity. We need to get comfortable with transitional care, but still show patients the value of continuity in the process.” Doctor burnout is also reducing the number of available physicians, with over half of primary care doctors reporting burnout in 2024.
The hidden dangers of episodic medicine
While urgent care offers speed and lower cost, doctors warn that sole reliance on these centres carries significant risks. “Urgent care isn’t bad medicine; it’s episodic medicine,” Dr. Howard Willson, a Washington-based emergency medicine doctor who works in urgent care, has said. “Nobody’s watching the long arc of your health.” Because clinicians at urgent care centres typically meet patients for the first time and lack access to their full medical records, they cannot provide the comprehensive understanding that a primary care physician develops over years. Dr. Sarah Nosal, president of the American Academy of Family Physicians, has warned that this can lead to missed or incorrect diagnoses, potentially creating greater health problems down the line.
The limitations of episodic care become particularly concerning when set against rising rates of serious disease in younger populations. Colorectal cancer, for example, is increasing in Americans under 65, according to the American Cancer Society. Incidence rates are rising by 3 per cent per year in those aged 20–49 and by 0.4 per cent per year in those aged 50–64. Rectal cancer now accounts for nearly one-third (32 per cent) of all colorectal cancer diagnoses, up from 27 per cent in the mid-2000s. For adults under 50, colorectal cancer is the leading cause of cancer-related mortality, and three in four cases in this age group are diagnosed at advanced stages. The American Cancer Society recommends screening begin at age 45 for average-risk adults, but only 37 per cent of individuals aged 45–49 were up to date on screening in 2023, and that figure fell to 14 per cent for those without insurance. Lack of access to care is a major barrier.
Primary care physicians, by contrast, are trained to detect problems before symptoms become obvious and to assess risk for genetic conditions. “You have even more of a reason to get a primary care physician and regular checkup if you have a biological relative with a strongly genetic illness like colon cancer,” Dr. Edward Kim, a primary care specialist at UChicago Medicine Medical Group, explained in a 2022 statement. “That changes our medical decision-making because you may qualify for a colonoscopy at 25 years old.” Urgent care centres are not designed to manage long-term health problems. While they can provide a bridge to such care and increasingly offer routine monitoring and medication management for flare-ups, they are not a substitute for the continuity, preventive focus and longitudinal oversight that a primary care team delivers. The risk is that younger adults who rely entirely on urgent care will miss early detection of conditions like hypertension, diabetes or cancer, and will have no single clinician tracking their overall health trajectory.
Addressing the crisis
Fixing the growing disconnect between younger patients and primary care will require a multi-pronged approach. One suggestion is online marketing that allows doctors to display their expertise and attract millennial patients. Expanding scheduling options and telehealth services can also improve access, meeting patients where they are. “Convenience and access, for patients, trump continuity,” Bhuyan said, emphasising that the value of continuity still needs to be demonstrated to patients. Physician burnout, a key driver of the shortage, must be tackled by training and financially supporting more primary care doctors and eliminating pay gaps between primary care and specialist physicians. Dr. Peter Grinspoon, a primary care physician at Massachusetts General Hospital, wrote in a 2022 blog that “we need to buttress those doctors who are currently trying to stick it out as primary care doctors, so they don’t cut down hours or quit. These doctors urgently need emotional, financial, logistical and psychological support.” Technology can help reduce administrative burdens, and strengthening community-based family medicine alongside screening awareness campaigns — particularly for colorectal cancer starting at age 45 — are essential steps. Without such measures, the drift towards episodic care will continue, leaving a generation without the long-term health surveillance that only primary care can provide.
