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I have a story I want to share with you, but I’m finding it hard to do without it reeking of privilege. This is a story about feeling 100% welcomed in one place when you don’t feel that way in many others. This is a rare for me, and perhaps it will feel like a poor example to you. Yet, it is part of my lived experience and brought something home for me that made me think of the Urgent Care community and how it may help us grow as an industry. I hope you will take it in the spirit in which it’s told and forgive me if it offends you in any way.

The other day, I was running errands, looking rather shabby—no makeup, messy ponytail shoved into a baseball cap, sloppy clothes. Consequently, I felt myself slinking in and out of the stores I went to, not making much eye contact, not really speaking to anyone. I didn’t want to run into anyone I knew or put forward this version of myself in a way that would be noticed. I was hiding. Then there was Ulta.

Ulta is a cosmetics store—one that has been very outspoken in its definition of beauty—in opposition to the majority of the beauty industry. In its marketing, Ulta is very clear that the definition of beauty is infinite because everyone is beautiful in their own way, no matter what they look like. On the doors of its retail stores, Ulta is very clear that hate is not tolerated, and when you get into the store, the diversity among the sales staff is absolutely striking.

What I found walking into Ulta is that I suddenly quit worrying about what I looked like because I knew that in there it truly didn’t matter. I knew that because they told me over and over again in direct and indirect messaging throughout the store. Walking in there was like laying down a small burden I didn’t even realize I was carrying. I relaxed, asked questions about what I was looking for, got help, and walked out feeling better than when I’d walked in.

Let me remind you, I am a middle-aged, white, heterosexual woman, and this is just a cosmetics store. But I realized I was still carrying shame into that store because of how I looked that day.

How must it be for our patients who worry about how they might be perceived every day, in a high-risk situation like an Urgent Care, where they are confessing their health issues to total strangers, hoping not to feel shame—however unwarranted—at the same time? And most importantly, what are we doing to eliminate that shame and fear before they even walk in our doors? Probably not enough.

UCA’s Commission on Diversity, Equity and Inclusion (DEI) has been working on a new Commitment Statement and Commendation for our Certification and Accreditation programs. As we’ve been looking at the criteria for these, we’ve recognized that Urgent Care’s commitment to DEI cannot just be internal. It must be external to actually be effective in addressing healthcare disparities because if our communities don’t know about our commitment, many patients may never consider coming in our doors. Think about this as you think about your visit counts. The cost of that fear is not just spiritual, it’s economical.

This work continues to convict me as a leader of UCA as well. When I look at “The People Behind UCA” on our website, I see diversity, and we have made it transparent that DEI is important to UCA. We have also improved our recruiting policies and evaluated our boards, but are we doing enough? Almost certainly we are not.

And I’m not talking about checking boxes. I am talking about creating a “place” where everyone in Urgent Care can relax for just a minute. For example, does everyone arrive at our conventions thinking, “At last I’m somewhere I can just be myself?” Probably not. We still have work to do. Let’s go into 2024 committing to doing it together.

The Cost of Fear

Lou Ellen Horwitz, MA

Director of Staff Development & Communication at MultiCare Retail Health & Community-Based Care, Chief Operating Officer at the Urgent Care Association
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