I step into the waiting room of the St. Catharines Urgent Care Centre on a Tuesday morning, notebook in hand. It’s not yet 10 a.m., but the rows of chairs are already filled with patients – an elderly man clutching his side, a mother with a feverish toddler, a construction worker with what appears to be a workplace injury.
“We’re often the first stop for people who don’t have a family doctor,” explains Dr. Madeline Ashby, an emergency physician who’s worked at this Niagara Region facility for over eight years. “And unfortunately, that’s an increasing percentage of our population.”
The scene playing out before me has become increasingly common across the Niagara Region, where urgent care facilities are evolving beyond their intended purpose as intermediate care options. Instead, they’re becoming primary access points to healthcare for thousands of residents.
According to data from Niagara Health, urgent care visits increased by 27% between 2019 and 2023 across the region’s three facilities in St. Catharines, Fort Erie, and Port Colborne. What’s particularly notable is that approximately 40% of those visits were for non-urgent conditions that would typically be handled in a primary care setting.
“I don’t have much choice,” explains Linda Kavanagh, 64, whom I meet in the waiting room. “I’ve been on the waiting list for a family doctor for three years now. When my blood pressure medication runs out or I need a referral to a specialist, this is where I come.”
Kavanagh’s situation reflects a growing reality in the region. Statistics Canada reports that nearly 19% of Niagara residents lack access to a regular healthcare provider, compared to the provincial average of 14.5%. This gap has direct consequences for how people access care.
Dr. Ashby walks me through the triage area, where nurses quickly assess incoming patients. “We’re seeing everything from prescription refills to chronic disease management to mental health crises,” she says. “The urgent care system wasn’t designed for this volume or variety of needs, but we’ve had to adapt.”
This adaptation comes with challenges. Wait times at Niagara urgent care facilities now average between 3-5 hours during peak periods, according to quarterly reports from Niagara Health. Staff burnout has increased, with nurse turnover rates rising by 15% in the past two years.
In Fort Erie, where I visit later that week, the situation appears even more pronounced. The community lost its hospital in 2009, making the urgent care centre the only medical facility within reasonable distance for many residents.
“This place is a lifeline,” says Ron McPherson, a retired factory worker who uses a wheelchair. “I can’t easily travel to St. Catharines or Niagara Falls. When my health acts up, I don’t know what I’d do without this centre.”
Dr. Karen Lee, who splits her time between urgent care and a small family practice in Niagara-on-the-Lake, points to demographic factors intensifying the situation. “We have an aging population here in Niagara, with higher-than-average rates of chronic conditions like diabetes and heart disease,” she explains. “These patients need regular, ongoing care – not episodic urgent care visits.”
The latest community health profile from Niagara Region Public Health confirms this demographic reality. Adults over 65 make up nearly 23% of the region’s population, compared to the provincial average of 17%. This older population typically requires more frequent and complex healthcare interactions.
The reliance on urgent care as a primary contact point creates ripple effects throughout the healthcare system. Research published in the Canadian Medical Association Journal demonstrates that patients without continuous primary care experience more hospitalizations, poorer chronic disease management, and ultimately higher healthcare costs.
“It’s a vicious cycle,” explains Teresa Wong, a nurse practitioner at the St. Catharines site. “Without primary care, conditions that could be managed early become urgent. Then patients return repeatedly for the same issues because there’s no follow-up. It’s inefficient and frustrating for everyone.”
Some community initiatives are attempting to address these gaps. The Niagara North Family Health Team recently launched a mobile clinic that visits rural communities twice weekly, offering limited primary care services to unattached patients. Meanwhile, Brock University’s nursing program has partnered with local community centers to provide health screening clinics staffed by supervised nursing students.
I attend one such clinic at the Dunlop Drive Community Centre in Welland. The gymnasium has been transformed with privacy screens and basic medical equipment. About two dozen residents wait patiently for blood pressure checks, diabetes screening, and basic health advice.
“This isn’t comprehensive healthcare,” admits Sophia Martinez, the nursing instructor overseeing the clinic. “But it helps identify problems before they become emergencies and connects people with resources they might not know about.”
Back at the St. Catharines Urgent Care Centre, I observe the afternoon shift change. The waiting room remains full, with new faces replacing those who were there in the morning. The digital display shows an estimated wait time of 3 hours and 42 minutes.
Dr. Ashby looks tired as she prepares to hand over her patients to the incoming physician. “We’re doing our best with the resources we have,” she tells me. “But urgent care wasn’t meant to be anyone’s medical home. Everyone deserves continuity of care with providers who know their history.”
As I leave, I notice an elderly couple entering, the woman supporting her husband as he shuffles slowly through the automatic doors. The triage nurse greets them with recognition. “Back again, Mr. Patel?” she asks gently. He nods, and they begin the familiar routine – a poignant reminder that for many in Niagara, urgent care has become their de facto primary care, one episodic visit at a time.
