I would tend to agree with his assessment:
At one end, there’s the growing field of concierge care. People pay from $1,000 to $10,000 a year just for access to a doctor. The doctor has a lesser workload, and the patient in theory gets more personal attention.At the other end is emergency rooms, public health clinics and practices that handle high volumes of people with little personal attention.
“In between all this is a huge gap,” Mason said. “This model has a good chance of working because people want the same thing in their health care as they do in their retail — they want high quality and they want it quickly.”
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- How retail clinics will harm primary care and the public good
- Flea to the AAP: Suck it up
- Retail clinics and disruptive innovation
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{ 3 comments }
I am down with this business model. In the ER as a junior doc I am the one who mostly picks up the slack with respect to these patients anyway. The things that COULD be an emergency, but are often not. Chest pain, for example. Most of the time, if the history is good and the risk factors are there, we do EKG, CXR, one set of cardiac enzymes as well as some other stuff depending on the presentation. “GI cocktail” for suspected GERD, GB U/S for cholelithiasis, or mo-feen for suspected msk issue. All of this could be done by burnt out ER docs with lots of experience in an urgent care clinic near a hospital, especially if they have U/S. It’s better to let the Drs triage the pts anyway, cuz ppl just wont tell some things to nurses.
Gee, left out some stuff: d-dimers for low risk PE pts, amyl/lip for pancreatitis, and fingersticks for known DMers or AMS. Risk stratification (aka “triage”) would be key here. Let’s just exclude older, unstable, dysrhythmic, coagulopathic, or s/p revascularization-ers. Or anyone who might need a consult. Definetely AMSers or gomers. Many hospitals as well as mine already have a system in place for this: In 16 shifts I have yet to see an asthmatic patient, uncomplicated broken bone, uncomplicated abscess (’cept at night when the PA’s who staff the “other” ER go home). I think ppl would rather see a dr., tho.
Anything conceivably not requiring consult, admission, CT, or AMS workup would be ideal. Frustrated ER docs with ER’s clogged with sniffles and scrapes and drug refills would be ideal. Esp if U/S was a big part of it. Interesting.
Exactly right! “High quality and quickly” is the key to urgent care medicine. The Urgent Care Association of America is helping many physicians enter the growing field of urgent care medicine. It features two full-day (plus) conferences on starting an urgent care center each year. It is a great opportunity to find out what it takes to start an urgent care center. At Practice Velocity Urgent Care Solutions, it has been a great privelege to work with so many bright, motivated physicians in opening new urgent care centers.
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