Comments on: Are emergency physicians best served to staff urgent care centers?

By: Anonymous

Anonymous — Wed, 21 Oct 2009 20:34:52 +0000

“It is ridiculous. The great majority of visits are not urgent at all. All shift, I am thinking, “why couldn’t they wait for their doctors office to open?”

In a perfect world, everyone would be somewhat calm and collected when it came to smaller medical issues. However, this is far from a perfect world. I get a cut on my hand, I clean it, apply pressure if needed, slap on a bandage and I’m done with it. Someone else with the same cut might freak and need to see a doctor ASAP. if they can’t get in to see their regular doctor (or don’t have a regular doctor) going to an UC Center is more appealing than going to an ER. Suck it up, Suzie! it’s one of the many joys of being a doctor.

By: Anonymous

Anonymous — Mon, 04 May 2009 16:51:00 +0000

When I've worked in Urgent Care clinics, what I would find is the majority......the VAST majority.....of patients have problems that sould have been addressed in a primary care office.

The patients called. Not at 3-AM. Not on a Sunday afternoon. They called on, say, a Tuesday. At 9-AM when the office started answering the phone.

The patient gets told they cannot fit in the patient for the urgent problem. No time in the entire day. They can see the patient the following week.

Then they go to an Urgent Care, for a problem I could see in my office for half the price.

By: Rogue Medic

Rogue Medic — Sun, 03 May 2009 05:36:00 +0000

An urgent care physician shot back with an interesting argument, saying that emergency doctors are, in fact, not the best trained to treat urgent care problems. He found that, "emergency physicians, who tended to rely heavily on expensive and time-consuming labs and tests, were not always as fast at diagnosing and treating as internal medicine or family practitioners." Is there some research comparing similar patients? Is there outcomes research showing that emergency physicians are worse at treating patients?

And the big question - if these are the patients, who do not belong in the ED, is the comparison with ED patients anything but misleading?

There are many ED problems, but is promoting animosity the solution?

By: Anonymous

Anonymous — Fri, 01 May 2009 19:22:00 +0000

"Why would an ER doc want to work Urgent Care?":

1. No hospital admin. pinhead hassles
2. No medicare core measure BS
3. Insured, or cash paying patients.
4. no freeloading, medicaid entitled losers.
5. no unsolvable social problems
6. no EMTALA
7. less liability. If it is tough send to the ER
8. No futile G-tube, foley, daiper, dementia nursing home care.
9. No spitting, urinating, puking, cussing drunks.
10. No bipolar, dilauded seeking dope heads
11. No hospital admit boarding
12. No nurse call offs
13. Close at 10pm

just to name a few

By: Anonymous

Anonymous — Fri, 01 May 2009 17:28:00 +0000

I am a family practitioner who occasionally moonlights at an urgicare, which is usually staffed by er docs.

It is ridiculous. The great majority of visits are not urgent at all. All shift, I am thinking, "why couldn't they wait for their doctors office to open?"

The need for urgicare is a myth. There is no such thing as urgent care, things are either emergencies or they can wait. And I do not think urgicare saves the system any money by keeping people "out of the er"; in fact,it porbably increases cost by increasing utilization.

Urgi care is a lie, a disingenious attempt to further undermine primary care.

By: WhiteCoat

WhiteCoat — Fri, 01 May 2009 14:20:00 +0000

There are going to be high utilizers in any specialty.
Real determination is what services can be provided. Most internists I know won’t touch little kids or gyne problems. Many FPs I know aren’t comfortable with suturing or setting broken bones. I see very few other primary care physicians reading their own x-rays. If you can find someone in another specialty that performs all the tasks needed in an acute care clinic, hire them.
In response to Anon 9:15 – why do ED physicians want to work in an acute care clinic? Hmmmm. Minor cut in pay to deal with 90% less hassles, patients who are thank you for treating them, and a much more relaxed atmosphere. Tough choice.

By: Anonymous

Anonymous — Fri, 01 May 2009 04:50:00 +0000

In addition to testing the ER doc has a bevy of specialists to ask their opinions, since there is no specialty coverage at the urgent care.

By: Anonymous

Anonymous — Fri, 01 May 2009 04:01:00 +0000

I think it is an interesting argument, similar to the problem of ER docs treating primary care problems in the ED and how if a patient presents to an office and ED with the same complaint, will likely get different workups. As an ED doc, I understand the problem. We are taught to always rule out the emergencies, and I am constantly worrying about the worst case scenario, and likely will order more tests since they are at my disposal, which is not necessarily a bad thing for emergencies but is probably too expensive for less emergency conditions. This mind set, however, might not be the best for urgent care. However, we are used to doing minor procedures, suturing, fracture care, etc, which can benefit an urgent care.

I think there is enough business to go around for all right now.

By: Pete

Pete — Fri, 01 May 2009 02:42:00 +0000

As a Dad of 4 young, active and injury prone kiddos, our mantra when things go mildly wrong is “anything but the ED, please”. Local Urgent Care fits that bill when stuff happens after our Peds office is closed. Relatively short waits, decent care for the minor stuff we bring there…Key word here is “mild”. If I think for a moment that there’s something more significant or sinister than “mild”, I go to the ER. Far more resources there if the doo doo hits the fan.

Of course New Hampshire is a small “market” compared to say, Los Angeles. Not sure I’d have any clue how to manage this in a gignormous population.

By: Anonymous

Anonymous — Fri, 01 May 2009 02:15:00 +0000

i thought there was a shortage of emergency docs. why wouldn’t we want those docs to work in the er?
conversely, why do they want to work in the urgent care centers?