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    Convenient Care

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    When the first free-standing Urgent Care facility first opened up in a shopping center near me, between a bagel shop and a flower store, I thought the concept would never fly. As the years progressed, more and more clinics opened, and people embraced the idea that there is a need for convenient, fast care – just like there appears to be a need for fast-food establishments.

    Ten years later, I found myself working part-time in one, called the Immediate Care Medical Clinic (now closed). Two providers staffed this well-run facility, and we could see up to 90 patients a day in a 12-hour shift. We were open seven days a week and provided full-service care to people of all ages. We were conveniently located between a large super market and a pharmacy. The clinic closed after twenty years, became a Blockbuster Video, and is now a hair salon.

    Many free-standing convenient-care medical facilities are staffed by NPs and PAs; or with physicians working full or part-time. These are usually the same people you might see if you made a standard, medical appointment in a regular doctor’s office. The level of care should be the same. Convenient care does not imply inferior care, although one may reluctantly experience inferior medical care just about anywhere.

    The need for fast, efficient, affordable care for minor medical issues certainly exists. Busy people want to walk in the door, sign their name, be examined, diagnosed, and treated in a half-hour or less.  The patient or their insurance company is willing to pay a fair price for this convenient medical service, too, knowing that an ER would be much, much more costly.

    There are really four types of medical visits:  The well or worried well, the mildly ill or injured, the more seriously ill or injured, and the life-threatening emergencies. Life-threatening emergencies like cardiac chest pain, major lacerations, concussions, and motor vehicle injuries are best handled by a full-service emergency room at the hospital.

    Well patients often need physical examinations for work, school, camp, or because routine physical exams are important.  The “worried well” patient generally does not have anything wrong with them, but the patient wants to be sure. They want confirmation that their headache is not a brain tumor, their bellyache is not appendicitis, or their burning on urination isn’t a sexually-transmitted disease.

    Mildly ill patients fill the bulk of most practice appointments. Things such as colds, earaches, sore throats, pink eye, diarrhea, vomiting, back aches, or undiagnosed rashes are the most common. Mild injuries include such things as burns (including sunburns), cuts, puncture wounds, or stubbed toes/fingers. Most of these things can be easily seen in urgent care facilities.

    More serious illnesses or injuries include uncontrolled asthma, pneumonia, acute abdominal/pelvic pain, foreign bodies that have found their way into unusual places, lacerations needing sutures, or various fractures needing casts.  Only the largest and well-equipped urgent care facilities can handle these; certainly not the little module kiosks located in the corner of a pharmacy.

    Standard medical facilities have “continuity of care”. In other words, you will see the same provider year after year; someone who knows you and your medical history, and someone who you learn to like and trust. Any time that you go to an urgent care facility, you may see someone different and you don’t have much control over who you see — they may be an excellent clinician or one that should not be practicing medicine. It can be hit or miss when you go through those urgent care doors. In a standard medical practice, you can just change to a different clinician if the one you are seeing does not meet your needs.

    Urgent care facilities are here to stay, and more and more will be offering comprehensive care and expanded services. Find one that you like and use them when it is convenient. It is still wise to establish your care with a regular medical provider; someone who will take the time to get to know you as a person, not just a quick-fix illness.

    There is certainly room in the medical world for both.

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