Thursday, August 7, 2008

Back To The Mall: Urgent Care Clinics

One of the big trends we keep returning to is the retail health clinic. Located in malls or "big box" stores, they combine low cost, excellent access, and short wait times. These clinics are not what I am going to examine today. Instead I'd like to share an article about urgent care clinics.

What's the difference? Laura Landro of The Wall Street Journal defines it:

[...] urgent-care centers aren't to be confused with the new crop of retail health clinics popping up in drugstores, which are run by nurse practitioners who prescribe medicine for minor illnesses and provide vaccinations. Urgent-care-center physicians and other medical staffers can put casts on broken bones, sew up lacerations, provide intravenous fluids for dehydrated patients, and deploy advanced life-support equipment for both adults and children. They often have equipment not available in physicians' offices, such as X-rays.
So basically, this is a concept that could well step in and take a lot of pressure off of emergency rooms if it becomes widespread enough.
These facilities aim to fill the gap between the growing shortage of primary-care doctors and a shrinking number of already-crowded hospital emergency departments, with no appointment necessary and extended evening and weekend hours. Urgent-care clinics are staffed by physicians, offer wait times as little as a few minutes and charge $60 to $200 depending on the procedure -- a fraction of the typical $1,000-plus emergency department visit. Some offer discounts and payment plans for the uninsured; for those with coverage, co-payments vary by insurance plan but may be less than half the amount of an ER visit, which can range from $50 to $200.
The last time I went to the emergency room it cost me five thousand dollars, and all I got was a nine hour wait, some painkillers after hour four, and the useful information that "they're kidney stones and you'll just have to wait it out." This sort of personal experience, one which is incredibly common in modern America, predisposes one to look kindly on this newer breed of medical care.

Of course there are also issues and drawbacks, as there are with everything. The lack of standards or a system of accreditation are cause for concern amongst many. In an effort to address this and preclude formal regulation, the Urgent Care Association of America has struck an agreement with the Joint Commission (the non-profit responsible for accrediting hospitals and health-care organizations) to take over accreditation and publish national quality standards by 2010.

Lee Resnick, President of the Urgent Care Association and Director of University Hospitals Urgent Care, says urgent care clinics diagnose serious health issues like cancer for patients who come in for something that seems more trivial. Simple symptoms may bring in patients who the doctors recognize as having heart attacks or strokes. The short wait time allows these illnesses to be revealed in time to get patients into an ambulance and on their way to an ER, where admissions can be fast-tracked due to the initial diagnosis.

Go check out Ms. Landro's article. It has a whole lot more analysis.

SOURCE: "Options Expand For Avoiding Crowded ERs" 08/06/08
photo courtesy of Charlie Bosmore, used under its Creative Commons license

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