An issue getting some coverage in the press lately has been the increase in availability of and visits to urgent care centers, ranging from small “doc-in-a-box” clinics to larger facilities affiliated with hospitals or multi-location chains.
The increase in consumer demand for urgent care centers has been largely driven by the frustration of the average patient at having to spend hours waiting in an emergency room and pay a hefty fee to get treatment for lower level injuries and conditions, simply because the hospital is what is open when the patient is available to be seen (walk-ins, after hours and weekends). Most people would much rather pay a small amount of cash to be seen in a reasonable amount of time and get going on their way. From a convenience standpoint, I do believe urgent care centers are useful and that the average patient will be more efficiently granted medical care.
However, a major downside of urgent care centers, particularly from a subspecialty perspective, is that a patient may have diagnostic tests performed that may not be what the subspecialist (the next physician to provide treatment) needs to see. As an orthopaedic surgeon, I often have specific requirements for how a radiographic test (x-ray, CT scan, MRI, etc) should be performed to be useful for diagnosis and preoperative planning. For example, if an inadequate MRI is obtained prior to an orthopaedic consultation, I may not have the images that I need to properly diagnose and treat your complaint. In this case, a replacement MRI would need to be ordered and it can be very difficult to justify the cost of repeat imaging to an insurance company or to a patient who is paying out of pocket.
The growing trend of subspecialty practices providing an urgent care option is useful in combating this issue. When a patient is seen in an urgent care environment that only deals with a specific subspecialty, it leads to a better directed effort in getting a proper patient workup performed. Urgent care options like our OrthoNow Urgent Care Clinic offer more efficient delivery of care to orthopedic patients with acute injuries by providing a timely and appropriate workup. They also lower costs by avoiding emergency fees and the price of repeating radiographic tests.
In an age with projected physician shortages and crowded emergency departments with high fixed costs, the spread of urgent care facilities is inevitable. We, as a community of healthcare providers, have to work together to ensure the proper flow of information between providers to allow for comprehensive and consistent medical care. For instance, even with access to electronic medical records, it can be difficult to allow for continuous documentation of care for a patient, as that patient will often arrive at a subspecialty physician’s office without documentation from the urgent care center. We have to ensure that trying to provide medical care as efficiently as possible does not interfere with providing medical care as comprehensively and accurately as possible.
Dr. David T Schroder is an orthopaedic surgeon, fellowship trained in total joint replacement, with The San Antonio Orthopaedic Group. He treats patients aged 11 years and up for most orthopaedic conditions, with the exception of spinal surgery. To schedule an appointment with Dr. Schroder, please call 210.281.9595.