Monday, January 19, 2015

I kind of want to post this everywhere



I know that Urgent Care is easy. And the hours are better. And you’re busy. But there are just some things that shouldn’t be seen at Urgent Care. To avoid the frustration of multiple trips, waiting too long, leaving with no answers, or being judged based on your chief complaint (it happens; I’m not proud of it, but at least I’m honest), try to follow these rules.

1)      We do not have unlimited access to specialists, nor will the specialists see you sooner if you are in the Urgent Care. We get countless walk-ins and even referrals from doctors wanting their patients to have an echocardiogram or EEG, see the pediatric dentist, or get in sooner with their rheumatologist. It’s not going to happen. If it’s truly emergent, you may be admitted at our main campus and see those specialists within 24 hours, who will then decide on any workup/treatment. Otherwise, we have to go through the same channels your pediatrician does to get to the specialists, and the vast majority of the time, we are only consulting by phone, often with a resident, fellow, or mid-level provider. The end result is usually adding you to their growing appointment list, often months out. If you want a specialist, have your doctor call them instead.

2)      Please don’t come in with 6 months of chronic symptoms without seeing your regular doctor first. If you’ve had something going on for more than a few weeks and haven’t been able to solve the problem with Dr. Google or with multiple trips to other ERs, chances are it won’t be a quick fix for us either. Our job is to rule out bad things and get you the right follow up, often with your regular doctor. Plus, if we start a lab workup or want to order tests, your doctor won’t always be able to follow up on the results (and chances are we won’t either, since many of the labs and imaging studies come back once our shift is over). Additionally, if you don’t get better in two days and decide to come back, you will be seen by someone different, who will have no idea how you looked the first time, may have a totally different approach, or may disagree with what has already been done. It’s a lot easier to solve long-term issues with a long-term plan—namely, your own doctor who can see you through the illness and follow up on what they recommend.

3)      We are an URGENT care. We are not an “I just had a quick question” or “I didn’t want to make an appointment with his doctor” care. The following are all real complaints that have come in to our Urgent Care or ERs—ear pain for 20 minutes (no meds given at home), band-aid stuck to leg, need a refill on Prevacid (which is now over the counter, by the way), the child felt warm, grandma said he needed to be seen, was exposed to someone with a sore throat but doesn’t have any symptoms. There are nurse lines for these sorts of things. We are always happy to offer reassurance, but please don’t expect me to rush in when I have other rooms filled with asthmatics, broken bones, migraines, seizures, pneumonia, partially amputated fingers, or other things more…urgent. It’s always the people who don’t really need to be there that balk at the wait times. Imagine waiting until your pediatrician’s office opened. In two whole hours.

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