The days of house calls by your family doctor are long gone, but all things are cyclical and the demand for easier access to health care systems that doesn’t require scheduling appointments (and actually works with your schedule) was bound to catch on eventually.
That being said, there is room for all types of care to co-exist and actually improve the overall care of the patient and help a nursing professional through some creative collaborations. This post will explain the advantages and disadvantages of primary care, convenient care (retail clinics) and urgent care (non-emergency room care) and how they can all work together to the benefit of the patient.
Table of Contents
Primary Health Care
Primary health care, also known as your family doctor, this has been a staple of healthcare for a long time, and is a fairly known quantity. When you get sick, you call and they try to work you in, usually in a day or two. For routine or chronic care, they set up appointments weeks to months in advance. This is your home base for health care and nothing about that should change.
While it isn’t always the most convenient place to go if you suddenly come down with a cold, need some immunizations for an impromptu vacation to Thailand or sprain your ankle in a pick-up game of basketball it still serves a very important function as the core center of your healthcare. The primary care physician should be the person managing your chronic conditions — such as diabetes, Chronic Heart Failure or COPD — and they should function as your gatekeeper to more specialized services. That being said, today’s hectic work and family situations demand more flexibility for healthcare to fit into crammed schedules. Some family doctors have started evening and weekend hours, but for the most part the hours of family practice doctors are 8 a.m to 5 p.m. weekdays, the time when a large percentage of the population is working or in school … not very convenient.
Convenient Care
Enter convenient health care or retail clinics, no appointments, walk-ins welcome and most are stationed in already existing grocery or retail stores where you can shop while you wait for them to see you, which fits well into a world where multitasking has become the norm. These types of facilities are great for the on-the-go, time-crunched person who can’t miss work, but has an outstanding health care need. Typical things these locations specialize in: allergy treatment, cold and flu, sprains and strains, rashes and immunizations. The last one can be a real big help if you travel.
Recently, my wife and I got married and had been planning a trip to Thailand for our honeymoon immediately following our wedding. With a week until the wedding day, it dawned on us that we hadn’t considered the various immunizations we should get going to such an exotic locale. A quick call to our primary care doctor told us they didn’t even carry some of the immunizations we would need, like Typhoid, and that they would have to order them, again, not very convenient.
Fortunately, our doctor recommended a retail care location that was part of the same health system that he was employed by. The clinic was located in a grocery store. We walked in, signed in and grabbed a pager, and knocked out our grocery shopping while waiting about ten minutes to get paged. We were able to get all of our immunizations that same day.
Now that was convenient. That said, my family doctor would still be my choice for care if I had a condition that needed follow up and considerable management, but for a quick series of shots or to run in a sick kid after work, the convenient care clinic was perfect.
Urgent Care
Now onto urgent care, which is usually defined as a walk-in location that handles the less-than emergency room stuff, the conditions that can’t wait for an appointment, but aren’t quite ER worthy.
Urgent care facilities usually have more capabilities then retail clinics, such as X-Ray capabilities and the ability to treat more serious injuries with a larger staff on location. Just took a tumble on the ice and want to make sure you didn’t break anything, but the thought of waiting in an emergency room makes you cringe? These places are perfect, with usually much nicer environments then your local ER with gunshot victims being carted in as you wait for hours to be seen for something that is obviously not life threatening.
These types of locations usually do have some overlap with the convenient care clinics in what they treat — such as cold, flu and allergies — but they are usually in stand-alone facilities compared to the retail clinics which are always domiciled in larger retail entities. And, like the retail clinics, these facilities usually have extremely convenient evening and weekend hours. The type of ailment you are suffering from will generally dictate to some degree where you should seek out care.
How It All Works Together
The best way to illustrate how primary care, urgent care and retail care can co-exist and even improve nursing care is to go back to my example of the last minute travel immunizations.
My doctor sent me to a location that expedited my care. As it turns out, it was part of the same health care system and had access to my electronic health care records, with my permission (they have to have your permission) they communicated the results of my visit to their location back to my primary care doctor. So the next time I went in for my check-up, my doctor knew I had some shots that I previously hadn’t. This is so important on so many levels. First, it saves everyone money, me on my co-pays, the insurer, for not having to do the same test again, and the doctor for not wasting his/her time repeating a function.
Let’s use a different example to illustrate, a person sprains their ankle, goes to an urgent care clinic, gets an X-ray and shows a hairline fracture. The urgent care clinic treats you on the spot, but recommends you see a sports medicine specialist and sends this information back to your primary care doctor. Your doctor, who sees the recommendation and X-ray, agrees with the urgent care diagnosis and refers you to a sports medicine doctor, who is also part of the same healthcare system and has immediate access to the same x-rays, and notes of the urgent care and primary care providers. This is all done electronically and seamlessly for the patient, versus three stand-alone visits to three stand-alone entities where you may have to be x-rayed three separate times at considerable cost and inconvenience.
Now it’s true that not all facilities are part of the same health care systems and communicate this way, but you are seeing more and more partnerships between hospitals, primary care, urgent and retail care and health insurers. It is a great idea to contact your health insurance company and see what types of services they have that communicate with each other or ask your primary care doctor if they partner with any urgent care or retail clinics.
This is the direction health care systems and the nursing professional is heading, probably must head in order to control costs and the good news is it should be better for the patient in almost every way.