The Debate on Westchester Walk-in Medical-Care
They’re fast and convenient, but are urgent-care centers good for our healthcare system?
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Contributing to (or confusing) the discussion is the variety of service-offerings that fall under the definition of “urgent-care provider.” The designation encompasses retail clinics like those in CVS that provide—at least now—a limited range of services administered by nurse practitioners; doctor-owned clinics sometimes referred to as “doc-in-a-box” offices; and full-service walk-in facilities operated by major group practices like MKMG and WESTMED Medical Group as part of the spectrum of care they provide. Blurring the lines are fast-track units set up by six Westchester hospital emergency rooms, including both Hudson Valley and St. John's Riverside Hospital. Basically, all aim to serve the patient who can’t see a personal physician for one reason or another, but who doesn’t require (or wants to avoid) intensive, expensive, emergency-room treatment.
From the consumer’s standpoint, the argument probably doesn’t matter. When you’re sick, you want care—now. As Annette Choolfaian, chair of the Department of Health Policy and Management at the New York Medical College School of Health Science and Practices points out, “These things have popped up and been relatively successful because they fill a need that traditional practices and emergency rooms have not filled in the past.”
As the business of urgent care grows, it’s drawing more and more players. Jason Lupow, MD, is one of five board-certified ER doctors who trained and now work together at Montefiore Hospital in the Bronx. “We all moonlight or work extra shifts for the hospital, so we decided to do something for ourselves,” he explains. “We saw urgent care popping up everywhere, especially in Florida and Long Island. They all seem to be doing pretty well.” The group opened MDxpress in Mamaroneck in March and is already thinking about expansion. “The reception has been great. We’re seeing easily 30 patients a day, and we have a lot of repeat visits.”
One of the biggest needs everyone points to is the declining number of primary-care physicians, the traditional go-to guy or gal who takes our temperature, puts that chilly stethoscope on our chest, and cures most of what ails us—pretty much on demand. "It's very hard to find primary care doctors," says Hayworth. “Even an organiztion like ours has trouble hiring them.” While exact numbers for Westchester aren’t available, there’s plenty of anecdotal evidence that points to a shortage of independent doctors who practice family medicine, internal medicine, general pediatrics, and OB-GYN. Have you tried to get a same-day doctor’s appointment lately?