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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How do walk-in-care charges compare with non-emergency-care charges from a doctor’s office? Apples-to-apples comparisons are difficult to make, but a 2009 study by the RAND Corporation and published in the Annals of Internal Medicine looked at 2,100 patients in Minnesota with three common acute conditions (ear infections, soar throats, and urinary tract infections) as they were treated at retail clinics like CVS MinuteClinic versus at doctors’ offices, urgent-care centers, and hospital emergency rooms for the same conditions. It found retail-clinic overall costs were about 30 percent lower than urgent-care and doctors’ offices costs and 80 percent lower than emergency-room costs. What’s more, quality scores were basically identical across the board.
For WESTMED patients, there’s another advantage to urgent-care service, according to Jason Shuker, MD, managing physician for WESTMED's four ugent-care centers. Co-locating urgent-care facilities with the group practice's full-service offices, he says, “essentially provides one-stop shopping. It’s somewhere you can go to get all your stuff taken care of in one place.” If you come to them with abdominal pain that turns out to be appendicitis, for example, WESTMED Urgent Care will confirm it by examination, CAT scan, and lab work before contacting a surgeon—which may well be one of theirs. “In that situation, because the surgeon is already aware, the patient can avoid the emergency room completely.” Because WESTMED’s urgent-care clinics are located within their existing facilities, testing and imaging are immediately available and specialists are oftentimes found just a short walk down the hall.
That patient’s treatment will also become part of WESTMED’s electronic medical records system, an important advantage that’s unique to them and MKMG among the local urgent-care providers. Clinics that don’t have that capability typically rely on faxes or even the patients themselves to hand-carry treatment records to their personal doctors. It’s analog procedure in a digital world.
Which is a major problem, according to Robert Amler, MD, dean of the New York Medical College School of Health Science and Practices. “The patient, or customer, is looking at a trade-off,” he says. “They are gaining the immediacy of care but losing the continuity of knowledge about their current medications, past medical history, family and social history, and so forth.” That lack of history cuts both ways. “The doctor or nurse practitioner in the urgent-care facility has to deal with the absence of information that can be extremely important.”