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Urgent Care Facilities
Old 11-28-2019, 06:05 PM
  #1

Help me settle a discussion: would you consider an urgent care facility your primary care physician? (I can give more specifics if need be but it came up in a discussion with a friend who seems to be struggling with a health concern that I believe wouldn't be happening if she had a regular doctor/practice that she went to rather than an urgent care facility....which doesn't seem focused on continuity of care.


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Old 11-28-2019, 06:08 PM
  #2

I know some people who use the urgent care doctor as their primary physician.
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Old 11-28-2019, 06:12 PM
  #3

Yeah and I can totally see why people do that, especially if they don't routinely need health care but only occasionally need it for things like ear infections or sinus.
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Old 11-28-2019, 06:29 PM
  #4

I wouldn't but I also have other health issues. But I feel like it's smart for everyone to have a regular doctor to go to occasionally, even if it's just for a physical every now and then. You never know when something is going to come up and it's a lot easier to find someone you like when it isn't urgent.

The urgent care I've been to (for things like strep tests on the weekend or whatever) is also a doctor's office. There's just a few of the doctors who are there after hours. They are regular doctors, but they obviously don't know me or my medical history.
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Old 11-28-2019, 06:32 PM
  #5

I absolutely do NOT. I have a regular internist whom I see regularly. I only go to urgent care in dire situations because I hate them. I wait forever, they rush me through and they donít know me. Once, my rapid strep back back negative and they blew me off. I still wasnít feeling well and sure enough they called back a few days later and the normal strep test came back positive. My normal dr would have prescribed something anyway because she knows me.


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Old 11-28-2019, 06:33 PM
  #6

Don't many insurance plans give you a reduced price for visits to a primary care physician when you designate one?

Are people avoiding the cost of a new patient exam? I'd think urgent care visits would be more expensive. Does your friend have health insurance? I'm perplexed too.
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Old 11-28-2019, 06:51 PM
  #7

I'm not entirely sure why although they're all good questions. I'm relieved to hear that your responses are much in the line of mine.
My friend does not "adult" the same way I do, for lack of a better explanation, and her struggles and life choices often perplex me.
She has some sort of heart condition so sees a cardiologist but does not have a primary care physician. Last week, she hit her head and was diagnosed with a concussion. She was still experiencing symptoms this week (blurry vision, headaches, etc.. We have to go through concussion symptoms/treatment overview often so I was like "What did your PCP say when you talked about your concussion? Didn't they tell you do things like stay off television/computers/phones, take a break from physical exertion, and stay in a darkroom?" Come to find out that she was diagnosed at the Urgent Care, who gave no recommendations about how to handle a concussion---probably assuming that she'd follow up with her regular physician and probably even saying exactly that. And she didn't.
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Old 11-28-2019, 06:51 PM
  #8

I have numerous health conditions due to having MS and feel like my primary care physician is kind of like the "gate keeper" to know what is going on with all my other doctors.

On the other hand, I went to urgent care this past Spring, after having been to my regular doctor for week-long fever (where I ended up seeing the nurse practitioner, rather than my doctor) who sent me home with instructions to wait it out since flu test came back negative. By the following Sunday I was so ill that I went to urgent care only to find out I probably had a kidney infection. Cost: $0, care: awesome, with a call back on both Monday and Tuesday to make sure the antibiotics were working and I was recovering.

Same visit to my primary would have cost a $10 co-pay, and call-back would be unlikely.
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Old 11-28-2019, 06:52 PM
  #9

That is not their purpose, but people do use it like that. I currently don't have a PCP and got sick and went to one. All the paperwork says to follow up with your PCP.

I struggle with finding a doctor I like. My last one is now a far drive and the one before that passed away. I never really think about finding a new Dr until I am sick. Then it's too late.

I do see an ob regularly so I feel like I am kinda keeping on top of things.
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Old 11-28-2019, 07:05 PM
  #10

In some places it is hard to get a new primary physician so I can understand why an urgent care could fill that need.

Urgent care is not designed as primary care. Continuity of care is a concern. But, if one goes to the same urgent care all the time a problem should show up in the records and be dealt with.

Cost. My insurance is structured so that my copay is less for primary doctor than an urgent care. So if I used urgent care as my primary, my cost would be greater.


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Old 11-28-2019, 07:16 PM
  #11

Quote:
Come to find out that she was diagnosed at the Urgent Care, who gave no recommendations about how to handle a concussion
I don't know, I find it hard to believe they would diagnose a concussion and truly give her no recommendations. Could she just have not been listening/paying attention? (Although with a head injury, I'd feel much better going to the ER for. What if she needed a CT scan?)
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Urgent care
Old 11-28-2019, 07:28 PM
  #12

That is NOT the purpose of urgent care. If a person has health concerns, they should get together with a primary care physician. This type of health care wastes the time of the ER docs...
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Old 11-28-2019, 08:32 PM
  #13

I get really nervous when I donít have a PCP. When my longtime doctor retired, I almost panicked. I really like my new one, though. Sheís an ARNP. Iíve got several medical issues that I feel need to be monitored by someone who knows my history. I do see someone at urgent care when Iím sick, though. I rarely go to my ARNP with an acute illness. Itís easier to go to urgent care.

DH sees a ARNP at a clinic that has an after-hours/weekend clinic. That has almost made me consider switching to his clinic just to have the same facility doing regular and urgent treatment.

I do know several people who donít have a regular doctor. My cousin uses the ER as her primary care doctor. She could save some much time and money with a regular doctor. Her mom sees multiple specialists, but there is nobody in the center keeping everything together. She takes a ton of medicine, and I know that some of them could go, but nobody sees all of her records because sheís always somewhere different.
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Old 11-29-2019, 12:04 AM
  #14

[QUOTE]She could save some much time and money with a regular doctor.[/QUOTE

Does she have insurance? Sometimes I wonder if urgent care / ER is used a primary care by people who have Medicaid / Medicare due to not being able to find a regular PCP who will take those forms of insurance due to the low reimbursement rate.

Also, I may be wrong, but I'm thinking that Medicaid patients have a very low co-pay, if any, for ER visits, so cost is not a deciding factor. For me, ER is a last resort due to increased cost.
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Old 11-29-2019, 02:31 AM
  #15

I, personally, only use Urgent Care if it's the weekend or if I can't get into my regular doctor. But on our insurance Urgent Care is now free!! Seems like they are discouraging people from seeing their doctor.

In your friend's case, she definitely needs a regular doctor, even a specialist! Encourage her to go.
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Old 11-29-2019, 04:01 AM
  #16

I would not consider it as my PCP. I feel they should be used for times when you can't get a Dr. appointment, when your PCP office is closed, or it is not a serious thing.

They are there for reactive care, not preventative care or for physicals/ yearly checkups.

Any time we have gone to urgent care, they have always told us to schedule a follow up with our PCP.

Ima makes a great point on having someone who really knows you. I went to urgent care with stomach pain and the Dr. immediately told me it was my gal bladder. I insisted it was not , and he insisted it was and got pretty irate with me, telling me not to use WebMD. I repeated that it was NOT my gal bladder because I did not have one!
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Old 11-29-2019, 04:55 AM
  #17

I would not! I also think Insurance distinguishes between urgent care and a walk-in clinic, just fyi. Urgent care might be more directly connected with a hospital? Like a step down from the ER?

We have a couple walk-in clinics here. My Anthem insurance covers those and I have used them for things like a UTI or strep after hours from my regular doctor's office. One of them now has an online sign in to get your appt time :-)
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Old 11-29-2019, 06:17 AM
  #18

I use a combination, but still have a primary physician. Our urgent care is linked to my doctor's office, so all records show up in either office.

My urgent care will not prescribe medications that are needed on an ongoing basis, like blood pressure and thyroid meds.

My primary care physician is impossible to get into with less than a week's wait. So any illness (example: sinus infection) is handled through my urgent care office.

Both cost the same with my insurance.
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Old 11-29-2019, 08:01 AM
  #19

I would prefer not to, however....I'm still waiting for my PCP to return the call I made on October 9 regarding an emergency UTI.

We were leaving for Zion NP that day. CVS' Minute Clinic saw me right away, prescribed, and we went on our trip.

For anything requiring follow-up care, sure, having the same doctor is ideal. But, here anyway, doctors are so overworked, they can rarely provide it. It takes months to get an appointment.
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Old 11-29-2019, 09:09 AM
  #20

My first choice is my primary doctor. I have, however been very thankful to see an urgent care facility in the past! Especially when my doctor's office was closed, or I couldn't get an appointment when one was needed for a minor issue that needed be taken care of with the no wait of an urgent care.
I'm very thankful for urgent care facilities!
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Old 11-29-2019, 09:29 AM
  #21

I personally have a PCP, but I've been to urgent care once or twice in the last 1-3 yrs.

I'm sure people probably do that though.
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Old 11-29-2019, 12:18 PM
  #22

I have high deductible insurance, so absolutely everything is full price out of pocket unless I spend $4,000 in a single year. Since I would never spend that barring a serious accident, it feels like not having insurance. For me, it's significantly cheaper to go to an Urgent Care or Walgreens clinic and pay out of pocket than to go to a Kaiser facility in the vast majority of cases, where it is hundreds of dollars to simply walk in the door.

I could see if you had a serious ongoing condition where it would make more sense to have a regular Dr. Most of my coworkers and I do go to Urgent Care though because of the cost and the way our insurance is structured. I personally just don't go 95% of the time- the only way I'd make an appointment is if I were very sure I had a specific illness that absolutely needed antibiotics.

I recently had a stupid accident that required stitches and received excellent care from the Urgent care, with two call backs to see how I was doing.
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Old 11-29-2019, 03:09 PM
  #23

Thank you all for your responses! Everyone's responses make complete sense and I appreciated the perspectives.
FWIW, we live in an area where there are a plethora of PCP. As strange as it seems,I can totally imagine an Urgent Care place diagnosing her with a concussion and then not telling her to follow up her regular doctor or simply assuming that she would. (I've been to the same urgent care and the recommendations like this, as common sense as it is, tend to vary with the doctor that you get.) I can also imagine them telling her that and her not really processing the information.
I do realize that the rotating doctors can be true with PCP depending upon where you go...I should say that's not always the case though (when I go to my PCP I literally always see the same person) and the rotating doctors is uniformly the case with an urgent care doctor.
I worry about my friend because she seems ill-equipped to deal with the regular adult world. Partly upbringing, partly personality, she seems to have huge gaps in her knowledge of how to negotiate the world and is often easily overwhelmed with daily life. My poor friend is undergoing a stretch of really tough times and I know she's stressed out. The concussion doesn't help. She has some health difficulties. Under different circumstances, she might be able to keep on top of everything. This is not the best of circumstances for her, however, and she's not able to coordinate all the interactions of her health concerns. She mentioned getting a concussion last week and then this week complained of having continued symptoms. It hit me---she hadn't allowed herself to recover after the concussion. I asked, "Oh what did your doctor say about what you should do to recover from the concussion?" She was like oh the Urgent Care people just said I had a concussion. Come to find out she didn't have a regular physician to see.
It made me curious about what others perspective was.
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Old 11-29-2019, 08:53 PM
  #24

The one advantage I can think of to using an urgent care facility is the fact that you can go anytime without an appointment where with a primary care you sometimes cannot get it for a day or two (or more) when you're sick. I think UC centers would be much more likely to send you to specialists even when one isn't necessary, because they don't know you and your history as well. My PCP prescribes my Lexapro and Wellbutrin. I am sure an UC center would have sent me to a psychiatrist and I would have had to pay a much more expensive specialist co-pay. I too know some people who do that.

Nancy
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Old 11-30-2019, 02:56 PM
  #25

My daughter is a family nurse practitioner. When she was in school and looking for places to do her clinicals, she was not allowed to pair up with a family nurse practitioner that worked at an urgent care facility. The reason was that a family practitioner is one that works as a primary care provider. One that has patients that follows and watches their health histories. Urgent care providers/facilities take care of immediate health needs. They don't follow and keep up with patients' histories.

Everyone needs a primary care provider whether that be a physician or practitioner. I've seen several friends have issues go undiagnosed for too long before they finally see a primary care or specialty care physician. Of course that is my opinion.
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