Saturday, January 3, 2015

Sometimes Medical Care Requires More Than Just A Minute (Clinic)

The truth is, I know it's easy to go to the Minute Clinic.  I know the enticement of not needing an appointment, of being able to shop while you wait, of having the prescription ready to pick up by the end of your appointment.  Who doesn't like convenience and a friendly smile to add?  Who doesn't like the customer service offered at CVS, Target, or your local pharmacy?  I certainly do.  And I know that the doctor's office can be a pain.  I also loathe the annoying phone tree that leads to a tired nurse or secretary, and possibly the hours of waiting to have the physician call you back and tell you to rest and drink fluids anyway.

Realize, though, that these clinics do not have your best interests at hand.  Of course they can manage the typical medical problems that often don't require much intervention in the first place: respiratory infections and minor rashes and such.  They can even treat your strep throat or urinary tract infection.  Until, of course, something goes wrong.  At midnight when your temperature soars and you are unable to swallow because of tonsillar swelling, there will be no one at Target to prescribe you steroids.  Or when your simple bladder infection turns into pyelonephritis, there will be no expertise available to guide your way.

You then will be stuck calling me, the beleaguered primary care physician.  I, however, am a vanishing breed.  Because I saw the writing on the wall years ago and became a hospitalist, or concierge doctor, or departed from clinical medicine.  And those few of us who are left, certainly won't want to clean up the mess of a pharmacy clinic at some ungodly hour when we would rather be sleeping.  You didn't come to me in the first place, why should I now be responsible when taking care of you has suddenly become inconvenient?

Yep, now you're getting it.  These clinics pick off the easy, high margin care and then punt when push comes to shove.  They have less interest in your well being, and more in your wallet.  Low acuity, high volume primary care can be very lucrative.  Don't expect them to be there, however, when you really need them.

And don't expect me either.

Because I'll be long gone.  Forced to abandon my life's work due medicine's lack of convenience.

Looks like someone will be going to the emergency room.

Good Luck!


Jody said...

I went to a minute clinic today for the first time, ever. Why was that? I called my PCP yesterday in the AM, by this afternoon, having no return call, it is Saturday now and I have been deaf in my ear from a wax impaction for 2 days, you know, that wax I asked to have flushed out the past 3 visits. Complication? I have bronchitis, a nightmare of a cough, the narcotic cough syrup ran out because as usual she gave me a way too small, I cough so hard I take it around the clock, tore or pulled something inside, but hey, no refills, too soon, not supposed to really take it every 4 as needed only daytime so SOL there.
At least she(the cnp) has empathy, something I don't get from the soon to be former PCP of many years, and well, I can hear as I hack up a lung.

Diane said...

We are being "forced" to use the Minute Clinics. Most Americans are now facing massive deductibles. Large co-pays and invasive government into our electronic records. For a reasonably healthy person, it costs far less to stop into the minute clinic. Pay out of pocket, get in and out same day for an ear infection or bladder infection. You can even swing in on your lunch hour. We haven't found a family practice that has more then 1 same day appt. If they do, it usually entails waiting hours. Even worse the 2 hours on the phone with the Dr.s staff who read from a "script" that makes India customer service look appealing. Then often the smaller practices have to outsource their labs. The larger ones put fiscal above patient and you get your labs when you get your labs- takes days. They go home at 5pm and you go home sick. At a minute clinic the testing and script come within minutes. Is it "good" medical care? No. It simply treats the symptoms and throws a bandaid on it. Sadly, that is the medical services that are available for the middle class even with private insurance. Love our family Dr but if I have puss coming from my ear I am not going to wait 5 days to be seen and another to be treated. Thank the medical establishment and their "business" model and Obamacare. America in a matter of years went from great care to care that only hands out bandaids.

james gaulte said...

You points are well taken.However, at some level (at night and over the weekend),many family practices, and internists practices) the rescues for treatments gone bad are found in the ER.Call your family doc after five and you get a recording telling you to call back in Am for a refill and go to ER if it is an emergency.So how does that differ from the minute clinic?

Never Again said...

I found out the hard way that the government in its infinite wisdom decided that primary docs were no longer capable of performing the tests required to keep a class A license.

My doctor refuses to go back to school, at great expense, so that he can perform the stupid tests that any high school student can do. It isn't cost effective and what's he going to learn anyway?

So I have to go to the minute clinic where they are rolling in money anyway and give them my hard earned tell me I'm healthy, which *I* already knew as well.

Another problem is the advanced practice nurses that seem to be populating every single practice. I don't pay all that money to see a nurse, usually an insufferably arrogant one, or a PA, also arrogant. I have no answer.