Selecting the Proper Care Middle for Your Should-See Well being Challenge

Choosing the Right Care Center for Your Must-See Health Issue

There are emergencies and there are emergencies. Terrible chest pain or a sick baby are major e-emergencies. Back pain that occurs while on vacation, a hard-to-reach piece of glass, or a sprained wrist generally requires medical attention but may not mean you rush to the emergency room.

Once upon a time, patients had two options to meet their medical needs – a visit to their own doctor or a visit to the local emergency room. But today the choices have multiplied. In addition to a personal doctor and the emergency room, there are emergency clinics, retail clinics, and online services. So the question arises: how can a person know where to go?

There are many places where medical care is available Made with Google Slides

"The terminology gets really confusing," explained Ateev Mehrotra, MD, MPH. Dr. Mehrotra is an Associate Professor of Health Policy at Harvard Medical School. Dr. Mehrotra spoke to Medical Daily about retail clinics, telemedicine and e-doctors.

How can someone tell if they're looking for a retail clinic or emergency care? There are three major differences, starting with the location. "A retail clinic is inside a retail store, while an emergency center is usually free-standing, so you're in a parking lot or other office building," said Dr. Mehrotra.

The second is the differences in each offering. “The retail clinics have their menus online and they will say exactly, 'These are the things we treat, these are our prices. & # 39; “Clinics typically have fewer services than a primary care office.

In an emergency center, the offer is wider. "For example, emergency care facilities can introduce IV fluids, do X-ray and CT scans, and even sew large incisions," said Dr. Mehrotra. In comparison and depending on the practice, an emergency center could offer more services than the average doctor's office.

And the third difference?

Is the type of health care provider that you will see.

"You almost always see a nurse in a retail clinic, and a combination of nurses, but mostly doctors, in an emergency center," he said.

Retail clinics and emergency centers rate their services differently. According to Dr. Mehrotra, a retail clinic could be 30 to 40% cheaper than emergency care, which is likely to cost about the same or slightly more than a doctor's office.

Infographic copy 3 The Differences Between Retail Clinics and Urgent Concerns Made with Google Slides

The retail clinic

Retail clinics are located in larger stores like CVS, where they are called MinuteClinics, as well as Walmart and Walgreens. The CVS Clinic can offer up to 125 services, while Walmart Clinics offer around 40. Currently, Walmart only has clinics in Arkansas, Georgia, and Texas.

Angela Patterson, DNP, CVS 'Chief Nurse Practitioner, said in an interview with Medical Daily that CVS has 1,100 clinics in 33 states and Washington D.C. She said appointments at retail clinics can either be walk-in or scheduled. There are likely to be appointment costs and lab testing may be additional. Dr. Patterson stated, "… there are some services that government regulations may vary. These differences typically concern the minimum age of the patient to provide specific services and age restrictions for the administration of vaccinations." So, for patients looking for a specific immunization or procedure, it is best to check first.

Retail clinic patients are not necessarily first-timers with a minor emergency. Dr. Patterson stated, "It is not uncommon to see a patient two or three times a year for a variety of different services – a range of vaccinations or treatments for common acute illnesses." The smallest clinics, like the health care providers, are connected to one system. This means clinics in other areas can access the patient records, which makes retail clinics very useful for travelers.

Who shouldn't go

"However, the minute clinic is (not) suitable for more urgent medical matters that should be handled by emergency rooms and emergency centers," said Dr. Patterson. She also said they are not suitable for young children under 18 months of age. People who may be a little older or who have several serious medical conditions might consider another treatment option, she added.

Show me the money

A big plus with a retail clinic is the price transparency. At a retail clinic, visitors have a good idea of ​​what they are paying for, although services are limited and patients are likely to see a nurse or a medical assistant.

Infographics copy 5 Does the insurance cover this? Made with Google Slides

The pharmacy

While not retail clinics, pharmacies can be an option for some types of health care as well. Sometimes they can be found in grocery stores or stores like a target. These pharmacies don't do as much as retail clinics. According to a representative from Wegmans grocery store, pharmacies can offer vaccinations, but they can also provide other services such as eye tests for driving or providing Naxalone, a drug used to reverse opioid overdoses. A pharmacist will likely be the healthcare provider, the pharmacy will often buy insurance, and all of this can happen during a shopping visit.

Other options

Dr. Mehrotra discussed online health options that were available before the pandemic made it ubiquitous. Telemedicine providers include a patient's own doctor and new companies like Teladoc, Amwell, and Doctor on Demand. E-doctors like Lemonaid or Heydoc are also available. Patients complete a survey or may speak to a doctor, and they may be given medication if necessary. The Lemonaid FAQ states, "Some states require a brief video consultation with our team, other states require a phone call, and some states do not require a video or phone call." Expect slightly different rules depending on where the call is coming from.

A new problem

"We ask patients to self-examine," said Dr. Mehrotra. Patients are now responsible for determining how serious their problem is and then choosing the best option for care. That's a lot more complicated and a lot more complicated Dr. Mehrotra suggested calling either the health center the person had previously gone to or their own doctor to simplify today's process of self-enrollment or the doctor's office.

Call in experts

People with a family doctor can get help with this decision. Kate Cronan, MD, Emergency Pediatric Care Department, Nemours / Alfred I. duPont Children's Hospital, Wilmington, DE, said, “If I had something relatively speaking that was not that serious, I could call my doctor or doctor on call and see what they thought. "According to Dr. Cronan, this can help keep the patient's doctor informed. It is not necessary but can be useful." … They may advise you to go to an emergency room or say, & # 39; You know what, we can see your first thing in the morning. & # 39; "

An additional benefit of calling the doctor is that the nurse or on-call doctor has access to medical records and will review the patient record if the medical situation arises after the practice closes for that day. Viewing the patient's record can help doctors provide good advice on whether to stay home, make an appointment, go to emergency care, or go to the emergency room.

The emergency room

When do people actually need to go to a hospital emergency room? While it may not be obvious whether the situation requires immediate attention, if it feels like an emergency, go for ED, said Dr. Cronan. Experiencing the symptoms of a heart attack – severe chest pain in the center of the chest or arms – is a great example.

These could be initial symptoms or symptoms that you had previously. "But now you have really annoying chest pain and you feel really bad. You should go to the emergency room," advised Dr. Cronan. The pain could indicate that a heart attack has occurred or is about to occur.

The other emergency is a stroke, which occurs when an oxygen-carrying blood vessel on its way to the brain is either blocked by a clot or has burst. As the brain is deprived of oxygen and other nutrients, the brain tissue deprived of oxygen and other nutrients begins to die, as does brain cells.

The American Stroke Association (ASA) has a quick achronic for stroke symptoms.

  • F – face drooping

  • A – arm weakness

  • S – language difficulties

  • T – time to call 911

If it's a real emergency, call an ambulance. The sick person shouldn't be in a car. Dr. Cronan said, "Time is of the essence, so it really has to (for ED)."

Where does it hurt?

It looks a little different for babies and children. Dr. For babies under three months old, Cronan said a fever likely meant a trip to the doctor or emergency room. Regarding children, Dr. Cronan that putting a child there is okay most of the time, although pressing concerns see fewer children than adults. However, families can always ask their pediatrician for advice. "I don't want to pat us (pediatricians) on the back, but I do say that emergency pediatricians and pediatricians in general have been trained to read the patient." A young child may not be as good at explaining what hurts how long has did it hurt or where exactly does it hurt? A call to the family doctor can help figure out where the best treatment should go.

The urgent care

An emergency center is somewhere between an emergency room and a retail clinic. Just as medical centers have levels, so do pressing concerns. Dr. med. Franz Ritucci is the liaison officer for the accreditation organization for emergency care, the National Urgent Care Center Accreditation.

One level I badly need, the highest level, is a freestanding ED. Most urgent concerns are Level II or higher. A Level II facility is your typical emergency care. Most have doctors, nurses, and nurses, said Dr. Ritucci. Level II facilities can take x-rays, treat cuts, and see children. "They have equipment to evaluate (from) pediatric to geriatric clients," explained Dr. Ritucci. A Level III emergency care is similar to a retail center like a Walgreens or CVS.

Level III facilities have nurses and are therefore limited in the type of conditions they can be prone to. A computerized program determines which diseases they can treat. If the situation goes beyond these limits, the doctor must instruct the patient to go to either an emergency room or an emergency center for assessment, said Dr. Ritucci.

"On the whole, a lot of people will go to a retail clinic because it's convenient and close," said Dr. Ritucci. “You go to the pharmacy (to buy a patch) (and find) the clinic is here. Let me look for Condition A, B, or C. ”“ If the situation doesn't improve. The next ward is an emergency center, ”he said.

For people who are wondering where an urgent care is, the NUCCA counts them. These are voluntary rankings so a particular center may not be on the list. Dr. However, Ritucci said people can always call and find out who is manning emergency care. Dr. Ritucci said his first question would be, "Is a doctor physically present?"

Primary care?

Dr. Ritucci had a word of caution for the patients. Urgent care centers will more or less meet a medical need that requires immediate care but is not an emergency. "They will fix you and then take you back to your provider." These centers are not the ideal places to deal with a chronic illness.

Freestanding ED or trip to the hospital?

For people considering freestanding ED – the highest level of emergency care – Dr. Mehrotra some advice. Patients who go to these places expect a certain amount but end up paying a lot more. "We find that patients go there thinking this is (just) an emergency center, (with) a cost item in mind, (but) they pay ten times more for care." Also, people should be careful about identifying, how much it will cost, whether the insurance has been taken out and whether all the necessary services can be provided.

In a 2019 study, Dr. Mehrotra notes that emergency clinics that switched to freestanding EDs often saw the same patients as before in the same way for more money. However, the Centers for Medicare and Medicaid Services are now allowing some facilities to temporarily see Medicare and Medicaid patients due to the pandemic.

The doctor is in

Finally, there are basic services and special types of basic services. In an emergency, there may not be time to make an appointment, but it is sometimes worth calling to check. In addition to private basic care, there are also non-profit specialist organizations such as planned parenthood, which often offer fixed benefits on a scale of graduated prices, and state-qualified health centers (FQHC). FQHCs provide inexpensive care for people who otherwise may not have access. For patients looking for more than a single treatment, FQHCs could be a long-term solution.

Infographic copy 4 A quick guide to where to go Made with Google Slides

Bottom line

So where should anyone go? Each person has to weigh time, price and care needs. In an emergency, ED is the best option. People can always call ahead and ask who could see them, if the disease can be treated there, and so on. For severe but minor injuries like burns, scratches, and the like, urgent treatment can be a quick and easy option, as can retail clinics, telemedicine, and e-doctors.

Sabrina Emms is a science journalist. She began as an intern on a health and science podcast on Philadelphia public radio. Before that, she worked as a researcher studying the way bones are formed. When she is not in the laboratory and at her computer, she is in the moonlight as an assistant to a pig veterinarian and bagel baker.


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