You thought the "Doc in a box" was bad....

We've all seen the rise of small 'clinics' - usually in a small strip mall storefront or small building. With a couple of medical types with medial provided by or overseen by a Physicians Assistant (PA) or Nurse-Practitioner. These clinics may have X-ray equipment, but are pretty basic stuff. They are sometimes called Urgent Care Cneters. Of course, if what you have is really an emergent condition, they will happily dump you on the local ER. Where they have doctors, labs and stuff.

So, an operation much like a 1950's doctors office - but with no doctor.

I was waiting for these to show up in the larger malls. What I didn't expect to see was a 'medical kiosk' using "Tele-medicene" to provide 'care'. Yes - a walk-up kiosk in a mall with (I assume) staff with very minimal training. You get 'examined' digitally via a networked piece of equipment (otoscope, etc).
(The Doctor is in, at downtown Anchorage mall)


This is in town, mind you, not in Tititlik or Buckland (AK) .

Anyone else seeing these pop up in their area?

 

At first I thought of the VA's "Check the Block Doc" aka a C&P Exam. But with the C&P Exam all you stand to loose is time and money.

What you described, well you could loose your life.

Others may have a better explanation but the Urgent Care is a buzz word that lets them charge near ER rates for less than adequate care.

 

Don't see it much different than the care I get now seeing a nurse practitioner or a physician's assistant at the clinic under Medicare. They go thru the motions, triage you, send the sickest to the ER, in most other cases order some meaningless expensive tests, give you meaningless prescriptions, and if you don't get better and don't die, in about a week you can see a specialist who can be paid enough under Medicare to actually look at you and look at the lab test results and set up a proper care plan. Wife had a bad appendix, PA knew it sounded bad, sent her to the ER, as she couldn't order tests that would be done at once, and Medicare was billed $5,000 for tests, ER fees, ER doctor, experts diagnosing the problem, and setting up emergency surgery. Billed another $12,000 for emergency surgery, found benign tumor on appendix and a hole in it, removed it, and 6 hours post surgery sent her home. This is for a 75 year old woman and although fairly healthy, has had bypass surgery and hysterectomy among other problems. The wonders of Medicine under our present system where anyone with any money pays incredible fees for insurance and receives what ever care the insurance company allows the Doctor to give.

 

I see a real live, competent, GP doctor when I need to, which is not often...I get specialist referrals when necessary, which is rarely....pathology, imagery and other health care services, all bulk billed to Medicare Bulk billing - Wikipedia. But you guys don't want to hear about socialised medicine.

 

I've used the local urgent care a couple of times, since it takes a few days to get in to see my regular doctor. Last time was for bronchitis that they initially thought was pneumonia, but an x-ray said no. It is well equipped and has trained staff, doctors and PAs. It also has a pharmacy. In and out is as quick as it can be, since there is usually no more than one patient ahead.

I have to say they've been pretty good, especially since both times that I've needed them has been on weekends, when you can forget a regular Dr. appointment.

 

I've used the "urgent care" clinics and I was very satisfied with the care I received. In one case, I had a raging case of pink eye...on a weekend. Not bad enough to justify an ER visit, but bad enough that I did not want to wait till Monday to call my doctor and hope they can squeeze me in the same day.

I went to urgent care at 8:00 on a Sunday morning and was seen by a nurse practitioner. I was out by 8:20 with a prescription for antibiotic eye drops and by Monday morning my condition had improved greatly.

The "quickie clinics" where you see a PA or a nurse are not a catch-all solution, but for simple common maladies they are a valuable resource. As for doing it on video from a kiosk...hmm well I'm not sure I'd be ok with that.

 

I went to a Urgent Care unit on a Sunday many years ago. It was located along the Gulf Coast and a good deal for it saved me the trouble of missing a days work. Insurance paid in full and I was back home in a few hours, sleeping off a bad case of allergies that hit all at once.

Many Docs available to me and all have their place. The Saturday morning I woke up knowing I was having a MI meant a quick trip to a local Hospital where my Cardiologist was on staff. I had other choices but my nearest Hospital did not have a Cath Lab so all they would have done was stuff me in a chopper and send me to Heart Center 30 minutes away.

In my choice of Hospital I was seen and treated to relive the pain while they ran test for a MI, before the test were complete my Doc arrived and we planned for a Sunday meeting in the Cath Lab. In and out in 2 days.

Good care has a lot to do with patient awareness and honesty during the Doc/Patient meeting.

Most recent interface with my VA Doc was via E benefits via secure email. I emailed a recovered scan from my crashed computer. Doc's PA answered back in a few minutes stating they had checked all my records and the Doc had ordered a test to be set up at my convenience. I did so by phone and that is in the works for after Christmas at my choice.

Modern Medicine should be combined with modern computer access to the systems now in place.

 

Do these Quickie Clinics work for those of us not on a health insurance plan? Take cash or check?

 

Plastic or Paper, either way.

 

The ones around here do. They also accept those care credit cards.

 

I had to use an 'Urgent Care' this past summer when building the greenhouse and had a 2x4 fall and hit me in the head, needed stitches. It was okay, no complaints, but the wait was almost 1.5 hours. Yes, I was seen by a real doctor who even sewed me instead of stapling me because I told him I was not going to come back again due to the wait just to have the staples remove (I don't know how to remove staples).

Frankly, I think we will see computerized doctors in the future and my personal opinion is they will be just as good, probably better if you think about it, than normal doctors. Obviously, they can't stitch you up but I will bet their diagnosis is faster with a higher percent of being correct.

Healthcare in the USA...is rubbish - no - let's call it what it truly is: crap. The entire system is flawed. I purchase my medicine in Canada because the cost is so much cheaper, so much so, that it is worth it to drive the 2.5 hours and even seeing a doctor is cheaper $65 vs. $$200+.

The latest American medical care insult was when wife went for a checkup. Doctor saw we didn't have medical insurance and even told me that "These medications might be too expensive, if so, come see me and/or ask the Pharmacist." I hit the floor when the Pharmacist told me cost and recommended something different at a fraction of the price, $20 vs. $600. One can't blame the Doctor because she was simply prescribing the best medicine for the situation and who cares about the cost if medical insurance pays for it and THAT is the real problem. Health Insurance doesn't care what the cost is either and simply raises its rates. The drug companies can charge whatever the market will bear - so - they increase costs 6x-10x more than most other countries. You mix all these flaws together and what do you get? Certainly not healthcare but crap.

 

I've been a couple times to the walk in clinics
First one was a breeze in and out in no time
2nd was a major cluster F , Ended up in the ER with kidney stones then sent home when in all actuality had nerve damage, Still having problems with the back and feet.

 

As crazy as this sounds , preventive care and personal education in basic issues is far more valuable in the long run.
A lot of issues I see people going to the medical community for can be dealt with at home .
Not making the time to learn these things falls on one's self .
The practice of medicine is just that , practice, because they are guessing ,and you are paying for it whether you are cured or not.
If you take the responsibility for your own medical needs ,
1. if your honest ,you know more about your self than any one else can.
2. Cures already exist and take a bit of faith in pursuing them, no less the faith you invest in modern medicine.
3. often times the modern med cure comes with a price your not made aware of till it's too late. not the $ but the side effects your gambling against .
4. modern medicine is going to bad mouth alternative medicines , they have no profit in it.
5. modern medicine does not make any money on healthy people, nor those that know how to care for them selves.

 

The real fun is going to come when you can go to Walmart and have somebody in India use a bank of Waldoes to do a remote appendectomy on you, and then sew you back together with the Singer Suture attachment on Hand # 5, right next to Eye #3.

Not to be mistaken for the Testicle Extractor on Hand #3, right next to Eye #5.

I think the minimum wage in India is low enough that everyone can qualify. Especially if they want to be a doctor.

 

On the other hand, non-evidence based folk remedies can also have appallingly negative outcomes. Peddlers of 'patent complementary medicine nostrums' not only profit from the sick, but also from the healthy and neurotic hypochondriac.

I don't want to derail the thread into a critique of 'alternative medicine' vs evidence based medical science and practice, but Tim Minchin pithily explains it in a Youtube Clip called "Tim Minchin's Storm the Animated Movie"....salty language is contained within. Storm!!!!!!!!

 

I called a Urgent Care clinic one night and it would have been $400 just to get in the door. Those clinics are nice and convenient but not cheap if you do not have their acceptable insurance.

 

The rules are different in each state. In my state, there are three levels:

• Traditional emergency room physically attached to a hospital. Top-level care, but big $$.
• "Free standing emergency rooms". Not physically attached to a hospital, but they are staffed with actual doctors and have lab and X-ray capability on site. They can deal with all but the most serious medical emergencies. Not as expensive as an true ER, but still a big bill if you're not insured.
• "Quick care" clinics. These are the places you see inside drug stores, Walmart, etc. Staffed by nurse practitioners and PA's. They do basic stuff...colds, flu, ankle sprains, school sports physicals, and such. Very low $$.

I once went to a "free standing ER". They took good care of me and the bill was about $450. Still a lot of money but not nearly as much as a real ER. I have insurance so it did not hit me too hard.

When I got the pink eye mentioned in my last post, I went to a "quickie clinic". The bill for that was only $90, which is much less than going to my regular doctor & I did not have to wait. After insurance my share was something like $20. I thought that was an excellent value for the money to get immediate quality care for a simple need on a weekend.

 

Many years back, my late Father cut himself badly on a jointer-planer, and his BIL who was there rushed him to a nearby clinic (long closed now). A foreign doc (likely Pakistani) used a,skin grafting technique to get a flap of chest skin to grow over his much-shortened thumb. It took time, but worked. Dad's hand was held immobile against his chest - made doing basic things difficult!
That was the good part. Dad's HMO paid the bill. But, that doc tried to cajole Dad into also paying the bill himself upfront. That barstage wanted to double-dip!
I suspect that's why he left, and the building has been empty twenty years now. Goid location actually, across the street from a busy shopping center in the fast growing Southside of town, which can really use a well-run clinic. It's five minutes from my home, so I'd like to see it open again. The two hospitals are way across town, with a $1,000 ambulance fee to be taken there. Ouch!

 

Back in the Civil War era, country people hated to have to call a doctor because they were so expensive.

When they finally called one, they rejoiced if the doctor didn't show up within five days.

That's because in something like 85% of even the most serious cases the patient would survive without any formal medical treatment--whereas getting treated by a sawbones was downright dangerous.