The emergency department utilization debate has heated up again. For those of us who may read the New York Times, the Wall Street Journal and even those who might peruse the Journal of the American Medical Association, we’ve all been treated to a lively debate on the overuse or underuse of emergency departments for routine health care issues, the appropriateness or not of ED visits, and the small degree or large degree of cost savings we could achieve if we decreased ED patient volumes, which by anyone’s calculations are increasing nationally.
Many of us with a stake in the Urgent Care game can get mired in these discussions, especially those of us who eat, sleep and dream about the urgent care mission. For me, getting worked up over documenting who is being seen in what type of setting (primary care, retail clinic, urgent care center or the emergency department) and at what cost savings isn’t as interesting as demonstrating programs and models where all the players work together in the best interest of the patient. Let me give you two quick examples.
One of the largest primary care practices near ConvenientMD‘s Windham clinic had received specific guidelines for antibiotic prescribing for its patients who were members of a specific health plan. Our urgent care wasn’t aware of these guidelines for respiratory infections until we received a call that the network physicians were being penalized for some of our antibiotic prescribing practices. These primary care physicians weren’t happy and for good reason. By working together, we were able to understand the guidelines and make sure all our urgent care physicians understood them and why they needed to be followed. We are currently monitoring our respiratory antibiotic use and with the help of these local practices are tracking our improvement. In the end, it’s the patients of these physicians we might see for an occasional urgent care visit who benefit.
A second example occurred with a local emergency department. We had been sending certain patients with cardiac issues to other emergency departments because of our understanding of the services provided at each hospital. After an invited tour of the aforementioned ED and a better understanding of the cardiac services they had onsite, we were able to offer more informed cardiac treatment options to our patients with improved access and coordination of care to the aforementioned local emergency department.
Protecting our turf in our clinic-centric mind set will always cost us more in the long run. We all need to understand that a patient-centered model of care delivered in our local communities will be the answer to many of our health care challenges.
Jeffrey Collins, MD
ConvenientMD Urgent Care