4 ms·

At night the ED is the only place open. I believe there should be 24/7 Urgent Care centers, where people like the person in the opening of this article could go

At night the ED is the only place open. I believe there should be 24/7 Urgent Care centers, where people like the person in the opening of this article could go and receive care that (1) is not life-threatening but (2) can't wait till dawn. However, in the mean time there are ways to help. 1. If you don't already have one, get a Primary Care Physician. Go for a wellness visit, get their practice to know you. Then if something like that happens at 1am, you can call the office, leave a message and get a callback from a nurse within 15-30m who can help you through your options and help with over-the-counter options to make it through the night until the office opens (or until urgent care opens). Or of course they can counsel you to go to the ED if they think there's a risk. But the point is, you can already weed out some unnecessary ED visits that way. Note: not all providers have that service, so it's best to enquire when selecting a physician. 2. Many insurers have a nurses hotline but few people know about it. Check your policy. In the same way, they can help triage your situation, though it's less ideal since they don't know your medical record so they will tend to play it safer (ie. higher likelihood to send you to the ED). But it's better than nothing. 3. If the issue is pain management, you can also try your neighborhood 24/7 pharmacist. They can't diagnose you but again they might have tips to help you through the night until you can get proper care.

maxerickson 9y ago
The only way to get widespread 24 hour urgent care in the US is to make it a billing code in the emergency room. There's often already 24 hour urgent care available in major urban centers. Of course, this raises the question. Why isn't urgent care a billing code in small emergency departments?
- staticautomatic 9y ago
  Is that a rhetorical question?
- FireBeyond 9y ago
  Pushback lobbying from healthcare companies and the American College of Emergency Physicians, to be blunt.
- chimeracoder 9y ago
  > Of course, this raises the question. Why isn't urgent care a billing code in small emergency departments? Because it's still emergency physicians performing the work, for the same cost (both marginal and overhead). The answer is to open up actual urgent care practices, which are cheaper to run, not to change the billing codes used in emergency room settings.
  - maxerickson 9y ago
    I remain unconvinced that running an entire separate practice is obviously cheaper than adding primary care doctors to ERs. I'm sure it makes more financial sense given the current regulatory and reimbursement regimes. I mean, when I've been in the local ER it hasn't exactly been a hive of urgent activity, you chat with the intake nurse and then watch her sit there and do things other than interact with patients for half an hour.
    - chimeracoder 9y ago
      > I remain unconvinced that running an entire separate practice is obviously cheaper than adding primary care doctors to ERs. I'm sure it makes more financial sense given the current regulatory and reimbursement regimes. Emergency medicine and primary care are completely different settings. "Adding primary car doctors to ERs" doesn't really make any sense. The structure of care delivery is completely different.
      - maxerickson 9y ago
        Is the structure of care delivery different for good reasons or is it different because ERs don't make accommodations in their care delivery for the many non-emergency cases that walk into ERs? (and of course they don't because they aren't going to bill insurance companies any less than they can consistently get them to pay)
        chimeracoder 9y ago
        > Is the structure of care delivery different for good reasons or is it different because ERs don't make accommodations in their care delivery for the many non-emergency cases that walk into ERs? Yes, the actual structure of care that is delivered is entirely different. You can't just stick primary care inside an ER and expect it to work. The two aren't similar.
gozur88 9y ago
>...receive care that (1) is not life-threatening but (2) can't wait till dawn. How often does this happen? If it's not life threatening, why can't it wait until dawn?

maxerickson 9y ago

The only way to get widespread 24 hour urgent care in the US is to make it a billing code in the emergency room. There's often already 24 hour urgent care available in major urban centers. Of course, this raises the question. Why isn't urgent care a billing code in small emergency departments?

staticautomatic 9y ago
Is that a rhetorical question?
FireBeyond 9y ago
Pushback lobbying from healthcare companies and the American College of Emergency Physicians, to be blunt.
chimeracoder 9y ago
> Of course, this raises the question. Why isn't urgent care a billing code in small emergency departments? Because it's still emergency physicians performing the work, for the same cost (both marginal and overhead). The answer is to open up actual urgent care practices, which are cheaper to run, not to change the billing codes used in emergency room settings.
- maxerickson 9y ago
  I remain unconvinced that running an entire separate practice is obviously cheaper than adding primary care doctors to ERs. I'm sure it makes more financial sense given the current regulatory and reimbursement regimes. I mean, when I've been in the local ER it hasn't exactly been a hive of urgent activity, you chat with the intake nurse and then watch her sit there and do things other than interact with patients for half an hour.
  - chimeracoder 9y ago
    > I remain unconvinced that running an entire separate practice is obviously cheaper than adding primary care doctors to ERs. I'm sure it makes more financial sense given the current regulatory and reimbursement regimes. Emergency medicine and primary care are completely different settings. "Adding primary car doctors to ERs" doesn't really make any sense. The structure of care delivery is completely different.
    - maxerickson 9y ago
      Is the structure of care delivery different for good reasons or is it different because ERs don't make accommodations in their care delivery for the many non-emergency cases that walk into ERs? (and of course they don't because they aren't going to bill insurance companies any less than they can consistently get them to pay)
      - chimeracoder 9y ago
        > Is the structure of care delivery different for good reasons or is it different because ERs don't make accommodations in their care delivery for the many non-emergency cases that walk into ERs? Yes, the actual structure of care that is delivered is entirely different. You can't just stick primary care inside an ER and expect it to work. The two aren't similar.

gozur88 9y ago

>...receive care that (1) is not life-threatening but (2) can't wait till dawn. How often does this happen? If it's not life threatening, why can't it wait until dawn?