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It is maybe a little bit crazy to design a system that charges people based partly on how well they are able to self-assess their need for care. The ER and urg
by maxerickson 3y ago
It is maybe a little bit crazy to design a system that charges people based partly on how well they are able to self-assess their need for care.
The ER and urgent care at my local hospital are next door to each other. Until the last year or so, it was the only urgent care in the area (and is the only ER).
- tptacek 3y agoThe system I'm describing does no such thing. Urgent care is the doctor's office. It takes less self-assessment, not more, to go to urgent care, because you can go inexpensively and with no notice or appointment. Got a weird itchy bump? Stop in on your way back from work. If it's a rash, they'll tell you take Benadryl. If it's Fatal Familial Itchy-Bump-Itis, they'll square things away with your PCP and get serious diagnosis and care expedited. It works extremely well with my doctor's health system, and I'll add that my doctor's health system is notorious in the area for sucking to work with, so if I switched to, like, Rush or Northwestern, presumably it'd be even better.
- maxerickson 3y agoWhy should that stop cost more of you walk in the other door? One argument could be that treating non emergency cases would ruin availability or increase costs, both of which seems like big assumptions at a system design level (vs the actual constraints and incentives that have lead to the existing service configuration).
- tptacek 3y agoAt the point where you're noticing that Urgent Care costs less than a primary care appointment and find that problematic, it really starts to feel like you're just searching for things to disagree about. It's OK if we run out of things to dispute!
- maxerickson 3y agoI'm talking about the ER not having a triage level that is equivalent to urgent care, not comparing urgent care to primary care.
- tptacek 3y agoLots of hospitals do have attached urgent care clinics.
- maxerickson 3y agoYeah, like I described in my first reply. Seek care at the wrong spot and you pay a lot more, for reasons that I don't think are particularly clear. I'm sure that there are regulatory drivers, but I expect they are things we should seek (as a society) to improve, rather than accept and ignore.
- ianburrell 3y agoER is expensive because have to deal with life-and-death emergencies. They also have to deal with treating everyone. Primary care is good for dealing with ongoing issues. It is cheaper because only staff what they need. But have to schedule appointments far out. They could leave slots open for urgent issues but then would cost more. Urgent care is to handle the urgent but minor issues. Stuff that doctor could handle if they were open or had appointments. They are more expensive since they are open longer hours and less likely to get insurance. One thing that would help fix the system is lots more free 24-hour urgent care clinics. That would keep people out of ER.