Turning the Tables: My Patient Experience

I am not an avid or advanced skier, a fact I proved while attempting to conquer ‘just one more’ icy slope this past weekend.  While I didn’t require assistance from the ski patrol or a ride on  the back of a snowmobile, I did bang up my knee quite a bit, and the swollen size convinced me I might as well get it checked out my a doctor.

Thanks to the recent proliferation of “Urgent Care” Centers, even our local orthopaedic institute has one now, promising quick access to a team of experts no matter your injury. I figured that was the most appropriate option, so I walked in around 11am, filled out a basic history on an iPad, and handed over my insurance card.  The kind woman at the front desk asked me about my injury- briefly- confirming what body part I’d hurt.  Minutes later I was upstairs getting several x-rays, before I’d ever even seen a nurse.

Had anyone asked about the problem with my knee, I would have emphatically explained the issue was a bit of swelling and mild muscle pain – I hadn’t heard any pops, cracks, or snaps, and everything seemed to still be in place.  A quick physical examination would have informed any clinician that it was likely just a pulled ligament (which did happen, only after the x-ray). Instead, I was sent to be scanned, ensuring that the office could cash in on the comprehensive insurance I’d presented.

For obvious reasons, I don’t consider myself an “average” patient; I’ve spent far too much time reading about healthcare and considering the problems of enormous healthcare costs in the US.  But that was precisely what I found so disturbing about the straight-to-x-ray process, as well as the unnecessary brace I was given (which I will not wear, and would have told anyone in the office who’d asked).  Both are guaranteed payments from my insurance company, despite their questionable medical necessity.  I understand some patients may be comforted by an x-ray, or enjoy the extra support of a brace; but I can’t agree that they should be standard.  To be honest, the genuinely excellent care I received when I was finally seen by a PA would have been more than enough to calm my fears.

Generally, the availability of urgent care centers (for a variety of specialties) are a movement I applaud.  They provide an excellent alternative to the ED that is generally more convenient and more appropriate in terms of level of care. But the indiscretion in ordering tests and treatments is a profit-making technique I cannot get behind. Ensuring these urgent care centers help to reduce overall healthcare costs will require some additional oversight and responsibility.


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