Anyone else exhausted by managing midlevel screw-ups?

[wholeheartedly]

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Was your move that sudden? If not then if you felt the need to get a doctor you could have made appt before you moved ??

no, move wasn’t exactly sudden but it was a cluster. i was hoping to get recs from my new coworkers on who to see. i didn’t need refills on anything for awhile and came from a place where getting a primary doc in a couple weeks was no prob, so i didn’t prioritize it like i should. things are very different here than other places i’ve lived.

so yes, better preparation on my part could’ve likely avoided the issue. while i agree primary care should be the main venue for this, i’m still not opposed to urgent cares existing for some uses/situations.

 

[EctopicFetus]

no, move wasn’t exactly sudden but it was a cluster. i was hoping to get recs from my new coworkers on who to see. i didn’t need refills on anything for awhile and came from a place where getting a primary doc in a couple weeks was no prob, so i didn’t prioritize it like i should. things are very different here than other places i’ve lived.

so yes, better preparation on my part could’ve likely avoided the issue. while i agree primary care should be the main venue for this, i’m still not opposed to urgent cares existing for some uses/situations.

Reality is the system is set up for what we have. the incentives of the market give us what we have now. Many of the UCs don't take Medicaid. Those people just go to the ED. Patient satisfaction and other nonsense have made the ED a bit of a convenience / second opinion center.

PCPs have to have a full schedule and essentially only peds do sick visits. Hell during covid pcps wouldn't see anyone who possibly had covid.

 

[EMhawkeye]

I like to give other providers the benefit of the doubt because patients misunderstand and lie, but I feel like I am getting flipped off by pcp's telling their patients: here's some abx for your uti, if you aren't feeling better just go to the ER.
Instead of managing their own patients with outpatient problems.

 

[RustedFox]

Was your move that sudden? If not then if you felt the need to get a doctor you could have made appt before you moved ??

C'mon, man.

 

[CoolDoc1729]

no, move wasn’t exactly sudden but it was a cluster. i was hoping to get recs from my new coworkers on who to see. i didn’t need refills on anything for awhile and came from a place where getting a primary doc in a couple weeks was no prob, so i didn’t prioritize it like i should. things are very different here than other places i’ve lived.

so yes, better preparation on my part could’ve likely avoided the issue. while i agree primary care should be the main venue for this, i’m still not opposed to urgent cares existing for some uses/situations.

I think this is an ideal use of urgent care. I don’t think I’ve ever planned ahead for pcp visits when I’ve moved. Come on.

The urgent cares shouldn’t be allowed to take the copays of the 85yo’s with chest pain, then send them to the ER +/- ekg no other workup.

The problem is how few people understand what to go to pcp, urgent care or ER for, and also that ER has to take all comers and the lower levels of care can screen by whether you have non-Medicaid insurance. People with private insurance generally are pushed towards urgent care because they have a higher copay for ER visits, even for inappropriate things , and uninsured/Medicaid come to ER for inappropriate things because no one else will take care of them. I don’t mind but realistically I’m not as good at adjusting anti hypertensives as a pcp, and I’m liable to get called to a code in the middle of a complicated facial lac repair.

 

[EMhawkeye]

Midlevel failing to call back a uti with gram negative bacteremia and saying "oh they're on po abx, they'll be fine"