doc-in-the-box urgent care facilities

[LaurieB]

What do you guys know about doc-in-the-box urgent care facilities?

Have you ever worked in or done a rotation in one of these clinics? If so, what are the patients like and what is the lifestyle like?

Finally, have you ever heard of anyone splitting their time between an ER and an urgent care facility?

Just curious. I'm a long way off on choosing a specialty, but it seems like doing EM is a great specialty for a balanced life and I'm curious if the same is true for physicians who work at urgent care facilities?

Laurie

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[dr.smurf]

alot of the time urgent care centers are staffed with family practice guys. the em guys i know dont b/c they can make more $$ in the e.r. but, im sure it does happen.

 

[Seaglass]

Yeah, my understanding is that most of the $$ comes from critcal care billing, and of course there is a lot less of that in the doc-in-the-box type places.

C

 

[docB]

Be careful. Those places can be tricky. You do a lot of physicals for various things like jobs and schools and if you don't know the paperwork really well it causes lots of problems. I also looked into one of those places when I was a resident and I was about to sign on when I found out that you had to take your own Xrays. Not read, TAKE. I don't know how to take Xrays. I'm sure I'd vaporize some poor patient.
"Take a deep breath sir."
ZZZZZZZZZZZZAP, POOF
"Ok sir you can breath again. Sir? Sir?"
and there's just a wisp of smoke and a sooty reverse shadow on the wall. Anyway, I didn't take that job.

 

[EMRaiden]

Originally posted by cg1155
Yeah, my understanding is that most of the $$ comes from critcal care billing, and of course there is a lot less of that in the doc-in-the-box type places.

C

I have been told that you can make about as much seeing several Level 1-2 patients and as if you see 1 or 2 Level 4-5 patients.

 

[NinerNiner999]

From my experience and after talking to several EM docs, urgent care does not pay as well, but it is an easy way to supplement an income. One of the attendings here works 3-4 days/week, and fills out his 5 days/week at urgent care for 8 hours per shift (as opposed to 12 hours in the ED).

 

[The White Coat Investor]

You will be better prepared for urgent care by completing an FP residency than an EM residency. An EM residency will prepare you adequately however, as will just about any internship.

Urgent care cannot be billed above a level 3 ED visit. However, you can make just as much in a UC as in an ED because you can see so many more patients.

EPs tend not to work in UCs because they don't find it stimulating/challenging enough for their skills. They enjoy taking care of a few critically ill patients per shift. Urgent care docs hope none of their patients are critically ill.

Most dollars for EPs don't come from critical care billing. A fair amount comes from procedures, but most comes just from the level 3,4, and 5 billing they do just seeing patients.

 

[DrQuinn]

Originally posted by Desperado
Most dollars for EPs don't come from critical care billing. A fair amount comes from procedures, but most comes just from the level 3,4, and 5 billing they do just seeing patients.

Most of the money that I get is from selling Demerol and Dilaudid shots on Ebay.

Q, DO

 

[DocWagner]

You guys are on the right track.
Most certainly urgent care has a lower hourly wage compared to emergency depts...primarily because of the reimbursement from a billing level (as noted more level 4's and 5's in ED's). By virtue of Physician to Physician communication, collecting previous medical records, and interpreting chest films and EKG's, billing level increases. All of these things are FAR more readily available in a hospital setting versus off site private "urgent cares".
A plus from the urgent care stand point is the location...if it is a wealthy suburb, then co-pays are more readily collected and "bad debt" goes down. If potentially you work in an urgent care in a wealthy suburb, "treat em and street em" at a high rate, then you can make up for the lower level of billing...but the point is moot if you are an hourly employee. Obviously, the owner has the incentive...then again if there are productivity incentives, the less hourly wage can be overcome.

 

[docB]

Originally posted by Desperado
EPs tend not to work in UCs because they don't find it stimulating/challenging enough for their skills. They enjoy taking care of a few critically ill patients per shift. Urgent care docs hope none of their patients are critically ill.

Is that what I'm doing? I feel like I see 1 or 2 really sick people per shift and an army of whining chronic players for whom the main service I perform is assuming their liability until the next doc sees them.

 

[ERMudPhud]

Originally posted by docB
Ithe main service I perform is assuming their liability until the next doc sees them.

Sometimes I feel like my shifts are like a game of "tag you are it" or that other game hot potato.