Is working urgent care stressful?

[Poit]

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It seems like the majority of things are fairly straightforward. I feel like I have a pretty decent handle on the majority of chief complaints as a 3rd year. If there are any "oh crap this might be serious" cases, they get sent to the ER. Seems like a nice gig, even if it isn't very intellectually rewarding.

 

[NeurologyHopeful2018]

Yes - Urgent Care is the best kept secret in medicine. Know a resident who was not able to complete his general surgery residenct and now works urgent care locum - he loves it. The hours, pay, and level of care is great.

You do shift work of an ED doc, but with much lower stress.

 

[MudPhudHopeful]

What are the requirements for working in urgent care? Just a medical license? Or is it restricted to specific specialists?

 

[Oso]

It seems like the majority of things are fairly straightforward. I feel like I have a pretty decent handle on the majority of chief complaints as a 3rd year. If there are any "oh crap this might be serious" cases, they get sent to the ER. Seems like a nice gig, even if it isn't very intellectually rewarding.

 

[doc05]

It seems like the majority of things are fairly straightforward. I feel like I have a pretty decent handle on the majority of chief complaints as a 3rd year. If there are any "oh crap this might be serious" cases, they get sent to the ER. Seems like a nice gig, even if it isn't very intellectually rewarding.

It's a terrible gig. This is not the kind of work you can do for a career.

 

[Poit]

It's a terrible gig. This is not the kind of work you can do for a career.

Do you mind elaborating on this? What's so bad about it? You get your fair share of drug seekers and people wanting antibiotics when it isn't indicated, but other than that, it seems like easy money.

 

[doc05]

Do you mind elaborating on this? What's so bad about it? You get your fair share of drug seekers and people wanting antibiotics when it isn't indicated, but other than that, it seems like easy money.

Doing mind-numbing work for many years will lead to burnout.

 

[NeurologyHopeful2018]

Doing mind-numbing work for many years will lead to burnout.

How can it be more mind numbing than PhD scientist or professor (running reptitive experiment over and over, falsfying research), teacher (teaching same subjective over and over, dealing with bad students), and police officer (terrorizing society at large due to boredom?)

I dont think anyone will argue Professor/teacher/cops are bad careers..

 

[DubbiDoctor]

What are the requirements for working in urgent care? Just a medical license? Or is it restricted to specific specialists?

Believe you just need to get through intern year and have a medical license. A lot of burntout ED doctors do it though.

 

[VA Hopeful Dr]

How can it be more mind numbing than PhD scientist or professor (running reptitive experiment over and over, falsfying research), teacher (teaching same subjective over and over, dealing with bad students), and police officer (terrorizing society at large due to boredom?)

I dont think anyone will argue Professor/teacher/cops are bad careers..

Because it's very superficial medicine. Outside of laceration repairs, it's very unsatisfying. You're basically an antibiotic vending machine.

 

[DubbiDoctor]

Because it's very superficial medicine. Outside of laceration repairs, it's very unsatisfying. You're basically an antibiotic vending machine.

They're going to be overtaken by independent NPs soon enough, reducing pay.

 

[DocWinter]

You answer your question, it's not very stressful. And I think we all could find many other careers than ours in medicine personally unsatisfying, so it's pretty subjective.

 

[NeurologyHopeful2018]

Because it's very superficial medicine. Outside of laceration repairs, it's very unsatisfying. You're basically an antibiotic vending machine.

In the end of the day - every specialty - its just a job. A job = a job = a job.

In terms of income per effort/stress and portability - urgent care is a pretty damn good job.

 

[VA Hopeful Dr]

In the end of the day - every specialty - its just a job. A job = a job = a job.

In terms of income per effort/stress and portability - urgent care is a pretty damn good job.

No, it isn't.

Listen, I've done it multiple times at multiple different companies.

It sucks. Every time.

 

[NeurologyHopeful2018]

No, it isn't.

Listen, I've done it multiple times at multiple different companies.

It sucks. Every time.

Fair enough. The disgraced surgery resident must be sugar-coating his experience to save face

 

[deleted859535]

Urgent care is where medicine goes to die. I am an EM attending, and part of what I do with my group is that we have a certain shift or two in certain places that are largely urgent care-type medicine. Most of us hate them. Mind numbing stuff.

 

[libertyyne]

Are urgent cares appropriate for moonlighting during residency? Even if you are in a surgical specialty?

 

[VA Hopeful Dr]

Are urgent cares appropriate for moonlighting during residency? Even if you are in a surgical specialty?

Yes to the former, maybe to the latter.

Depends how much general medicine you remember.

 

[theonlytycrane]

As a pre-med awhile back I used to volunteer in an urgent care and thought "oh this is cool!". Now I realize how boring it must have been working there (runny noses all day and *maybe* a sprained ankle).

 

[IM-2019]

Is that different from what you might see in outpatient FM? Runny noses and minor MSK complaints seemed like half of what the patients presented with, and chronic DM/HTN/HLD management was relatively routine too.

 

[VA Hopeful Dr]

Is that different from what you might see in outpatient FM? Runny noses and minor MSK complaints seemed like half of what the patients presented with, and chronic DM/HTN/HLD management was relatively routine too.

One of the big problems I always have with Urgent Care was the lack of any follow-up. This meant that you couldn't really work up anything there was even moderately complicated like fatigue or insomnia. Basically if it cannot be fixed in a single visit you can't do anything about it in the Urgent Care.

 

[bonemann]

Do practicing surgeons ever do this as a side gig to keep their general medicine knowledge sharp?

 

[MakeLifeHappen13]

Low stress, decent pay, predictable hours, never on-call, no patient follow up, no billing headaches, plus most Urgent Cares have scribes at this point. Sounds like a good way to make a living to me. Yeah it can get repetitive and boring but don't all specialties at a certain point?

 

[VA Hopeful Dr]

Low stress, decent pay, predictable hours, never on-call, no patient follow up, no billing headaches, plus most Urgent Cares have scribes at this point. Sounds like a good way to make a living to me. Yeah it can get repetitive and boring but don't all specialties at a certain point?

Then go nuts.

I'll be here when you come back burnt out to tell me I was right.

 

[BigRedBeta]

Low stress, decent pay, predictable hours, never on-call, no patient follow up, no billing headaches, plus most Urgent Cares have scribes at this point. Sounds like a good way to make a living to me. Yeah it can get repetitive and boring but don't all specialties at a certain point?

Like anything, depends on the expectations. If you're just looking to pay the bills, and go in knowing it's limiting in so many ways, then maybe you can make it work for the long term. But many people (even if unwittingly) get into medicine precisely because it offers variety and isn't so much of an assembly line. If nothing else, by the time you've gone through your training, you've experienced the breadth of your chosen specialty and going backwards becomes untenable. While every field has it's bread and butter, there are rewards out there that urgent care lacks. Even things like FM and General Peds or IM provide continuity of care and longitudinal relationships that many find satisfying - either through watching your patients progress through life, or helping them overcome/manage their maladies. Urgent care isolates the routine low level care and removes anything else that may prove satisfying. Doesn't seem like an outcome that justifies the tremendous expenditure of time, money, and work that medical school requires.

 

[Oso]

Do practicing surgeons ever do this as a side gig to keep their general medicine knowledge sharp?

I doubt you could ever pay a surgeon enough money to staff an urgent care

Also, in my opinion, there’s not much ‘General medicine’ in urgent care

 

[NeurologyHopeful2018]

Like anything, depends on the expectations. If you're just looking to pay the bills, and go in knowing it's limiting in so many ways, then maybe you can make it work for the long term. But many people (even if unwittingly) get into medicine precisely because it offers variety and isn't so much of an assembly line. If nothing else, by the time you've gone through your training, you've experienced the breadth of your chosen specialty and going backwards becomes untenable. While every field has it's bread and butter, there are rewards out there that urgent care lacks. Even things like FM and General Peds or IM provide continuity of care and longitudinal relationships that many find satisfying - either through watching your patients progress through life, or helping them overcome/manage their maladies. Urgent care isolates the routine low level care and removes anything else that may prove satisfying. Doesn't seem like an outcome that justifies the tremendous expenditure of time, money, and work that medical school requires.

Your argument is that Urgent Care is simply boring - but yet boring has to be a better experience than a full blown malignant and toxic specialties like Gen. Surg and Ob Gyn - no?

 

[Oso]

Your argument is that Urgent Care is simply boring - but yet boring has to be a better experience than a full blown malignant and toxic specialties like Gen. Surg and Ob Gyn - no?

I think his argument was more nuanced than that -- that urgent care lacks the "low lows" and "high highs" of other specialties due to its routine nature, which can make it less satisfying to many people and not worth the amount of training it takes to get there.

I wouldn't call gen surg or ob/gyn full blown malignant and toxic specialties. Would I ever do one of those? **** no. But I bet many people would choose those two specialties, despite the more intense atmosphere, higher stress, and colorful personalities, than work in urgent care.

BRB isn't saying one is better than the other, he's saying it depends on what you're looking for and how you get fulfillment from your career.

 

[VA Hopeful Dr]

BRB isn't saying one is better than the other, he's saying it depends on what you're looking for and how you get fulfillment from your career.

Bingo, and there is nothing fulfilling about Urgent Care.

It pays the bills, but that's about it.

 

[BigRedBeta]

Your argument is that Urgent Care is simply boring - but yet boring has to be a better experience than a full blown malignant and toxic specialties like Gen. Surg and Ob Gyn - no?

In general when speaking to medical students and residents I try, and encourage everyone, to avoid judging specialties based on the people. People change, locations change, the medicine doesn't.Also, Academic Medicine is not the same as private practice. There are tradeoffs for everything and many people find fulfillment in Surg and OB/Gyn despite the personalities.

It's not just that Urgent Care presents a very narrow scope of pathology, it's that it doesn't offer much of what many people claim they want from a medical career. It's not particularly lucrative in the grand scheme of physician compensation, there are few diagnostic dilemmas or other interesting pathology, scant procedures, rare longitudinal relationships (and may would argue that if there is a longstanding relationship, something is very wrong), it's not prestigious, you can't create a research career out of it. Further, it's prone to things that many physicians worry about including corporate ownership, over protocolization/cookbook medicine, significant mid-level creep, over emphasis on Press Ganey and other "satisfaction" metrics. Now I'll readily admit that some people DON'T want any of these things, but I'm not sure I've ever met any of them.

So what's left to make it attractive? Set hours (although still evening and weekend heavy), no call, low administrative demands, billing presumably handled, quick triage of sick patients (although you still have to manage them while waiting for EMS), and....???

Again, if you go in with eyes open and are woke to what the reality of UC is, then by all means, go for it. But I don't think UC is going to become the new favorite of graduating residents anytime soon.

 

[NeurologyHopeful2018]

In general when speaking to medical students and residents I try, and encourage everyone, to avoid judging specialties based on the people. People change, locations change, the medicine doesn't.Also, Academic Medicine is not the same as private practice. There are tradeoffs for everything and many people find fulfillment in Surg and OB/Gyn despite the personalities.

It's not just that Urgent Care presents a very narrow scope of pathology, it's that it doesn't offer much of what many people claim they want from a medical career. It's not particularly lucrative in the grand scheme of physician compensation, there are few diagnostic dilemmas or other interesting pathology, scant procedures, rare longitudinal relationships (and may would argue that if there is a longstanding relationship, something is very wrong), it's not prestigious, you can't create a research career out of it. Further, it's prone to things that many physicians worry about including corporate ownership, over protocolization/cookbook medicine, significant mid-level creep, over emphasis on Press Ganey and other "satisfaction" metrics. Now I'll readily admit that some people DON'T want any of these things, but I'm not sure I've ever met any of them.

So what's left to make it attractive? Set hours (although still evening and weekend heavy), no call, low administrative demands, billing presumably handled, quick triage of sick patients (although you still have to manage them while waiting for EMS), and....???

Again, if you go in with eyes open and are woke to what the reality of UC is, then by all means, go for it. But I don't think UC is going to become the new favorite of graduating residents anytime soon.

If that is your mindset - then Neurology must be even worse than urgent care. Much narrower focus of pathology and very few treatment available.

 

[deleted859535]

If that is your mindset - then Neurology must be even worse than urgent care. Much narrower focus of pathology and very few treatment available.

Apples and oranges.

 

[Wordead]

If that is your mindset - then Neurology must be even worse than urgent care. Much narrower focus of pathology and very few treatment available.

People have been looking for an easy way out of medicine since the inception of the current system. Not sure why anyone would think urgent care would be a "well kept secret" like nobody is aware of it.

 

[VA Hopeful Dr]

If that is your mindset - then Neurology must be even worse than urgent care. Much narrower focus of pathology and very few treatment available.

Yeah I mean we don't have any treatments for seizures, MS, migraines, neuropathies, or strokes...

 

[BigRedBeta]

If that is your mindset - then Neurology must be even worse than urgent care. Much narrower focus of pathology and very few treatment available.

Not sure how you arrive to that conclusion. Just last week while I was on service in the PICU, the cases I consulted Neuro for included status epilepticus, ADEM, TBI, meningitis, stroke, Guillain Barre syndrome, and a couple of patients who had resection of seizure focus procedures done by the Neurosurgeons. Is it all neurons? Yeah, of course. But that's way different than URI's, sore throats, back pain, sinus infections, and viral exanthams that you'd see as an urgent care physician. There are some real diagnosis that goes on for those neuro conditions, some real thought to be put into their treatments, and they weren't just one off "here's your z-pack prescription" encounters never to be seen again.

The point again however, is not just that UC sees run of the mill pathology, but that it is devoid of pretty much anything else that doctors routinely say provides job satisfaction. If someone goes in recognizing the limitations and still wants to run with it, then that's totally their right. If someone just wants to pay the bills and deal with as little stress as possible, then UC is a reasonable option, but if they are looking for much more than that, they're likely going to be disappointed.