Our group covers the Urgent Care connected to the larger hospital in our area, and yesterday I worked my first shift there. Wow. What an experience. If this is the future of healthcare under the current system, I want to know if I can switch specialties… like to pathology.
We saw, in our humble Urgent Care, about 80 patients in a 12 hour period. Now, I know I had colleagues who moonlighted during residency and had 200+ days in our Western NY town, but the volume for me was frantic considering I see about 20 patients a shift during my 12 hours in my E.D. Luckily, I was with an experienced “old timer” who talked of the days he worked the UC by himself, and a nurse, with just a bottle of PCN and a stethoscope that was missing an ear piece. But, I digress.
I almost felt as though I was somewhere in a third world country. And, the scary part is that most of my patient population was under the age of 30. Now, I know there’s a lot of methamphetamine use in this part of the country, but the dental caries and disease I saw in the “never used drugs ever” crowd was pretty scary. I began to wonder what’s in the local water. I also found out there’s a three month wait time to see a dentist. Even longer if you’re on state funding and have to wait for the one clinic that takes MediCal.
Then there’s the No PMD crowd that come in with their back aches, shoulder aches, neck aches, etc., and who seem to have never heard of acetaminophen and ibuprofen. But, somehow, they do know about “Norco’s and Perc’s” because they always have a “friend with some extras” and that seemed to work really well on that pain. Yeah, they’re not too happy with my “no narcotics” philosophy, although they don’t mind the work note giving them a three day weekend.
The ones I worry about are the “I have a PMD, but they don’t do anything.” There’s a two to three month wait time to get an appointment with a primary care physician; more if you’re not an established patient. I had several patients come in with chronic problems who wanted me to give them a “quick fix.” Let’s see… you just saw your PMD three days ago, you didn’t address this problem with them even though you tell me it’s been bothering you for three weeks, and now you’re not going to see your PMD again for 4 months. Yeah, mhmm…
Seriously, is this the future of healthcare? Or are we allowing for a “dumbing down” of our patients into a “take care of me” society? Please, don’t even get me started on the “can you write me for a Tylenol script because then I get it for free” patients.