Which Type of Doctor’s Office Should You Visit?
Whether you've sprained an ankle on vacation or just don't want to wait three weeks for a doctor's appointment, you now have more health care options than ever. A variety of clinics, offering a wide range of services from stitches to wellness exams, are popping up in neighborhoods near you.
Health Care on The Go
Many are stationed in drugstores and supermarkets, while freestanding chains such as NextCare, FastMed, and CityMD -- often referred to as urgent care clinics -- are designed to deal with more serious health issues requiring X-rays and other equipment.
One in four Americans has visited a rapid health clinic, and by the end of 2015, estimates show they will account for as much as 10 percent of nonprimary care visits. "It's the convenience revolution in health care," says Ateev Mehrotra, M.D., an associate professor at Harvard Medical School who studies the issue for the nonprofit Rand Corp. "We demand 24-7 instant access for banking, movies, grocery shopping," he says. "Why not health?" With a national shortage of 16,000 primary care physicians, many experts say these types of centers fill an important gap. So, where should you head next time you're not feeling well? We've reviewed what's on tap at these outlets to help you decide.
Retail Health Clinic
You'll find these in drugstores, supermarkets, and other retail outlets. They're a great option when you can't see your regular doctor, but services are often limited. Many of these walk-in clinics don't have a full-time physician,
and are run by either RNs, nurse practitioners, and/or physician assistants. Their care can be restricted to standard procedures and treatments, including immunizations and testing for strep throat. A growing number of clinics are also equipped to help manage
the basics of chronic conditions including diabetes, hypertension, and high cholesterol by taking readings and dispensing meds. Responding to demand, some retail clinics are offering preventive health services, such as wellness exams and routine physicals.
Found: In drugstores, grocery stores, and pharmacies.
Staffed By: Mostly RNs, physician assistants, and nurse practitioners, but in some cases a doctor is available during certain time frames.
Good For: Treatment of cold/flu symptoms and minor skin conditions (rashes, bug bites, poison ivy, ringworm, etc.); immunizations; pregnancy testing; treatment of non-life-threatening conditions such as urinary tract infections and conjunctivitis; screening for diabetes, high blood pressure, and cholesterol.
Be Aware: Read reviews on zocdoc.com (a website that vets doctors and clinics by geographic area) to make sure your outlet is legit. There are some documented cases of pill mills being marketed as health clinics.
Know your health history and insurnace info before you go. At stand-alone clinics, the staff won't be able to access your complete medical history. It's up to you to bring relevant information (like the medications you're taking) and keep records of what happens during your visit.
You can get a basic checkup or diagnosis via a computer program or app. "The fact that we can send pictures, relay important information, and even see each other face-to-face on screens means that some diagnoses can happen virtually," says Bryan Vartabedian, M.D., assistant professor of pediatrics at the Baylor College of Medicine and co-founder of the Medical Futures Lab, dedicated to studying the intersection of medicine and technology. Options come in the shape of websites or apps, where you enter basic health information, a description of symptoms, and photos if they're called for. (The SpotCheck app, for instance, sends photos of moles to doctors for analysis.) You can also consult experts as an add-on service: The chain One Medical Group offers phone, e-mail, and video chat sessions with health care professionals. Sometimes a diagnosis can happen without doctor contact; symptoms are analyzed by computer algorithm and then, if need be, checked by a medical staffer.
Found: On your computer or smartphone.
Staffed By: Various health care professionals, depending on the service. Often there's an option to connect with a doctor in real time for an additional fee.
Good For: Conditions like a cold or cough that can often be diagnosed by relying on verbal descriptions, pictures or videos of symptoms, and possibly lab results you may already have.
Be Aware: These services are so new that the jury's still out on their effectiveness, especially since an online consult is often just a first step. If you're experiencing new, unusual, or severe symptoms, your safest bet is to see a health care professional in person.
Urgent Care Clinic
Headed by doctors, these outlets are a middle ground between a retail health clinic and the emergency room. They're best for injuries and illnesses that need to be dealt with ASAP, but aren't serious enough to warrant an ER visit. Urgent care clinics typically have a licensed physician at the helm, are open and accept walk-ins seven days a week, and have on-site diagnostic equipment, including an X-ray machine and tools needed for blood tests.
Staffed By: Doctors, nurses, and physician assistants.
Good for: Same services as retail health clinics plus X-rays, stitches and sutures, minor emergencies such as dehydration or fractures and dislocations, and treatment of chronic ailments such as migraines.
Be aware: Because there's always a doctor on site, costs at an urgent care clinic might be higher than at a retail clinic. Many are not open 24 hours, so call before you go.
Note: A visit to a retail health or urgent care clinic can be as much as much as 80% cheaper than going to the ER. And many now participate in discount programs like Medicare Part D and Medicare "Wellness" visits. Not all insurance programs are accepted and prices can vary, so always check with your insurance company to find out which services -- and types of clinics -- are covered.
ERs are better equipped and more fully staffed than a health clinic. But the costs can be considerably higher. "While minute clinics and urgent care practices provide a valuable service to those with simple medical problems, they're not prepared to handle significant medical emergencies like chest pain, shortness of breath, concussions, or symptoms suggestive of a stroke," says Kevin Campbell, M.D., assistant professor in the Division of Cardiology at the University of North Carolina School of Medicine. "In fact, if you go to a health clinic with one of those symptoms, they'll likely call 911 and have you transported to the closest facility that provides ER care." One good rule of thumb: If the symptom came on suddenly and/or gets rapidly worse, head directly to the ER.
Found: In hospitals or other primary care clinics/centers.
Staffed By: Doctors, nurses, and physician assistants.
Good For: Severe symptoms including
(but not limited to) chest pain, shortness of breath, loss of balance, severe bleeding, head or eye injuries, extremely high fever, fever in newborns, sudden heart palpitations, dizziness, repeated vomiting, seizures, and difficulty speaking or other signs of mental confusion (which could mean a stroke).
Be Aware: Cost and wait times can be significantly higher than at a retail health or urgent care clinic.