Bronchitis Urgent Care in New York

I just had my first encounter with the US medical system outside of university. The place was part of the Beth Israel Medical Group, called Docs Physicians, and I went as a walk-in to the branch at 55 E 34th. They opened at 9am on saturday morning, so I arrived a bit early and had a coffee and bagel next door before I went in. There were two patients before me, and the wait was short (30 min) even though there was only one attending physician. I told the doctor that the last time I had suffered a prolonged cough from a cold, I had been prescribed an inhaler, and may have accelerated the diagnosis a bit that way. Docter was Keith Uleis, he ended up prescribing an antibiotic (Azithromycin), an inhaler (Albuterol) and a steroid (Prednisone) for inflammation control, after putting me on a nebulizer for 15 min to gauge the possible asthmatic effects. The charge for the consultation was $225, and filling my prescription next door at Pasteur Pharmacy cost $10 (steroid) + $40 (antibiotic) + $50 (inhaler) = $100.

I can’t believe it took me this long to figure out that I needed to go to urgent care – am seriously wondering about the purpose of having a primary care physician, which I spent part of yesterday trying to pick out. The differences: one, familiarity with medical history;  two,  a more relationship-based, as opposed to transaction-based, incentive system; three, most importantly, scheduling flexibility.

Giving doctors uniform access to standardized medical records gets rid of the first point. As for the second, I dislike decision by anecdotal evidence, which is what the relationship model encourages. What I want is for my accessible doctor pool to be more effectively commoditized, by virture of some standard success record. Urgent care centers may provide that by acruing reputation as a collective and not on a doctor basis.

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2 Responses to “Bronchitis Urgent Care in New York”

  1. Huiyi says:

    The reason you needed to go to urgent care is because you don’t have a primary physician yet. A primary-care doctor should have been able to make the same diagnosis. Data from previous records is actually really useful for diagnosing a chronic illness, and prescribing treatment that had previously worked. It was just fortunate that you actually knew enough of your personal history.

  2. Chiao says:

    Primary physicians take too much time to make an appointment. If indeed the primary care person was going to make the same diagnosis, then I would prefer urgent care, barring the fact that it is more expensive. Please note that urgent care is not ER, so I am not crowding out critical patients. I would not use urgent care for a chronic illness, though you might argue that the recurrent nature of my situation may make it cross that line.

    Also, why assume that a primary physician will read your medical history better than the urgent care guy? If it is just because he has a monopoly on your record and is the only person who has a copy, then that is a ridiculous advantage to give the guy. There is a familiarity bias in medical care – just because someone has your record and has seen you before does not make him more competent at treating you. Consistency and accuracy are two separate things.