Medicine is becoming more “retailized”, with more fragmented care for Americans. In this age of high-deductible insurance policies, Consumers (we aren’t looked at as patients any longer) are shopping around and finding low cost, convenient care at Urgent Care centers, free-standing Emergency Rooms and drug store clinics. Nurse-practitioners and physician assistants provide care in such settings.
Often, a patient’s own physicians do not receive copies of records from such visits. If the retail clinic NP’s or PA’s miss a diagnosis, there isn’t much of a trail to follow, and any X-rays, lab results and history information are not readily available for review in one place, even when the patient is referred to a primary care provider or specialist who might be able to help.
Many of my patients have ongoing health issues that seem refractory to therapy. Their continued suffering is sometimes the result of inexperienced health practitioners, fragmented records, overlooked results or a combination of these. The convenience and low cost of visiting a retail clinic rather than a doctor who is familiar with your problems might be fine for a routine cold or scraped elbow, but might not be the best choice for more chronic and severe problems. The retail clinics are also there for a reason. They boost the income for their parent companies by increasing same store sales, especially of high margin pharmaceuticals and over-the-counter medications.
It is very important (more important than ever!) for patients to keep copies of visit notes, lab test results, radiology and nuclear medicine test reports and medications. Often, the answer to their health problems is actually there, hidden in the disconnected mess of paperwork, and it can be ferreted out with some effort and persistence.
Establishing a correct diagnosis can save both money and time, as well as preventing progressive problems that might lead to more serious issues later.