When we get sick we go and seek medical advice. The choice is usually our family doctor or local General Practitioner. They treat almost all stable conditions but are limited in case of any emergency or semi-emergency. In that case our option is usually emergency department which is mostly crowded and a time consuming proposition. Other than that no other option is available when we see the healthcare of Pakistan. There is a gap in the coverage of illnesses, pertaining to diverse and semi urgent conditions. The concept of urgent care clinic is a perfect match for these illnesses.
Urgent care clinics can be understood as walk in clinics that offer out patient treatment for the minor illnesses and stable conditions requiring input from doctors. The patients come with diverse complaints ranging from minor headache to being dizzy, or abdominal pain to toothache or asthma exacerbation to depression and insomnia. It covers almost all specialties and almost all acute presentations, but mostly these are stable and non-life-threatening.
So what are the difference between Emergency Department and Urgent care.
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Emergency Department |
Urgent care Clinic |
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Emergency department deals with life or limb threatening situations and is best option for people needing immediate care. |
The urgent care is in between Emergency and Primary care office. It deals with stable or non-life threatening situations. |
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Emergency Department is open 24 hours a day and 7 days a week. |
Urgent care clinics usually are open 12 hours every day. Although they may be open 24/7 in some cases. |
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Emergency Department is staffed by doctors and nurses and plenty of other ancillary staff such as radiographer, nurse tech, lab tech, oncall specialist doctors and others. |
Urgent care is usually staff with limited number of people including doctors and nurses. |
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Emergency Department is designed to cater to all sick patients. |
Urgent care clinic is not designed to see all sick patients, and they have to send those sick patients to Emergency Department. |
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Emergency departments have all diagnostics available for them to diagnose conditions immediately. |
Urgent care have very limited diagnostic ability and they have to refer patients to Emergency Department if extensive work up is needed. |
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Emergency Departments cost more to treat. |
Urgent care is usually cost effective due to less resources involved. |
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Emergency Department may have longer waiting time to be seen. |
Urgent care clinics are usually faster, and patients can get in and out after treatment within hour or two. |
It is fair to say that the healthcare system in Pakistan is not ready for this type of care because of plenty of reasons, including the cost and competency of the doctors. If we look at the competence level of doctors, there are not many trained doctors who can manage patient in Urgent Care Clinics. Also the cost of treatment is higher than general practitioner, and there always are concerns about potential legal implications, because of no regulations regarding urgent care and its treatment.
IS IT REALLY WORTH?
When we look at the attendance of patients in the public emergency departments, we will be amazed to see how many patients come to get treated. This load makes it difficult for all the patients to get better care due to resource and workload mismatch. Any patient who can be treated away from Emergency Department would make things easy for all.
Secondly in areas where Emergency Departments are far, then it is better to have an Urgent Care Clinic than general practitioner clinic. As the General Practitioner are much limited in scope and training when it comes to semi-urgent conditions like pain and high blood pressure and high pulse rate.
It is my wish and recommendation that we start thinking about establishing urgent care clinics to not just help the patients but also ease the load on the system to improve overall care of the patients in the Emergency Department.