The things I wonder...

8 1) If you have a primary doc, why don't you go to him/her? Why come here and expect to be fixed by someone who knows you not from Adam's housecat? I'm great if there's not an appointment available, or they're closed. But you just know that some are using the minute clinic as a candy shop, or don't want to be bothered with having to make an appointment.

Another thing in the same vein that I don't get...why, after, say, 3 rounds of abx for an upper respiratory complaint, is it considered an insult to advise someone to see their PMD?

Had that happen the other day. 3 rounds of abx in a month, no betterm chronic conditions that we knew little about. Suggested her PMD might be able to offer different tx that would be better for her. She got mad and left in a huff.

2) How can you not have a pediatrician for your child? That chaps my hide worse than any, I guess. A minute clinic is not a pedi office, yet you'd be amazed at how many people drag the kiddos in here, expecting immunizations, well-child care, etc.

Had one the other day that brought in a young teen, wanting the clinic to clear her for sports. New patient, no one had any history on her. The aunt brought in the physical form from the school, filled out front and back with all the child's health problems, including a rather severe heart condition. No cardiac follow up in 7+ years, no general medical exam in 4+ years. I flat-out refused to clear her, and I kept the clearance form with me, that woman was so squirrelly, I'd not have put it past her to forge a siggy. Called the PMD of record, they'd only ever seen her once. How can you consciously do that to a child with those problems?

3) Why does it always have to be our fault, when we've advised, treated, been ignored and then (GASP!) they don't get better? I know the answer to that, just frustrated, lol.

Feel free to add whatever confounds you.
I guess those minute clinics are there for a reason: convenience, lack of primary care physician, cost. Not everyone has great insurance. Are all your clientele bothersome to you?

People can be sooooo annoying!

Not at all. I truly like the vast majority of them. And the clinic is very convenient. Just makes me wonder, especially with the kiddos...no primary can be a dangerous thing.Not knowing history can be a dangerous thing. Never said that I minded seeing them. Just a few things I don't get. As I said, most HAVE a primary, but are seriously loath to see them, even so far as to lie about not being able to get in (we find that out when we call to get a history in the event of chest pain, etc.)I have no worries at all about their insurance, matters not to me, I treat, regardless. But for some things, like those I outlined, a minute clinic is simply not appropriate, no matter how convenient.

I know that lots of people don't have insurance these days. Many PCPs will charge you and arm and a leg if they allow you on the schedule. Some offices will make that visit way off in the future...Some people have heard that NPs are better for "caring" about things. They are very unhappy with their PCP. Lots of people do want to see NPs these days. CVS, Walgreens, I believe do advertise that they do these physicals... you will be associated with that. It will be cheaper for the patient without insurance to come to a clinic for this.

Quote from NoviceRN10I guess those minute clinics are there for a reason: convenience, lack of primary care physician, cost. Not everyone has great insurance. Are all your clientele bothersome to you?

Quote from AngelfireRN1) If you have a primary doc, why don't you go to him/her? Why come here and expect to be fixed by someone who knows you not from Adam's housecat?

Lack of insurance, unemployment, and tough economic times are among just a few things that cause a lot of the issues you're complaining about. Sometimes primary care offices don't have the best hours, so clinics that are open after hours are convenient. Where I work, all of our walk-in clinics are staffed by primary care physicians who are prepared to treat patients for whatever complaints they walk in with. There is no reason for someone to go to the ER with a cold or flu, and if they can't get in by their PCP, walk-in clinics are an excellent option. I always try to remind people that if it weren't for the patients we see, we won't have a job! ...Thank God for patients, even the ones you may be annoyed by. Maybe a walk-in setting isn't the right place for you? Have you considered other areas of nursing?

I guess it all boils down to continuity of care. Sure, I'll treat a sinus infection, but if I miss something, like the patient neglects to mention that they have chronic asthma and always require breathing treatments, BOOM. It comes back on me. I didn't have info I needed. Their PMD would have known.I want to provide the best care I can. I can't do that in these cases, plus then you have PMD offices haranguing you about having the gall to see thier patient, etc. Just a mess sometimes.

In the case I mentioned, I DID offer to call the PCP for the patient. She blew a gasket and stomped out. In most cases, they don't want the PMD called, because that know the PMD will read them the riot act about being here. Been in the room when the PMD called them on the phone and did just that. That was last week.And, while I do understand that the reasons listed are valid...there's just no excuse not to have care, continuous care, for your child.

Snifles and sore throats, great. Active chest pain, ACTIVE LABOR (no I'm not kidding), status asthmaticus, not so much.

Quote from Amanda.RNLack of insurance, unemployment, and tough economic times are among just a few things that cause a lot of the issues you're complaining about. Sometimes primary care offices don't have the best hours, so clinics that are open after hours are convenient. Where I work, all of our walk-in clinics are staffed by primary care physicians who are prepared to treat patients for whatever complaints they walk in with. There is no reason for someone to go to the ER with a cold or flu, and if they can't get in by their PCP, walk-in clinics are an excellent option. I always try to remind people that if it weren't for the patients we see, we won't have a job! ...Thank God for patients, even the ones you may be annoyed by. Maybe a walk-in setting isn't the right place for you? Have you considered other areas of nursing?

Angelfire, I've read some of your other posts and know you love your job. Valid questions! Does your clinic have a written policy about some of those things?The Walgreens clinic here advertises sports physicals for a very reasonable price. I think it's a great idea in general. But yeah, you could uncover a serious problem in a previously healthy kid too. I saw that happen once. I mean, that's the point of a physical, right?But, to speak to your larger issues, people just don't know. It's not a character flaw. They just don't necessarily know stuff like what the ER is for (and huge billboards that say "Our doctors will see you NOW!" don't help).