Urgent Care Imaging

So I just read this article by Alan Ayres, who is an urgent care specialist/expert. And the article is titled, “ Why x-ray is vanishing from urgent care centers”.

Well I have some limited experience with urgent care centers. Locally, my medical institution sponsors a few urgent care centers, one that has both x-ray and lab services and an urgent care center that is just 100% clinical (no imaging or laboratory).

In my opinion, both types of centers have a role and both types can serve a very important function for a local population. However, I do believe whether you offer lab services, x-ray or just clinical diagnosis, you should have some sort of relationship with a higher end medical center or hospital that can do more advanced imaging and work-ups. I am opining from experience here as we do get same day referrals to the hospital from our urgent care centers all the time. Yes, of course, I am somewhat biased as a radiologist. I happen to love imaging and teaching, but I obtained these biases and will continue to remain biased for good reason. For example, when I was a radiology resident, I was taught by my trauma attending‘s that up to 15% of neck fractures can be missed on x-ray; and yes I have seen this in practice as well. The cervical spine can look completely normal on x-ray and CT will reveal a subtle fracture. Can you imaging how hard it may be to see a fracture on an elderly patient with horrible degenerative changes? We’re talking needle in a haystack here. Additionally, I have also seen firsthand how you can have a completely unremarkable abdominal x-ray, but the CT on the same patient a few minutes later can look like a bomb went off in the patient’s abdomen. This is why I am biased towards more advanced imaging. Although x-ray is a great first choice for many conditions, many times the CT will reveal so much more.

OK, so now I’m getting really off topic and I have certainly moved away from the focus of the article which I will link to here. Alan was bringing up several points, that it’s expensive to train, retain and can be hard to find rad-tech’s who can staff some of these positions and still justify their salary due to the limited use of x-ray in these facilities. For example, if you are only doing films on 15% of the patients that come into your urgent care center, that has a pretty good chance of NOT paying for the salary for the technologist, the cost of the equipment, the upkeep on the equipment, and the cost of the professional read by a radiologist. This is very understandable. And Alan had some great suggestions in his article regarding things that can be done to try to work through this problem. Some of his ideas involved working with some of the national payers (insurance providers), to emphasize the importance of this non-emergency type of care, which keeps our emergency rooms from getting overwhelmed, so that they can concentrate better on the more critical patients.

So this is why I said earlier, that it’s important for an urgent care center to have some sort of relationship or affiliation with a hospital, with one of the goals in mind, of keeping the ER’s from being overwhelmed with patients that can be handled on a less emergent basis. It may even make sense for the hospital or larger medical system to subsidize these urgent care centers so that patient’s needs can be handled more appropriately with regards to the type of care they actually require. Not everyone needs a CT from head to toe! If no urgent care facilities existed and everybody just showed up at the ER for every little issue, then I think you can easily see how this can negatively affect the care of the more critically needy patients. When the ED is overflowing with patients, delay of diagnosis is a real thing. And when necessary, just like in my medical system, when a patient shows up to urgent care with a more serious condition, the facility sends them right over to my hospital with a simple phone call and transfer for a higher level of diagnosis and treatment.

So, that’s all I wanted to share with you guys today. Perhaps you’ll find Alan’s article as interesting as I did. He provided a nice summary and now you have some of my editorializing as well. And if you’re a Rad-Tech who has some interest in learning CT, I have an awesome FREE Course that you can try out, which can elevate your status and put you on the straight and narrow to become one of the most desirable technologists to work with. Don't miss out. Just go to www.CTSuperTech.com to get instant access to your course!