School’s back in session, which means sick season is approaching quickly! The pure volume of sick visits can be overwhelming for any clinic, whether visits are scheduled or walk in, but the nature of walk in clinics makes the volume unpredictable. Sometimes no one in walks in, other times several come at once. Urgent cares and walk in clinics are wonderful for the overall speed at which one can be seen, but how can you help streamline the process? How can you keep your primary care physician in the loop? Here are my top tips for a successful urgent care trip and knowing when to avoid them.
1. Write down symptoms.
It sounds crazy to write down things since you know your child better than anyone, but if your child is sick you are probably sleep deprived and might forget important details.
Writing things down helps everyone summarize what is going on and get facts straight. The diagnosis often lies in the history, and if the person bringing the child in does not know symptoms well, it’s difficult to make a proper diagnosis.
This also forces you to think about the symptoms, and you might realize that you don’t know everything that’s going on. This is especially true if your child spends time away from you at school, daycare, or with another parent. It’s better to recognize that you need more of the story before you get to the clinic!
2. Expect to be seen for one acute problem.
Illnesses typically have more than one symptom despite being a single illness. It’s appropriate to bring a child in for multiple symptoms, such as cough, fever, and sore throat.
It is not appropriate to bring them in for those issues as well as a wart and headache of 3 months off and on. If there are unrelated things, expect to deal with the most acute issue and then follow up with your usual physician to discuss the more chronic things at a scheduled appointment.
The nature of walk in clinics is that they move rapidly. The number of patients checking in at any given time can be large, so each visit must be quick. If you need more time to address many issues or one big condition, schedule an appointment.
3. Don’t attempt to get care for a chronic issue.
Chronic issues are always best managed by your Primary Care Provider (PCP), but exacerbations of chronic issues might need to be seen quickly.
This means that sudden changes to a condition, such as wheezing in an asthmatic, can be addressed at an urgent care, but routine asthma management should be done during a scheduled visit. Your child can go to the walk in for the wheezing, but should follow up with the PCP with a scheduled appointment to discuss any changes needed to the daily medication regimen (Action Plan) to prevent further wheezing.
This is especially important if you went to another urgent care or ER for initial treatment so that your doctor knows about the recent exacerbation of a chronic issue.
4. Do not add additional children to the visit.
Many parents bring additional kids to the visit and ask if we can “just take a peek” in their ears.
If you want them to be seen, check them in too. Again, walk in clinics move quickly and the “quick” peek often takes longer than you’d think because the child is running around the room or fighting the exam.
The quick peek also does not allow for documentation of findings in the medical record, which might be helpful in the future.
5. Have your insurance card and co-payment ready at check in.
Streamline checking in by having everything ready.
It’s surprising to me how many people must return to their car for their wallet. For safety reasons, never leave a purse or wallet in your car.
6. Try to bring only the child who is being seen.
It is difficult to focus on one sick child when another is running around the room, falling off the exam table, or constantly asking questions. This applies to scheduled as well as walk in visits.
I know this becomes a childcare issue, but it can really help focus on the child being seen if you leave additional children at home if at all possible. Think of friends who always offer to have a play date with the healthy child. Or maybe plan to bring one child when the other is at school.
If you must bring multiple kids, set the stage right by avoiding bringing tired and hungry kids. Don’t come at nap time if at all possible. Tired kids are miserable kids. Give them a healthy snack before going to the clinic. Don’t feed your kids at the office – another child could have a food allergy to whatever you’re feeding them, which can put other kids at risk. Bring books or toys that your kids can be entertained with during the visit.
7. Bring medications your child has recently taken.
Often parents have tried treatments at home, but are not sure what was in the bottle.
Bring all medications to help us advise on correct dosage and use of the medications. This includes prescription medicines as well as over the counter supplements, medicines, and natural therapies.
8. Use your regular doctor’s office if available.
I know not all doctor’s offices have walk in hours and most are not open all night long, but most walk in type visits are not emergent and they can wait until the next business day.
Treating symptoms with home remedies is quite acceptable for most illnesses for a couple days. This might even be beneficial to see how the symptoms change over time. Some kids are brought in at the first sign of fever, and look normal on exam, only to develop cough and earache over the next few days. When the symptoms change, so might the exam and treatments!
This is a very important issue and I’ll write more on it next week. Stay tuned! ***Check out Why Wait to See Your Regular Doctor ****
9. Please don’t use walk in clinics to have health forms filled out.
I know it is tempting to get a quick physical to get a sports form or work physical signed, but doing so breaks the concept of a medical home.
If you get these forms completed outside your PCP’s office, you don’t get a comprehensive visit. The visit with your PCP should include reviewing growth, development, safety, immunization status, and more. It’s more than just filling out forms. You lose the opportunity to share what has happened in the past year and continue to build a trusting relationship.
If the medical home does all the well visits and vaccines, we have up to date records and can update them as needed. Some kids have missed school because vaccines were missed and they can’t return until they get them. Others have gotten extra doses of vaccines because a record of a shot was missing and parents can’t remember where they got the vaccine.
We request a well visit yearly in the medical home after age 3, more often for infants. If in need of a well visit, please call the office to schedule!
10. Call first if you’re not sure!
If you’re not sure if it’s okay to tough it out at home overnight, call your doctor’s office.
We can often give tips on how to manage symptoms to save the emergency room co pay and germ exposure. Sometimes we do advise going to be seen. If there are concerns about dehydration, difficulty breathing, mental status changes, or other significant issues, waiting overnight is not appropriate.
Most urgent care visits are really not that urgent. They can be handled during normal business hours in your medical home!