Urgent Care Medical Offices: How Do They Work?

In theory, this type of medical office is supposed to bridge the gap between your primary care doctor and the emergency room. You can visit an urgent care center for non-life-threatening matters that require more immediate treatment than are usually available within the appointment time frame to visit your regular doctor.

Notice I said, "in theory." Theories are wonderful, but in practice, do not often live up to their promise. As an aunt of mine used to say, "Paper is patient." Her meaning was that you can put any old idea you wish down on paper, and the paper won't complain or point out the flaws.

The flaws with the so-called "urgent care" system are many. The following story is absolutely true, and was inspired by another author's also true horror story of her experience with this boondoggle.

My husband and I were out of town at a car show in which we were participating. There was a good deal of extra "baggage" in the form of a sun canopy, and the extra items for our show display. It would not all fit into our "show" car, a small PT Cruiser, so we had loaded it into our truck and driven both vehicles.

On the way back to the hotel between the daytime and evening segments of the show, an inattentive 20-something driver used the front wheel of my truck for her brakes, pushing me sideways a good 10 feet from where I was already in my turn. It is the worst possible place to hit a vehicle. The impact totaled my truck, crumpling up the passenger-side floorboards, bending the frame and tweaking the engine 15° off center on its mount.

The truck was a model made prior to side-airbags, and seat belts do not hold you in place against a sideways impact. I was tossed sideways against the driver's door, and sprained my wrist. Police and paramedics both showed up; our truck was towed, and we had to stuff-cram all of the extra stuff into the poor PT.

It was bad enough that this had happened, but this was also a mini-vacation; our first get-away in several years. I declined treatment at the scene, as I did not want to have the entire trip ruined by sitting for hours in a strange emergency room and miss the rest of the show. So, I managed to wrap the wrist, jury-rig an ice pack, and continue on.

As small consolation, the next day at the awards ceremony, we found we had won first place in the show-and-glow nighttime segment, and I got a very lovely trophy as a "hardship award," an annual presentation given to any participant who had arrived at or continued on with the event under difficult circumstances.

Whoop-dee-doo!

As I was then a victim of my county's free, so-called "basic health care system," I was not covered for any treatment, whether emergency or not, outside my home county, and even there, I was only allowed the county hospital; they wouldn't cover any of three that are much closer to where I live!

Since my wrist was still paining me, and in fact feeling worse, my auto insurance had told me to just go to Urgent Care. I knew they would pay, even though the county would not. So, I called my daughter to drive my husband and I over to the "urgent" facility, as our car was still crammed full.

Upon arrival, I explained why I was there, needing an x-ray to be sure I had not broken the wrist. Their answer was to inquire whether I had an appointment!

Excuse me?? Now, I don't handle pain well, and by this time, a day after the injury happened, I was feeling more than a little bit testy. I informed them in no uncertain terms that my injury had not made an appointment, and that my auto insurer had told me to go directly to urgent care, and that I was not going anywhere until I was seen.

They finally relented under my evil stare, and booked me in. We sat in the waiting room. And sat. And sat. And sat. When we were done sitting, we sat some more. All told, it was nearly 3 hours before we were finally called into see a doctor!

Once in the exam room, the nurse did all the usual blood pressure, temperature, etc. I was in a nasty mood by then, and acidly told her that I had sprained or broken my wrist, which does not cause fevers. We waited at least another half hour before the doctor came in.

Once the doctor arrived, poked and prodded a bit, she then informed me that they couldn't send me for x-rays because their partners in the building did not accept "third-party" payments. I went through the roof. I told her they would be paid directly by my insurance, and that my insurer had told me that their payment system was considered a first-party payer.

They were adamant, and the doctor informed me there was nothing she could do but refer me to the emergency room anyway. I lost it, and told them in no uncertain terms how dysfunctional their entire system was. I think the doctor was somewhat intimidated, as she brought in their "counselor" to try and 'reason' with me. They underestimated the extent of my ire. There was going to be no 'reasoning' their way out of this boondoggle. I insisted that I had not sat around for over 3 hours to end up with a refusal to treat.

Since they had offered to wrap the wrist and give me some over-the-counter type pain medication, they tried to argue that it was not a 'refusal to treat.' I looked them square in the eye, and said, "You are not offering me what I need, which is an x-ray, and you are not offering any further treatment than I can do for myself at home, so yes, it is a refusal to treat." I finished off this sally with, "Don't try to argue semantics with an English major!"

With that, I stormed out of the office, and as I exited the waiting room door to the parking lot, I called back at those unfortunates still in the waiting room, "Go home! You're wasting your time--they won't help you here!"

For all of my, my husband's and my daughter's wasted time; for their refusal to treat me, they had the nerve to send me a bill of over $300. You think I had gone through the roof when I was there in person? Oh, baby, you hadn't seen anything yet.

I went back and forth with them for one round on the phone, and one round by letter, explaining that I did not have the ability to pay that amount. They then sent another bill anyway.

Do you know how I finally handled that major mistake on their part? I back-billed them for our wasted time,making sure that my bill was bigger than theirs. I spelled out my daugher's hourly wage, her wasted time, and I listed our hourly rate as if we had still been working at our handyman service (the principle of the matter, if not the fact of the moment). After all, wasted time is wasted time, and time, as they say, is money.

I told them in no uncertain terms that since I had not been treated, they were not getting a penny out of me, and in fact I considered that they owed me the amount itemized in my back-billing. I ended the letter saying that they could either pay me my demand, or drop the matter entirely and call it even. It worked. I never heard from them again. Nor did it go to a collection agency.

After storming out with my blood pressure through the roof, we went home and had a bite to eat, after which I did end up going to the local emergency room anyway, where I sat for another 3 hours before I was called in.

They did x-ray my wrist. They did give me a couple of injections for pain and sent me home with another prescription for further pain. They did confirm it was just a nasty sprain, and provided me with a brace. They did accept my auto insurance as payment.

I learned that "urgent care" is anything but, and I learned why emergency rooms are so overwhelmed with non-emergency cases. Why go through all that, to end up not getting help, when you can walk into any ER, at any time of day or night, no appointment needed, and actually get help, money or not, insurance or not.

Our health care system is beyond broken. It cannot be fixed. It needs to be totally scrapped and a new system started from the ground up; single-payer is the way to go. Most other western civilized countries offer free health care to all their citizens.