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Culture War Roundup for the week of November 18, 2024

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I know this is an immensely frustrating experience as a patient but it is important to understand that this is not what urgent care is for.

If you saw a physiatrist (which is the specialty that handles this kind of problem) and they get it wrong....that person's license should maybe go away. A good PCP should get this right but these days we don't do nearly as much MSK work and hospital demands mean we aren't as good at this kind of thing as we used to, you may have PT be the replacement for managing it since it isn't really a medication issue.

But it's effectively out of scope of practice for Urgent Care and ED.

Patients go to UC and ED because it's more convenient than getting a PCP, but ED physicians don't handle these kinds of issues, their job is to triage and manage emergencies, which would likely involving turfing this back to a PCP or PM&R doctor for outpatient management.

There's all kinds of reasons why patients use UC and I get it, but ultimately it results in a lot of disastifiaction because it's generally not the right doctor for the problem.

The fact that I was able to get an issue solved by a Physical Therapist with an investment of about $50 and 30 minutes of time seems to suggest that the medical industry is overcharging for certain services.

Not sure what you'd suggest I do when I'm experiencing ongoing immense pain but no immediate danger and it'd take weeks or possibly more to get in with a specialist.

If the urgent care folks had said "oh, we aren't really geared for this, go see a physiatrist" then I'd give them credit.

That ain't what happened.

I mean a physical therapist is the appropriate medical professional for the issue you had. You went to the "am I dying" doctor and they said "shit I don't know, you aren't dying," if you were dying they would be able to help you. They have limited training in diagnosing MSK issues because that's not what they are for.

Routine issues and urgent care level emergencies are supposed to be managed through your primary care doctor who would say "this seems like an MSK problem, here's as prescription to go see a PT for that, as they are the experts in this area and can spend an hour with you twice a week and I can't do that without it being cost prohibitive."

We see this all the time, people go to the ED for non-emergent issues and get frustrated when they get what seems like poor quality care and it takes forever.

Furthermore patients don't like hearing this so you get some half-assed attempts at managing these issues in those settings instead of the correct response which is "no go see your PCP."

Ultimately if you say, go to your lawyer and ask for accounting help, they may charge you for it and try and help but they aren't an accountant.