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Letter to the Editor: Regarding urgent cares

Buyer beware! The recent article on the proliferation of urgent cares was a good initial introduction into the world of “fast food” health care [“Urgent Care: The new frontline of healthcare,” Sept. 11.]

While it is true that too many patients unnecessarily clog up emergency rooms, and that the urgent cares, hopefully, siphon off some of the ER workload, the big elephant in the room is the quality of care.

There are as many urgent cares, it seems, as flavors of Baskin Robbins, and while the following observation does not apply to every and single urgent care and every and single provider, it is generally true that the quality of care is not up to par with that of the primary care physicians or ERs.

With respect of pediatrics, especially, the amount of training received by a pediatrician versus that of family nurse practitioners [FNPs], who are the most common providers in St. Louis urgent cares, is significant. The quality of training also is vastly different.

Urgent cares, in general, overprescribe antibiotics. Not every child with a sore throat needs a strep test. Not every child with a “red ear” has an ear infection that requires antibiotics. Inappropriate use of antibiotics lead to acceleration of drug resistance and have potential significant side effects. The kicker here also is that some of these urgent cares dole out their own antibiotics; hence, they are being compensated for medications that patients do not need.

In addition, unnecessary imaging and steroid shots are being provided, both of which pad the financial cushion of certain urgent cares.

There needs to be oversight of the quality of care and the financial incentives driving the sprouting of urgent cares.

Ask your primary care physician for references if you do need to avail yourself of an urgent care, but don’t buy into the premise that faster is better. And, as flu season nears, please know that not everyone needs antivirals for the flu!

Katherine Shiue, M.D.

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