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Urgent care as New Grad


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Wondering what everyone's take is on taking an urgent care job as a new grad. The place I'm applying to is a full urgent care, not just one of those minute clinics.

A physician is always on site so I wouldn't be alone.

 

I've worked for the company as an MA for years and love the people and want to continue with the company but wonder if I should do it full time or just per diem and find an ER job full time.

 

Any thoughts?

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sounds like a good start , esp if you are interested in an urgent care career. If the offer is amazing yet you are on the fence about an UC career do no fret. I could see UC providing an easy transition to emergency medicine, internal mediicne/primary care, or even ortho depending on if you do casting/fx mgmt. 

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Would say go for it.  You'll get a chance to do some simple but fundamental procedures, see most of the basic problems of FM/IM and ER "fast track" type pts, as well as some FM basics like HTN, DM, etc.  Later you can move into a more challenging position if you so choose.  Plus the money seems to be slightly above average in UC.  The downside (or maybe upside) is they turn away medicare/aid pts so if you say move to the ER later, you will be facing an entirely different patient population.

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 The downside (or maybe upside) is they turn away medicare/aid pts so if you say move to the ER later, you will be facing an entirely different patient population.

depends on the UC. I work at one sometimes that is 24/7 and basically run as a freestanding ER that takes all comers. it is affiliated with the local trauma ctr and a feeder to it. we think of them as big county and ourselves little county. I work at both. the UC is actually in a worse part of town so we get more drop off shootings, heroin ODs, weird stuff. I have run codes there, delivered babies there, intubated there, etc.

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Thanks for all the input! - I know from my experience as an MA that this Urgent Care actually does take medicare patients. For a while they only allowed the Physicians to see medicare patients, but they've since transitioned to allowing PA's see them as well. 

 

I'm looking forward to seeing what the offer might be. Hopefully it's a good offer! 

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It will be a steep learning curve for you.

Urgent care is about acute complaints, so you likely wont see much health care maintenance or chronic illness management, which can be both rewarding and unexciting depending upon your personality.

Urgent care is also about volume. If this is a walk in place, your day can be quite busy or it can quite dull, depending upon the time of day and year and what viral illness is making the rounds in the community.

So you have to become adept at quickly assessing if the patient problem actually is a simple limited complaint and then professionally providing them assessment & treatment and moving on. No more 15 minute HPIs.

To do this without being a hack takes a certain skill set that you likely did not receive in school but is attainable with enough effort. 

Good luck.

G Brothers PA-C

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I've been in urgent care since I graduated May 2013 and have enjoyed it.  I also had a 14 year background in EMS and knew I didn't want to work ER (I do not function at 2am and wanted a steady schedule).  There are some advantages/disadvantages.  Some of these are specific to the company I work for but here are a few off the top of my head  (I also have a doctor with me at all times and we accept all insurance)........

 

Advantages:

see a wide age range of patients with a wide range of complaints - some of this will be mundane after awhile (URI's, etc) but you still get some really sick folks from time to time that you end up sending to the ER

skills (suturing, splinting, I&D), we read all of our own rads so you quickly learn this skill,

you can always refer someone to a specialist (I work a second job in a specialty and there you HAVE to figure it out)

while we do have some regulars that wear you down you aren't stuck with seeing the same "crazy" patient over and over

no charting from home, no after hours work, etc

I don't have to deal with the business side of medicine at all - no coding, no pre-auths, no mountains of paperwork, etc   (which also means I have no knowledge of this)

 

Disadvantages:

I have totally lost any knowledge of chronic illness management (HTN, Diabetes, etc)

I get my schedule on a month to month basis (I will get April around Mar 10th) and while I can ask for days off I get this vibe that it is sort of frowned upon - you also will be working holidays - a lot of holidays

I rotate offices and only work 3 days a week (12 hour shifts) - while I like this I also never get any feedback about my patients...are they coming back sicker in 2-3 days?  Did they get side effects from that antibiotic I prescribed?  What was  

     their final outcome after the specialist saw them?  This has been by far the biggest disadvantage - as a new grad as I feel like feedback is essential to learning and tweaking your style of medicine.  I rarely get any feedback on the

     outcome of my patients.

Each doctor I work with has their own style of medicine - rather than develop my own style I have to practice to the style of the physician I am working with that day. 

Some days I barely get to eat or use the bathroom.  I have to stuff my lunch down in 5 minutes.  The busiest day I've had so far was 106 patients with 2 providers. 

You are always under pressure to go fast - as G Brothers said you have to know - "is this patient sick?" quickly.  This is where my EMS background was essential.  I could recognize a sick patient. 

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Each doctor I work with has their own style of medicine - rather than develop my own style I have to practice to the style of the physician I am working with that day. 

 

I had to do this early in my career. Initially it gives great direction. Then you start thinking and reading and realize that some of the practices you have been emulating have not been up to snuff or have been overboard. Then you need to slowly adjust to your own practice. Takes time and babysteps.

GB PA-C

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