Why do I need a children's urgent care?

By Corey Fish, MD FAAP

By Corey Fish, MD FAAP

“Children’s Urgent Care?  Is that a thing?”  

“Why do we need an urgent care for our kids?”

“I didn’t know there were urgent care clinics just for kids…”

“What’s with all these urgent cares…”

These questions or others like them have either crossed your mind in the past or are now as you read Part one of this two part series exploring a bit about why I started Pacific Crest Children's.

Since I started in the medical field in 2005 as a student at the University of Washington School of Medicine I have seen the medical field change faster than pit mechanics at Le Mans change tires on a race car.  This phenomenon didn’t start then either.  It’s the nature of most jobs.  Change happens and it seems to happen faster and faster the older we get.

I admit, I’ve always had a romanticized view of medicine.  Ol’ Doc Brown coming to your house to deliver the baby, check on mom, dad, granny, baby brother and baby sister.  One person there to do it all with compassion, grace, and that wizened visage that we seem to associate with the figure in the black suit and leather bag in hand.

I was so enamored with this view of medicine that I went to Bozeman, MT to practice for my first two years out of residency.  And while I didn’t make too many house calls, I was part of a group of docs that pretty much did everything.  We attended deliveries, took care of sick premature babies, spent time in the ER, hospital, and even spent some long nights hoping that the helicopter would hurry and get there for that patient with the hole in his intestines.

Grab ski shot.jpeg

This type of medical care, though, is gradually being replaced by an increasing compartmentalization of healthcare.  Only in the smallest towns or remote places in the country does Ol’ Doc Brown still thrive.  This is the age of the specialist and the hospital based doctor that just cares for patients while they are in the hospital.

After I moved to Portland, I spent some time working on the opposite end of the spectrum from my time in Bozeman.  Don’t get me wrong, the decrease in hours and demands on my time from my career was a welcome change.  And I had the distinct honor and privilege of working with some great physicians, staff, and advanced practice providers.  I also got to take care of many wonderful patients.

But something was missing.  I always felt I could do more with my skillset developed in Montana.  I wanted to increase the ways I could help patients directly.  After much soul searching, consideration of options, and many ideas bounced off my sounding board, and love of my life, Annalisa, I decided to found Pacific Crest Children’s Urgent Care.

My reasons for starting this practice essentially boil down to the other part of medicine that is changing.  And not for the better.  The change I make allusion to is driven by money, big business, and politics and is rapidly driving healthcare costs beyond reach of many people.

A central pillar of this less than desirable change is costs associated with emergency and hospital based care.  Please don’t misunderstand.  Hospitals and emergency rooms have their place and they save lives.  The issue is that hospitals have to operate 24/7/365 and need the staff, equipment, and support to operate in that way.  This costs money.  A lot of money.  And unfortunately, that cost is passed on to the sick and injured or their families.  One illustrative fact is that across the five most common diagnosis groups that present to an emergency room, ER’s run about 5 times higher in total cost than an urgent care or other standard medical office.  

The rub is that, if you believe medical journals (which I happen to), probably 70% or more of patients who show up sick or injured to a hospital or ER could be safely managed somewhere else.  Like an urgent care or doctor’s office.  

Next week, I'll write about why I think a pediatric specific urgent care is valuable to you!

Thanks for reading...

This article was written by Dr. Corey Fish, MD FAAP.  Dr. Fish is the founder of Pacific Crest Children’s Urgent Care in Portland, OR.  Pacific Crest offers high quality, after-hours acute care services for sick and injured kids and young adults.

This article is the sole property of Pacific Crest Children’s Urgent Care and may not be distributed or used in any way without the author’s consent.