Park City clinics differ in offerings and payments
April 11, 2014
The Intermountain Healthcare clinics throughout town welcome patients of all kinds, but the clinic on Bonanza Drive no longer accepts appointments. It is now an InstaCare clinic, a place where people can go when experiencing acute medical issues and need to see a doctor right away.
The clinic is open daily from 8 a.m. until 8 p.m. All urgent medical symptoms that arise after 8 p.m. must be seen and treated at the emergency room at the Park City Medical Center on Round Valley Drive.
Dr. Geoffrey Crockett works in the emergency room, and said the department, during a busy month, will see anywhere from 50-80 patients a day. However, some of them might fare better going to the InstaCare clinic, he said.
"You should only go to the emergency room in an emergency, but everyone has their own definition of what an emergency is," Crockett said. "You can bet that everyone that walks in here believes their situation is emergent, but some could probably have gone to an InstaCare clinic. Those are available for people who have problems that can be resolved relatively easily."
Issues that could land patients in an InstaCare clinic include coughs, colds, minor injuries, cuts and scrapes, sore throats or even sprains. Each of those conditions qualifies as an acute medical issue, which means they are conditions that have suddenly afflicted patients. Chronic issues are things like long-standing back pain, high blood pressure, high cholesterol or anything that has been a medical issue for a long period of time.
For those issues, Crockett recommends patients see a general practitioner. Their offices are usually hard to just pop into. Most of the time, those clinics require appointments. The Intermountain Healthcare Park City Clinic on Round Valley Drive is one such clinic that does not take walk-ins.
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The University of Utah’s Redstone Health Center at Kimball Junction offers primary care services like family and internal medicine as well as obstetrics and gynecology. Other specialty care services offered include cardiology, dermatology, gastroenterology, neurology and optometry.
They do not accept walk-ins, and appointments can be made over the phone or online. They are open from 7 a.m. until 5 p.m. Monday through Friday. Saturday mornings, from 8 a.m. until 12 p.m., they accept call-ahead same-day appointments.
Richard Bullough, director of the Summit County Health Department, said it is not unusual for patients to walk into their offices thinking it is the Park City Clinic. While he often redirects them, the department does offer a few preventative care practices, much like general practitioners’ clinics.
"Public health is different from clinical health, but we do provide vaccines and some women’s services," he said. "We offer basic exams, sexually-transmitted disease (STD) testing, several methods of birth control and some counseling."
Crockett said general practitioners also offer routine preventative care, such as annual physical exams and even electrocardiograms (EKGs). It is best to make appointments for those routine exams at a general medicine practice, such as the Park City Clinic.
If someone is experiencing a sudden medical condition, such as shortness of breath or chest pains, it is best to go to the emergency room at the Park City Medical Center. While most people think of the emergency room as a place to treat traumas, Crockett said most of the patients they see are experiencing things like severe abdominal pain, severe headaches or symptoms of heart attacks or strokes.
Nonetheless, traumas are sometimes hard to evaluate. Broken bones may not always look like broken bones, and if they are small breaks like that, Crockett recommends they visit the InstaCare clinic.
"In medical terms, if a fracture is displaced and obviously deformed and is going to need to be manipulated or worked on, then you probably need to go to the emergency room," he said. "If the bone is breaking the skin, you are going to need someone to perform an intervention other than simply putting a splint on it."
If the break is minimal and can be taken care of by placing it in a splint, an InstaCare clinic is the best place to go for treatment. Most InstaCare clinics can perform x-rays and blood tests, he said, so any condition that may require more than that is best treated in the emergency room.
Marianne Becnel, a medical assistant at the Intermountain Healthcare Bonanza InstaCare clinic and former wilderness emergency medical technician (EMT), said they will usually send patients with chest pains or severe abdominal pain to the emergency room. This is because they do not have CAT scan or MRI capabilities.
"We treat minor sports injuries, acute illnesses and anything else that is not life-threatening, and we offer x-rays and some in-house lab testing," she said. "People who have a history of chronic illness that is acting up, like a pre-existing heart or abdominal condition, are sent to the emergency room so they can have access to the advanced treatment they need."
Those services can be pricey, Crockett said, adding that nine times out of 10, it is more expensive to visit the emergency room than an InstaCare clinic. Having insurance is important when visiting the emergency room, but those without it are not turned away.
All hospital emergency departments are required by federal law to screen every patient that walks in the door. The Emergency Medical Treatment and Labor Act (EMTALA) was enacted by Congress in 1986 to ensure medical treatment to all regardless of their ability to pay. Nevertheless, patients will receive a bill after having been treated. It is up to them to speak with the hospital about financial aid packages or payment plans.
On the other hand, InstaCare clinics are not held to EMTALA and can require a copayment before seeing a physician. Those without insurance can be turned away, but according to Becnel, the InstaCare clinic on Bonanza will charge the uninsured a $75 copayment.
The People’s Health Clinic, however, does serve the uninsured no matter what, but they usually do not accept walk-ins. They are in such high demand by the uninsured population that they can be booked for weeks at a time, Crockett said.
He added that now that health insurance is available for everyone through the Affordable Care Act, regardless of pre-existing conditions, it is best to get insurance so medical care is never denied.
"There’s a saying that goes, ‘The emergency department is and always has been a safety net for the uninsured population in this country,’" he said. "But now that affordable insurance is available to everybody, it’s perhaps wise for everyone to get insured."