By the numbers: Nurse-in-a-box clinics vs. the ER

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One of the most expensive places to get medical care is in the hospital emergency room. There’s a much better alternative if you need medical care when your doctor’s office isn’t open.

Comparing the cost of a nurse-in-a-box to an ER

‘Nurse-in-a-box’ facilities, which are typically located in drug stores, discount stores or supermarkets, offer the services of a nurse practitioner who administers basic medical care. They can be a great, cheap alternative to waiting forever in the emergency room. Customers love these kinds of ‘store within a store’ operations because they’re open seven days a week for extended hours.

But what’s the quality of care you actually receive at a nurse-in-a-box facility? It’s actually very good. The Annals of Internal Medicine published a study that examined the cost and quality of care people who had three common illnesses — otitis media (middle ear-infection), pharyngitis (sore throat), and urinary tract infection — received at a doctor’s office, at an urgent care center and in an emergency room at a hospital.

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The study was done by a team of PhDs and MDs from the University of Pittsburgh working in conjunction with two health-related research foundations, and the results are no surprise to us here on Team Clark.

‘Overall costs of care for episodes initiated at retail clinics were substantially lower than those of matched episodes initiated at physician offices, urgent care centers and emergency departments. ($110 vs. $166, $156, and $570, respectively),’ the journal reports. 

And then there’s this conclusion statement from the study’s authors: ‘Retail clinics provide less costly treatment than physician offices or urgent care centers for three common illnesses, with no apparent adverse effect on quality of care or delivery of preventive care.’

That last phrase — ‘with no apparent adverse effect on quality of care or delivery of preventive care’ — tells you everything you need to know!

Beware of this gotcha in the urgent care world

So now you know that nurse-in-a-box places (aka retail clinics) are the cheapest place for decent medical care. If you still insist on going to an urgent care facility, you’ve got to be careful what type of facility you walk into. There’s a difference big between urgent care facilities and stand-alone emergency room facilities. While the latter may have fancier equipment, an in-house lab, and more staff, it also comes with a heftier price tag.

Actually, make that a much heftier price tag. The Dallas Morning News reports that some consumers are facing enormous bills for minimal face time with a doctor, like one family who brought in their daughter with a partially dislocated elbow. ‘We were in the facility for less than an hour,’ the mother told The Dallas Morning News. ‘We received a weight check, a Popsicle, an exam and the doctor performed a maneuver that literally took two seconds to correct my daughter’s partially dislocated elbow. The total bill? Over $10,000.’

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If you don’t want this to happen to your wallet, be particularly careful with places that have ’emergency,’ ‘ER,’ and maybe even ’24/7′ in the title. When you go to one of these places, don’t settle when they say they take your insurance. That’s not good enough. You want to know before you agree to be seen what it’s going to cost.

Places like CVS and Walgreens will post price lists right there on a digital board at their in-store clinics. Know what you’re getting, and know what it’s going to cost. If they can’t tell you, you need to find another place to go.

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