Urgent Care Centers May Not Adequately Treat Complex Sinus Issues

Maximizing the Quality of Patient Care

For some patients, urgent care facilities are a great resource. “The benefit of urgent care is that it lends itself to ear, nose and throat problems such as ear infections or sinus problems,” said Subinoy Das, MD, director of the Ohio Statue University Sinus and Allergy Center in Columbus. “The more rapidly you see someone, the less likely it is that aggressive care will be needed.”

As with any service model, quality can range based on the provider. “Some urgent care physicians, or physician’s assistants, are fairly accurate with their diagnoses, and some are not; it depends on how well trained they are,” said G. Paul Doxey, MD, an otolaryngologist in private practice based in St. George, Utah. “It’s not all negative. Some are trained fairly well.”

The majority of urgent care centers, nearly 64 percent, are staffed with a mix of health care professionals: primary care physicians, nurse practitioners and physician assistants, according to the Urgent Care Association of America. In 65 percent of these facilities, at least one physician works on site the entire time the office is open.

Yet, some otolaryngologists worry about a lack of continuity when patients consistently choose an urgent care facility over a primary care physician or specialist. “I think [urgent care centers] contributed to ongoing fragmentation of care,” said Dr. Batra. “I think that’s true for any practice setting. I would be concerned if a doctor isn’t seeing a patient on a continued basis, because they might not know all the issues” involved with a patient’s background and history.

At many urgent care facilities, a nurse practitioner or a physician’s assistant is the front line of care, said Dr. Das. “They have to take care of so much of the body, and when caring [for] every kind of complaint, they might not catch the warning signs of a more severe problem.”

Most sinus problems are viral and resolve on their own, but approximately 10 to 15 percent are associated with a bacterial infection that can be accompanied by subtle signs that include facial swelling around the eye, forehead or cheek, or an intermittent fever. “If those signs are missed, that bacterial infection can become a life-threatening blood or brain infection,” he said.