Woes of Urgent Care

How Miscommunication Affects Student Perceptions

Students enrolled at MIT are guaranteed free access to help at Urgent Care, regardless of whether they use the MIT Student Extended Insurance Plan or an outside provider. Sounds great, right? Free round-the-clock coverage for problems such as strep throat or headache, conveniently located right on campus.

Not so fast. Talk to a handful of students about their experiences at Medical, and chances are you’ll hear someone complain about Urgent Care. The care is slow, the doctors misdiagnose students, nurses disregard complaints, etc. Ask the same students about the experiences they’ve heard via word-of-mouth, and the horror stories mount.

Is this an accurate portrayal of Urgent Care? Well, yes and no. There are certainly inadequacies in the care that students receive, but these inadequacies can (and should) be attributed to far more than Medical’s clinicians. I think student dissatisfaction with Urgent Care is threefold: expectations that run counter to Medical’s capabilities and design, incompatibility between student and medical schedules, and a seeming abundance of negative stories.

Students arrive at Urgent Care expecting a quick fix for any medical problem, regardless of the severity. The difficulty with this thought process is that Urgent Care is for acute problems, not cumulative ones. While Urgent Care should be able to treat a straightforward case of strep throat in one visit, it is much more difficult to treat a combination of nausea, headache, fatigue, and other symptoms that arise when a student is run-down in a single 20-minute consultation. Treating these symptoms requires the student and clinician to work together to change health habits. Understandably, that’s a daunting task; clinicians grow frustrated with students for neglecting their health, while students grow frustrated with clinicians for attributing everything to “stress.”

Furthermore, it is unrealistic for students to expect that a campus medical center should be free of the problems that any other doctor’s office or emergency room faces. Long wait times are simply an unfortunate characteristic of health care in general.

A second problem lies in the inherent difficulty of coordinating student and medical schedules. If you are enrolled in four classes, work in a lab, and/or have outside commitments, the free time you have during business hours is extremely limited. This leads to students not being able to make appointments with their primary care physicians (if they even have one — some students opt to use Urgent Care for every medical problem, thereby contributing to the inefficiency and long wait times), and relying on After Hours Urgent Care.

After Hours is a new beast entirely — the clinicians staffing Urgent Care are not the same every day, thus leading to an inconsistent standard of care. On a Friday night, the physician may be exceptionally good at communicating with the student to address a non-obvious medical problem. The next day, a different physician may not have the same diagnostic and interpersonal skills. While this is a problem at clinics everywhere, it is magnified on a campus where students have a lower threshold for illness for myriad reasons: sleep deprivation, caffeine addiction, poor nutrition, etc.

Finally, the horror stories about clinicians misdiagnosing serious problems are the largest obstacle to student satisfaction with Urgent Care. During my freshman fall semester, I walked into Urgent Care with a concussion, only to be told that the clinician thought I “seemed sad” and asked if I was depressed. Personally, I thought I was just sad that I had hit my head. I mentioned this to my friends, who proceeded to share their own qualms about MIT Medical. Was this a productive way to air our concerns? Certainly not. At the time, though, it made me feel slightly better about being told that I appeared depressed. Because I wasn’t the only one who disputed what a clinician from Urgent Care told me, I felt justified in thinking his assertion was completely off-base.

Additionally, negative experiences are more likely to be the topic of conversation than positive ones. Sharing details about an uneventful visit is usually boring, but shocking people with the alleged incompetence of a medical professional is anything but.

In the face of these discouraging problems, MIT Medical has acknowledged some of its shortcomings and taken steps to create a more efficient, streamlined Urgent Care. The new physical setup of Urgent Care is designed to decrease the overall visit time, and After Hours supposedly has a more consistent schedule of physicians. These ideas sound great in theory, but will they increase the standard of care students receive in practice?

I recently had a sinus infection. Unable to find a same-day appointment with my nurse practitioner, I caved and hoofed it to Urgent Care. Anticipating a several-hour ordeal, I brought a textbook, a problem set, and my iPod so I could at least pretend I was being productive.

Within an hour, however, I had checked in with reception; seen a triage nurse; seen a nurse practitioner, who wrote a prescription; filled said prescription at the pharmacy; and walked out the door. Is this an anomaly or the new norm? Only time will tell, but I hope it’s the latter.

Caroline Huang ’10 is a Tech contributing editor and co-chair of the Student Health Advisory Committee.