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  • Writer's pictureericjcarrig

More people will need urgent care unless we fix the social drivers of health.

We talked about improving the quality of life from the perspective of a former Air Force pilot and family physician-turned-urgent-care-doctor.


Dr. Worthe Holt has cared for patients, led health system operations, was the Deputy Chief Medical Officer for a large health insurance company. He served as a pilot in the United States Air Force, and as Major General, Special Assistant to the Commander, and Deputy Chief of Staff, in the United States Africa Command.



Photo by RDNE Stock project at Pexels


More people need care, but put it off, go to urgent care clinics, or simply don't get it. All that drives up costs.


1. There is a higher rate of chronic conditions like diabetes, hypertension, and heart problems. Sometimes it’s because people choose to drink too much, smoke, eat unhealthy foods, and not exercise. Sometimes it’s not a choice.


2. People live longer, and require more care as they age.


3. Social drivers can make poor health worse. Living where there is no place to get healthy food, living alone, or not having transportation make it difficult for people to take care of themselves and get to the care they need.

Further, social drivers lead to mental health issues because they create anxiety and depression as people struggle to survive.


4. People often can’t get an appointment to see a primary care doctor in a timely manner.


5. Health insurance companies encourage people to go to a primary care doctor and discourage them from going to the emergency department.

It is not clear that the government can effectively and efficiently single-handedly fix and pay for health care.


Urgent clinics have an unplanned, out-sized role in healthcare


We are asking the clinical community to help reduce costs and solve for social problems.


A doctor can provide guidance and treatment options to help prevent people from developing chronic conditions or to slow their progress.


Doctors can’t control what people do outside of the office, nor how the world around them influence their behavior.


Urgent clinics that were supposed to serve as a primary care release now provide a range of disparate care and often look more like an emergency department than a primary care clinic.


This kind of utilization seems to indicate that costs are so high and access so poor that people are waiting until their condition is so bad that only urgent care will solve it.


We all need to be part of the healthcare problem


We need to be empathetic of people in need of health care. It is frustrating and scary for people who are in crisis or have children in crisis. Lack of access and high costs just make the suffering worse.


We should be encouraging people to take care of themselves, not criticizing them — or defending their “right” to live how they want. People know that they should not smoke or drink too much and eat more healthy food and exercise more.


It’s ok for doctors to recommend behavior-change, but make it manageable. They don’t have to run a marathon. They can take a walk. They don’t need to change everything they eat. They need to swap a few things, like fruits and vegetables instead of pre-made, processed meals.


At the same time, people should demand access and affordability, while engaging in healthier behavior.


Health systems and drug companies setting prices for health care services and drugs AND insurance companies designing the co-pays and deductibles should be held accountable.


Unless we address high costs and limited access, plus a chronically ill and aging population together, more people will likely need urgent care because they can’t afford routine care.


More about Dr. Holt


He flew the F-4 Phantom and F-16 during military operations and helped design plane technology so pilots could operate high-performance jets, while their bodies go through the physiological changes they experience.


After he retired, he went from a volunteer, developing training programs for resident physicians to practicing urgent care.


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