Monday Morning Update 3/16/26

5 responses

  1. Robert D. Lafsky, M. D.
    March 15, 2026

    “ Pondering: if medical practices really care about patient health and access, why are their offices closed 75% of the time?”

    Offices that are equipped to handle certain really urgent emergencies will bring you in after hours. My retina specialist certainly does that for detachments, but he’s all set up with better equipment than the hospital has. For most types of practices that’s nowhere close to true, and if you need stat lab work, imaging or an urgent procedure the office is a waste of your time and the doctor’s.

    • Mom of 3
      March 16, 2026

      While that’s true for many urgent issues, there are plenty of simple (but still urgent) issues a primary care doctor could address. Somehow, defying all odds, my children always manage to get ear infections or strep throat on Friday nights, and I’m stuck going to urgent care for an antibiotic because there’s no way we’re waiting until Monday for the pediatrician’s office to open. And my husband is a CRNA who can rarely get to an appointment before 4pm, and certainly can’t guarantee it. Many offices take their last appointments at 3:30! You mention retinal detachment – he had a retinal tear and throughout the repair process, he needed to take two days off work solely for follow-up visits because his retinologist didn’t offer late afternoon appointments. I can only imagine how difficult it must be for people less fortunate than us, who might need to work two jobs or juggle public transportation schedules.

  2. Randy Bak, MD JD
    March 16, 2026

    The question of “after-hours” care stirs up thoughts about surge capacity in health care generally. If we want to resource for needs beyond the usual, how do we pay for it when it goes unused? Empty beds, empty time–it has costs.

    At scale, low frequency after-hours events can be funneled into a setting that is set up to manage that volume efficiently. ERs are supposed to work that way generally. Urgent care is an extension of that.

    Large practices can aggregate those needs over a population and provide evening and weekend clinic hours. They can also provide phone coverage by nurses and the physician staff without burning people out. Arguably, patients get better care, but as that scales, it loses the advantage of personal touch. Small practices are all about personal touch, but don’t stand a chance at deploying people 24-7-365, humanly or financially.

  3. my2centsareonlyworth2cents
    March 17, 2026

    When I read Mr. HISTalk’s pondering, my thought process went more towards availbiltiy for non-urgent appointments than urgent / 24-7 care. While there are a variety of work schedules, our society has aligned around a M-F 8-5 schedule.

    Why is it uncommon to have appointments for a physical or a specialty consult on a Saturday or after 5pm? The current construct of when routine, non-urgent healthcare is available means that so that people are forced to decide between using sick / vacation / unpaid time or rearranging work schedule / commitments and their health because the services are less likely to be available when they are. To Mr. HISTalk’s point, my vet’s office offered appointments until 8pm several days a week, so we only had to take time during the workday for an urgent issue.

    It would be an interesting experiment to flip the urgent / non-urgent care hours and see the impact on health outcomes and follow-up care. I don’t think it’s about offering 24-7-365, but having more scheduling options that don’t create a conflict and a choice between work / school and health. As mentioned above with my vet example, this doesn’t even have to be every day – could be something like 3x/week, the clinic is open from 12-8pm and 1 Saturday/month a full clinic schedule is available. Maybe there are some practices / healthcare organizations that offer this already?

  4. RetiredPracticeAdmin
    March 17, 2026

    This SNL skit was so good. I think the whole episode had great skits, but this one had me guffawing!

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