In praise of triage and urgent care

Could you use triage make more customers happier? Based on my recent experience with urgent health care, maybe you could.

My visit to Urgent Care

This weekend, while attempting to open some stubborn product packaging with a scissors, I stupidly managed to gouge a half-inch cut in the palm of my left hand. Being a man, I wanted to just put a Band Aid on it, but my wife, trained in first aid, took one look at the awkward spot of the cut and the bleeding and said “That’s going to need stitches. I’m taking you to Urgent Care.” She hastily taped it up with a gauze pad and off we went.

What is Urgent Care? It’s not the hospital emergency room, which is more appropriate if you’re having a heart attack, have a compound fracture, or just got shot. Urgent Care is where you go if you need help quickly for common problems like burns, fainting, UTIs, and stitches — especially when your doctor’s office is not open.

If you’ve visited an emergency room lately, you know it’s a terrible and terrifying experience. It’s crowded with people experiencing everything from drug overdoses to head wounds. The wait is likely to be long, unless you’re bleeding out or passing out. It’s a great place to catch an exotic contagious infection or film a dramatic and scary scene in a doctor show. And if you really want to get a heart attack, wait until you get the bills from all your doctors and see how much insurance doesn’t cover.

Urgent Care is far less frantic — at least the one I visited, which was run by Maine Medical Center, was. The charges are a lot closer to a simple doctor visit than an emergency-room trip. Parking was easy and there were maybe five people in the waiting room. I visited reception, and then was quickly seen by a triage nurse, who figured out that I needed a tetanus shot and wasn’t about to drop dead from loss of blood if I wasn’t treated in the next ten seconds.

Following that I quickly got called into the treatment area, where an administrative person took my information; a nurse gave me the tetanus shot; a doctor expertly shot my had full of anesthetic, sewed the cut up with two stitches, bandaged me, and gave me care advice; and another medical professional gave me followup instructions. The whole process took about an hour. My wife drove me home and the fact that I’m typing this now with both hands proves that the treatment was effective.

Why isn’t triage more common?

But this post isn’t about when to go to the hospital. It’s about triage.

Before these urgent-care clinics sprung up, there was a problem. Your primary-care physician’s office might not be open when you needed it quickly, and might not be able to fit you in even if it was open. As a result, emergency rooms ended up treating problems that weren’t really life-threatening emergencies, which was a misuse of expensive resources. Probably a lot of injuries and illnesses just ended up untreated, which isn’t good for anybody.

Urgent care was a great solution, because it helped people who needed help at inconvenient times but not the full resources of a hospital.

There are plenty of similar solutions in other parts of the economy. The supermarket has a 12-items-or-fewer checkout because why should you have to wait behind somebody with a full cart if you’ve only got toilet paper and a six-pack? For that matter, convenience stores are sort of the urgent care of grocery purchases. Fast food places serve people who are hungry but don’t need a gourmet meal. Handymen fix home repair problems that don’t demand a skilled plumber, electrician, or architect. Quick auto maintenance places can change your oil or replace a tire more cheaply and quickly than the car dealer.

So why doesn’t customer service work like urgent care?

We all dread calling customer service for our internet, our software, our travel reservations, or our tax questions. “I just have a quick question,” you think, but you know if that once you get in that phone queue, you’re going to have to wait a long time. Chat-based service is excruciating, and AI chatbots always unable to interpret your questions.

The customer service people have tried to fix this with those phone menus (touch 1 for billing, touch 2 for technical support), but often enough, you can’t easily figure out which category your problem falls into.

What we need is triage.

When I call, connect me quickly with somebody who can figure out which specialist I need to talk to.

If it’s a simple problem, pass me off to someone who can solve it quickly. Why should I wait in line behind people with complex issues?

If it’s more complicated, I know it’s going to take some time. I’m willing to wait for the expert. And I don’t want that expert working on the simplest questions — they should be reserved for the tough cases.

I want triage when I call the IRS, when my iPhone needs service, when I have an insurance question, and when I’m dealing with the motor vehicle department. I’m smart enough to know when I’ve got a quick problem and when it’s complicated and needs an expert. Why aren’t the people giving me service equally smart?

If the screwed up US health care system can manage urgent care and triage, why can’t every other industry do the same?