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Need Urgent Or Emergency Care? When To Go Where

When you’re in the middle of a medical crisis, you have options — emergency departments, 911, quick care services, doctors' offices, walk-in clinics, urgent care centers, retail health clinics — but the maze of choices could make you waste time wondering what to do or where to go.

Obviously, you want the quickest care possible.

Depending on the type of medical issue, however, the shortest route isn’t necessarily the emergency department, where you could wind up waiting longer for care if your issue isn’t life-threatening.

So understand your options in advance. Then, if you happen to face a medical crisis, you’ll know where to get the right care more quickly.

Emergency Department Or 911

Emergency departments are designed to handle serious, life-threatening, time-sensitive medical issues. People who experience any of the following symptoms should visit the nearest emergency department right away:

• Coughing up/vomiting blood

• Cut or wound that won't stop bleeding

• Head trauma

• Heart attack symptoms, including sudden/severe chest pain or pressure

• High fever with stiff neck, mental confusion, and/or difficulty breathing

• Poisoning

• Severe shortness of breath

• Stroke symptoms, such as numbness or weakness on one side of the body, slurred speech, and sudden loss of vision

• Sudden/unexplained loss of consciousness

• Sudden, severe abdominal pain

• Stab wounds

“In certain emergency medical situations, however, it’s safer to call 911,” says Dr. Brian Kelly, FACEP, Chief of Emergency and Occupational Services. “These involve conditions that could worsen and become life or limb-threatening on the way to the hospital, instances where distance or traffic could cause delay in getting critical treatment, or injuries that could worsen when moving without the assistance of a paramedic.” In the case of heart attack or stroke, in particular, “calling 911 quickens response and enables treatment to initiate sooner, and this is important when time is of the essence to saving lives,” says Dr. Kelly.

Sturdy’s Emergency Care Center (ECC), open 24 hours a day, treats more than 50,000 visits annually. To lessen waiting times in the ECC and facilitate treatments for less-severe conditions such as flu-like symptoms and suspected bone fractures without deformity, Sturdy offers a “Quick Care” program, available every day from 9 a.m. – 11 p.m. All applicable emergency department out-of-pocket expenses would apply for Quick Care services.

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Doctor’s Office

Health issues that are urgent but not life-threatening—things like sprains and other minor injuries, flu-like symptoms, allergies, minor lacerations, and minor abdominal pain—don’t warrant visiting the emergency department or calling 911. Patients whose conditions are at a higher level of severity and acuity are seen first for rapid medical intervention, while patients with minor illnesses or injuries are seen according to arrival at the emergency department. So, treatment for minor illnesses and injuries could take hours.

To avert long wait times in the emergency department, people with minor but urgent medical issues should call their primary care physician office first. “Primary care physicians develop relationships with their patients and know their medical history, conditions, and medications,” says Dr. Prabhu Ram, board certified Internist. “So, they would know the most appropriate course of treatment not only based on present issues, but the whole picture.”

This system where primary care physicians coordinate all aspects of patients’ care is called a “medical home.” Sturdy is committed to continually optimizing its performance as a Patient Centered Medical Home (PCMH), as this care model enhances access, effectiveness, and continuity of care. To manage care when patients have minor health issues, the primary care physicians at Sturdy Memorial Associates offer same-day sick visits for their patients. Patients can call their physician office at any time and based on the physician’s advice, can schedule a sick-visit appointment, visit the Mansfield Health Center walk-in clinic, or follow the physician’s recommendations for at-home care.

“Unless it’s a time-sensitive medical emergency, patients don’t need to be seen by a stranger. They can get the most effective care by someone who knows them—their own physician,” says Dr. Ram.

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Walk-In Clinic/Urgent Care Center

Sometimes, especially during flu season, physician offices are busy with an influx of patients. So if patients call their physician office and are unable to schedule a same-day, sick-visit appointment for an acute medical issue, they may be directed to visit a walk-in clinic (a.k.a. urgent care center), which doesn’t require appointments. Mansfield Health Center, located at 200 Copeland Drive, has a walk-in clinic that is open Monday – Thursday, 8 a.m. – 6 p.m. and Friday, 8 a.m. – 5 p.m. The clinic can treat patients with such medical issues as:

• Allergic reactions

• Bronchitis

• Cold and flu

• Flu vaccinations (in season)

• Fractures and sprains

• Insect bites

• Minor abdominal pain

• Minor burns and lacerations

• Pink eye

• Rashes

• Sinus, ear, and eye infections

• Sore throat

• Stomach upset

• Urinary tract infection

For patients within the Sturdy Memorial Associates system, records and reports of care received at the walk-in clinic are automatically sent to their primary care physicians to ensure care continuity. Onsite laboratory and digital radiology services are also available to provide more convenient, timely, and coordinated care for patients.

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Retail Health Clinic

Over the last several years, retail health clinics have been sprouting up in pharmacies, grocery stores, and general merchandise “superstores.” While most offer the convenience of weekend hours, the types of treatments offered are limited to common, minor illnesses such as: ear, nose, and throat infections; pink eye; strep throat; and minor burns and lacerations. They’ve also created some controversy among medical professionals and organizations. The American Medical Association, American Academy of Family Physicians, and Massachusetts Medical Society are some of the organizations that have expressed concerns over the disruption of existing patient-physician relationships and fragmentation of care that may result from seeking treatment at retail health clinics.

“Care can become spotty and episodic when patients repeatedly visit retail health clinics, where they receive treatment from advanced-practice clinicians who may not know them inside and out like their primary care physicians do,” says Dr. Bruce Auerbach, Sturdy’s President and CEO, and past president of the Massachusetts Medical Society. “Therefore, subtleties in the way patients present to the clinic may be missed. Another factor is that complete lists of all patients’ medications will likely not be available to advanced-practice clinicians in retail clinics, increasing the potential for either duplication or adverse medication interaction. All possibilities—factoring in medical histories, medications, and preexisting conditions—need to be considered in diagnostics and treatment.”

Visiting retail health clinics can also result in fragmentation of care. For example, immunizations administered at retail clinics may not make it into patients’ formal records at their medical home. The responsibility of ensuring that records from retail health clinics get back to the primary care physician falls predominantly on patients, who have to remember to bring visit reports back to their physician offices. “Conversely,” says Dr. Auerbach, “going through the primary care physician for urgent issues care averts this sort of care discontinuity.”

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Making The Call

If you don’t have a time-sensitive, life-threatening medical emergency—for which you should visit the nearest emergency department or call 911—you have to make the call between available urgent care options. So call your doctor first to help you decide what to do or where to go. Primary care physicians play very important roles. They manage not only preventive care and health screenings, chronic conditions, and overall health maintenance—they are there for patients when they are sick, too.

In need of a primary care physician? Sturdy can help you find a primary care to meet your needs. Call the FREE Physician Referral Line at 508-236-8500.

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