Maggie McKay (Host): It's tricky when you need medical care unexpectedly right away. How do you know where to go? Do you go to your doctor's office, urgent care, or the emergency room? Well, today we will find out when to go where with Emergency Department Director and Chief of Staff at Community Memorial Health Care, Dr. Chris Johnson.

Welcome to Wise and Well, a podcast presented by Community Memorial Health Care. I'm your host, Maggie McKay. Thank you so much for joining us, Dr. Johnson.

Chris Johnson, MD: Thank you for having me today, Maggie.

Host: Absolutely, so why is it important for people to understand when and where to seek health care when they're not feeling well or experiencing a medical emergency?

Chris Johnson, MD: Well, besides the public health implications and the conservation of resources, we really want patients to get the care that they need. And, urgent cares provide a certain level of service, and emergency departments obviously provide a different and higher level of service.

Host: Well, let's start by discussing the cases in which visiting the emergency room for care is necessary. What constitutes a medical emergency and when should someone call 9-1-1 instead of driving themselves or a loved one or a to the emergency room?

Chris Johnson, MD: It's a tricky question, but the, both sides of the spectrum are easier to answer, so obviously if somebody has onset of severe symptoms that occur suddenly, such as chest pain, or any stroke symptoms, like difficulty speaking, swallowing, walking, or any loss of vision, a various number of things such as broken bones and severe burns, abdominal pain that's severe in nature and sudden in onset. All of those things would definitely require a visit to the emergency department.

Host: As an emergency room physician, what are some of the most common reasons patients make unnecessary visits to the emergency room?

Chris Johnson, MD: Unnecessary visits, that's a difficult question to answer because we never blame patients for making the choice to come to the emergency department. If they feel their symptoms are severe enough and they're there, we take care of them and, address all their concerns. But some of the more common complaints that we see that sometimes are unnecessary are things like asymptomatic hypertension or elevated blood pressure.

If you have an elevated blood pressure that's less than 200 and you're not having symptoms such as chest pain or stroke symptoms or headache; those are the type of things that we'd like to have followed up with your primary doctor or even at an urgent care setting. Other things are children who have viral illnesses, fevers for one day, or even an episode of diarrhea. Minor complaints such as these can be addressed by your primary care physician or in an urgent care setting.

Host: Dr. Johnson, what types of injuries and illnesses are urgent care facilities designed to treat? And when should someone visit urgent care, rather than waiting for an appointment, say, with their primary care provider?

Chris Johnson, MD: Yeah, great question. Urgent cares are designed for those symptoms that are relatively minor. Things that you probably would see your primary care physician for if you were able to get in to see your primary care physician. But we all know that the primary care system is overwhelmed at this time and oftentimes you can't get in to see your doctor.

And so the urgent cares are there for a backup system for those type of cases. For instance, sore throats, runny noses, a minor fracture such as a finger fracture, or small lacerations, bumps and bruises; they're very well equipped to take care of these things.

Host: What role does primary care play in keeping patients and their loved ones out of the emergency room and urgent care? Why is having an established relationship with a family or internal medicine physician or pediatrician important?

Chris Johnson, MD: Sure, the primary care physician is sort of like the quarterback of the healthcare system. They make sure that we have all of the preventative care that we need. At various stages in our lives, we require certain screening tests for cancers, et cetera. We need vaccinations. We need physical exams and blood pressure checks to make sure that we aren't developing chronic illnesses. People will develop chronic illnesses, and the primary care physicians are there to take care of these. If they cannot take care of these, they are able to reach out to the various specialties to help you care for your particular illness in the most efficient and effective fashion.

Host: What can community members do to prepare for the upcoming cold and flu season? Because there's nothing more frustrating than when you're in a public place and people are sneezing all over each other and, oh boy, you're thinking like, come on, prevent it, prevent it. So what should we be doing?

Chris Johnson, MD: Just all the things that your mother taught you. So sneezing into your arm if you have to sneeze and washing your hands frequently. Washing your hands cannot be stressed enough, because this helps the spread of disease, and it's one of our most efficient ways of stopping the spread. Also, of course, get your flu vaccination and your COVID booster. These are very important at keeping you out of the hospital and keeping your family and yourself safe.

Host: I'm going to take that one soundbite and make a loop and send it to my son who's in college about washing hands because I have been telling him that since he was little and he doesn't believe me. But during COVID, he gave it a little more weight, but I'm telling you, that's what I say. It cannot be stressed enough. Wash your darn hands, right?

Chris Johnson, MD: That's right.

Host: So in your last almost two years as Community Memorial's Chief of Staff, what are some of the trends in healthcare that you've noticed impacting our community? How do the trends impact the way patients seek and receive care?

Chris Johnson, MD: I touched on it a little bit before, but our health care system currently is a bit overwhelmed. Here in the Ventura County area, we've done a great job at hiring and providing care for our patients, and we have quite a few primary care physicians, but at times, they get overwhelmed. And what I've noticed is that a lot of patients are coming to the emergency department and utilizing urgent care services for some of these chronic issues that could have been addressed at primary care offices or at urgent cares. Also, the chronic problems that patients had seem to have gotten worse during the COVID pandemic. Because these chronic issues were not being addressed as they were in the past, because patients were scared of going to the hospital or going to the emergency rooms, and procedures were postponed, and diagnostic testing was postponed due to the pandemic. And so we're playing a bit of a game of catch up at this point.

Host: Is there anything else in closing that you'd like people to know that maybe we didn't cover?

Chris Johnson, MD: One of the things I really want to stress is that when you come to the emergency department, please be prepared to bring things like your medication list, a list of your allergies, a list of procedures and surgeries you've had in the past. We want to know who your primary doctor is, and we also want to know if you have any type of implantable device, and the type of device that you do have.

If you could put these down on one piece of paper and keep it with your possessions, or better yet, put it on your phone. That is very, very helpful to us.

Host: That is a brilliant idea, especially having it on the phone because you know you're going to have your phone with you. Otherwise it might be hard to find a piece of paper, but I guess you could have that as backup just in case. Well, thank you so much for sharing your expertise. This has been such useful information and so helpful. We really appreciate it.

Chris Johnson, MD: Sure. Thank you.

Host: Again, that's Dr. Chris Johnson. To learn more, visit MyCMH.org. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. I'm Maggie McKay. Thanks for listening to Wise and Well presented by Community Memorial Healthcare.