Dr. Edmond Wong (Guest): Thank you. Good morning.

Deborah: You are a man after my own heart. My father was a specialized GP and also active with the Emergency Physicians Professional Association, so it’s a real pleasure to have you on the show.

Dr. Wong: Thank you.

Deborah: When should a person go to the emergency room, Doctor?

Dr. Wong: In general, the rule that you follow is if you think you are having a life-threatening illness or injury, that is the time to go to the Emergency Room. For example, if you think you’re having a heart attack or symptoms suggestive of a stroke, those are the things that you would go to the Emergency Room for. Other things to consider, if you were having something that was giving you severe pain, pain that you’ve never had before that was very intolerable. Those types of problems would also be better evaluated in the Emergency Room because that may need a more extensive type of work-up.

Deborah: So, acute pain instead of a dull pain is what you’re talking about.

Dr. Wong: Yes, anything that is very high in intensity that you don’t know where it’s coming from.

Deborah: Okay. This is a little sidebar. Yesterday, I read a small article about texting as being another one of those signs that your loved one might be having a stroke if you receive several totally garbled texts from them. That may be an indication that something is going on in their brain.

Dr. Wong: Certainly, that is something to consider, although you always wonder whether or not people are rushing through their texting and not actually typing very accurately but if it sounds completely garbled, I suppose that could be a warning sign of something going on in the brain.

Deborah: Yes, just one of many then. What are the other signs of stroke, by the way, while we’re on this topic?

Dr. Wong: Typically, if they are acting very confused, if their speech is slurred, if they are having focal weakness or loss of sensation in one part of the body or one side of the body, that would be worrisome. For example, if someone was walking and it looked like they couldn’t walk straight or if they were falling over when they typically have very good balance, that would be a worrisome sign.

Deborah: What other types of ailments or conditions can be treated in an urgent care center?

Dr. Wong: This is actually one of the great things about urgent care is that we can evaluate and treat almost any type of condition, except the life-threatening types of issues that we would want people to go to the emergency room for. They can stand the common things, such as infections, we deal with a lot of skin infections and abscesses; any of the common illnesses that you see, especially during the wintertime, respiratory things like bronchitis, pneumonia, sinus infections, ear infections, strep throat, tonsillitis. We’ve seen many of those types of cases on a daily basis. And injuries, lots of people get injured. We deal with sports injuries. We deal with car accidents as long as the injuries are not multiple, complex and severe. We get a lot of sprains and strains, weakened unintelligible and stabilized fractures and even dislocations. We have the ability to sometimes reduce the dislocation and stabilize it.

Deborah: What are the benefits of going to an urgent care center in a non-life threatening situation versus a hospital?

Dr. Wong: There are a couple of benefits that you get. Probably one of them would be a shorter wait time, especially during the winter season when the flu is active. Emergency rooms tend to get overrun with lots and lots of patients, some of them very sick and some of them not so sick. And so with less people coming through, you don’t have to wait as long between an urgent care than you would in a typical emergency room. A second benefit that you can have is that you are less likely to pick up some sort of serious infection or illness that you don’t already have. Again, during the flu season, you have lots of people who are sick with lots of different things, not just influenza but other types of virus or bacterial infections that they’re waiting to be seen and treated for. If you are in close contact with these people in the waiting room, you’re waiting there for hours and hours, you can certainly pick them up. And another benefit would be that it tends to be a much more calm and relaxed environment to seek medical care in. In the emergency room, life-threatening illnesses, emergencies, car accidents, and both patients and staff tend to be a little bit more stressed out because of the acuity of what people are coming in for. In urgent care setting, it is not so stressed and the staff tends to be a bit more relaxed as well as patients and it tends to foster a more enjoyable experience.

Deborah: Right. You know, you might be sitting next to somebody who’s just there for Botox as opposed to just coming off a horrendous car crash.

Dr. Wong: I look at the urgent care as being a type of bridge between primary care outpatient offices and the hospital and emergency room and it really fills this need when patients cannot get in to their doctor’s office because their regular doctor is overbooked or schedule is full or it’s the unintelligible time and the office is already closed. Urgent cares are here and we are open in the evening to provide care for all those patients that can’t get in to their regular doctor in a timely fashion, and especially if it’s something that needs to be addressed right away and yet it is not urgent or life-threatening enough to warrant going to an emergency room because you’re not dying of something. It’s just very uncomfortable or very worrisome and you know that it can’t wait for a couple of days or a couple of weeks, but you know you’re not going to die from it.

Deborah: Right, a couple more questions about that. We know that appointments are not required at most urgent care centers, but is it a good idea to call before we go in?

Dr. Wong: It actually isn’t necessary to call. The urgent care is set up with hours that are meant to make it convenient for the patient. In general, on weekdays, most of our urgent cares are open from the morning through into the evening, and then on the weekends, that we are also open and it varies from urgent care to urgent care with hours, but most urgent cares are open seven days a week. Our urgent care is open even on holidays. We are not closed any day of the year, and it’s set up to be convenient for patients.

Deborah: What about the quality of care when you get to the Urgent Care Center? Can we expect the same level of quality that we can in an ER?

Dr. Wong: Absolutely. I think you get excellent care when you come to an urgent care. The doctors are well-trained. They are board certified usually in family medicine, internal medicine, pediatric, and occasionally possibly even, we might get an emergency room physician working in the urgent care. And because many of us are trained in the primary care specialty, we tend to be very compassionate because we’ve also been trained to treat patients like we do in a regular office.

Deborah: Fantastic. What about the cost of an urgent care visit as opposed to an ER visit?

Dr. Wong: In general, the cost of an urgent care visit should be less than an Emergency Room visit. Obviously, it depends on each patient’s individual insurance plan, how much co-pay that they would have to pay for an urgent care visit versus an emergency room visit. But in general, most insurance plans, the urgent care co-pay tends to be a lower tier. Now, I would advise patients to, one, check their insurance card because oftentimes, it will list what type of co-pay that you have to pay for each. And if it does not, then what you should be doing is referring to your insurance plans costumer service line to find out how much you would have to pay.

Deborah: It sounds good. Dr. Wong, thank you so much for finding the time to talk to us about when we should go the emergency room or the urgent care center. I’m Deborah Howell. Join us again next time as we explore another Weekly Dose of Wellness, brought to you by MemorialCare Health System. Have a great day.