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0 of 3 Premium Clicks used this month SUBSCRIBE Print + Online Subscriber Activation | Register x Forgot Password | Need an Account? Topics Fitness Food Health Natural Pamper Special Style Events Medical Directory Reader's Picks RSS Info About OHL Advertise Archive Photos Return to Mail Tribune NEWS NOW Beach bacteria thresholds may tighten By Mark Freeman Mail Tribune Read Beach bacteria » Our View: Who politicized the UCC shootings? Not Obama Read Our View: Who» View from 100,000 feet By Ryan Pfeil Mail Tribune Read View from 100,» Beach bacteria thresholds may tighten By Mark Freeman Mail Tribune Read Beach bacteria » Our View: Who politicized the UCC shootings? Not Obama Read Our View: Who» View from 100,000 feet By Ryan Pfeil Mail Tribune Read View from 100,» ER vs. Urgent Care No one relishes the thought of a trip to the emergency room, but it is at times unavoidable. However, the rise in alternative treatment options means that those times can be less frequent. Comment By MARGARET BATTISTELLI GARDNER MailTribune.com By MARGARET BATTISTELLI GARDNER Posted Oct. 6, 2014 at 2:00 AM By MARGARET BATTISTELLI GARDNER Posted Oct. 6, 2014 at 2:00 AM When do I go where? --> When to head to the ER: ? Any serious cardiac event, such a heart attack or chest pain ? Stroke ? Shortness of breath ? Uncontrollable bleeding ? Severe trauma ? Br... » Read more X When do I go where? When to head to the ER: ? Any serious cardiac event, such a heart attack or chest pain ? Stroke ? Shortness of breath ? Uncontrollable bleeding ? Severe trauma ? Broken bones that are severe enough to see from the outside When an Urgent Care Clinic is best: ? Simple broken bones ? Sprains ? Coughs and cold symptoms, upper respiratory infections ? Musculoskeletal pain ? Rashes ? Vomiting that isn't severe or prolonged ? Infections ? Mild illnesses When to See Your Primary Care Physician ? Minor symptoms that can wait for a scheduled appointment ? Routine health checkups ? Prescription refills ? Management of ongoing illnesses, such as diabetes care When to Turn to Pharmacy-Based Facilities ? Mostly for minor symptoms when a primary-care physician is unavailable ? Conditions that can be treated with a quick prescription, such as for antibiotics ? Minor wounds and burns, etc. ? Nothing that requires any degree of diagnostics Don't Hesitate with Stroke Symptoms Cory Bergey, a doctor of osteopathic medicine at Providence Medford Medical Center, cautions that while many patients are quick to seek emergency care for suspected heart attacks, many don't worry as much about stroke. "People aren't as good with recognizing a stroke," she says. "We see some people three days to four months out after a stroke who just didn't get better and finally decided to come in. There are certain medications that can only be administered within six hours of the onset of symptoms, so time is of the essence." » Social News No one relishes the thought of a trip to the emergency room, but it is at times unavoidable. However, the rise in alternative treatment options means that those times can be less frequent. Urgent, non-urgent and chronic Urgent or immediate care clinics are growing in popularity in Southern Oregon. So when do you opt for which? "That's always going to be a difficult question for a patient," says Cory Bergey, a doctor of osteopathic medicine at Providence Medford Medical Center. But the consensus is that with any type of cardiac incident, stroke, appendicitis or other case that seems to be an immediate, life-threatening situation, never hesitate to head straight to the emergency room. "If the symptoms aren't particularly severe and have been ongoing for a while — like sprains, coughs and colds, and mild illnesses — those typically can go to an urgent care clinic," Bergey says. "If you present at one of these clinics, they can quickly identify something that is a true emergency, arrange a transfer and call ahead to give the ER a heads-up." And while it might seem counterintuitive, it's not always true that an ER staff can provide the best care in every situation. ER personnel are specially trained in emergency medicine and not necessarily as skilled in chronic diabetes or hypertension care, for example. "The ER is for emergencies," Bergey says. "That's how they were used when emergency medicine was developed in the '70s and '80s. In the early '90s, it became a catch-all for things no one else could take care of." Medical care challenges There's no denying that emergency rooms often are filled with people who don't really need to be there. Some don't have primary-care physicians, while others don't have insurance. ERs are required by law to provide care despite a patient's insurance coverage. Urgent cares, on the other hand, are not. So some patients opt for the much more costly ER, which seems "free" at the moment, rather than a less expensive urgent care clinic that may require at least some payment up front. "The federal Affordable Care Act's broadest plans provide a lot of wellness care but not necessarily sick care," explains Brent Kell, chief executive officer of Valley Immediate Care, which has four clinic sites in the area. "They will pay for colonoscopies and mammograms, but if you have a sprained ankle or broken wrist, they don't pay until you reach a $6,600 deductible. People are really surprised the first time they have health insurance and they come and see us and we have to say they're not covered for this." Unfortunately, it's not always easy to get an appointment with a primary-care physician in Southern Oregon. Or even to find one who's accepting new patients. According to Kell, the area has a large Medicare population yet the third-lowest Medicare reimbursement in the country — not exactly an incentive for primary-care providers to take up residence. "It's really hard to attract doctors to this area," Kell says. "That really low Medicare reimbursement is a huge factor. If you have young doctors with student loans to pay off, they're going to look at areas where they can make twice what they make here. The quality of life in Oregon is great, but if you can't support your family, you have to look elsewhere." Emergency education Acknowledging the widespread overuse of ERs for non-emergency situations, many hospitals are employing staff to educate people about the proper use of ER facilities. While non-emergency patients will be treated, they also may receive a visit from a staff member who will help them understand the difference between emergency and routine care, as well as the role of urgent care facilities. The "patient guide" also can help them find a clinic or primary-care physician who meets their needs — whether by medical specialty, sliding-scale fees, location or language. That education is vital not only to free up emergency-care resources for true emergencies, Bergey says, but also because "a continued close association with your primary-care provider" is the best way to ensure continued good health. Kenneth Lindsey, vice president of medical affairs at Asante Health Systems, explains that the relationship between urgent care clinics and primary-care physicians is becoming increasingly important and coordinated. The lines of communication are opening up thanks to generalized databases and record sharing, allowing all of the medical personnel involved in a patient's care to have easier access to test results and other data. It's a relationship that Bergey, Kell and Lindsey agree is essential to preserving the heart of emergency care. "Urgent care needs to be part of the solution," Kell says. "If the ER is the only place people can go when they can't see a primary-care physician, the emergency-medicine system won't stay viable." By MARGARET BATTISTELLI GARDNER MailTribune.com By MARGARET BATTISTELLI GARDNER Posted Oct. 6, 2014 at 2:00 AM » Comment or view comments Reader Reaction Archive Terms of Use Privacy Policy Contact Us Advertise Careers Copyright © . Local Media Group, Inc. All Rights Reserved. Southern Oregon Media Group: Mail Tribune.com | Ashland Daily Tidings | Medford Nickel