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Welcome back to Urgent Care Unscripted.

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My name is Barbara Reynolds.

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Here I am the director of operations and
business development for AFC Urgent Care.

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And this is Mohammad Salman and the
franchise here on earth devastated. And

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today we

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want to talk about, urgent care versus
emergency room.

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More precisely, when you have some kind
of an illness and you're trying to decide

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where to go, should I go to an urgent care
or, emergency room?

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We want to talk about that.

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And what are the most common scenarios
that,

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we face when you're making
when you're trying to make that decision?

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Yeah.

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Today we're joined by Doctor
Felix Pacheco.

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He is our medical director
and also a veteran E.R.

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physician. So welcome, doctor Pacheco.

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Hello. Thank you for having me.

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I would like to add,
you know, a lot of, patient complaints.

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I've seen emergency departments
that can adequately be handled.

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And as you can see them, you know,
think about your your pulse,

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your springs, if you ever walk on it
and you would be fine.

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You could probably see an urgent care.

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Got it.

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And so these are some of the scenarios
that you just mentioned, opportunities

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that are not complex
enough for people to warrant

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an urgent, emergency, visit,
I guess, right?

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Yeah.

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I mean, sometimes it's hard to tell,
but either way, I'll providers

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could make an assessment fairly quickly
and determine whether or not,

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you know,
a higher level of care is necessary.

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That's great.

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I think one point is to think about,
is this a straightforward case?

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Is it going to require,
you know, an MRI or a cat scan?

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Obviously not every patient knows that.

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But it's good to call.

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You can always call us and we can at least
guide you one way or another.

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Yeah.

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So once the patient has actually arrived,
saved

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the patient has made the choice
to come to an urgent care.

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How do

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we how
does the provider make that distinction?

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Should they give us the decision

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actually, to an urgent.

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So this is the, the issue is, evaluation

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and how the patient appears, you know,
you know, getting vital signs

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makes it even more objective, getting,
you know, a blood pressure or heart rate,

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temperature and such, that,

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you know, laying eyes on the patient
to see how much they structure it.

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That's said,
some things are going to be difficult.

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If you're coming in from a trauma that,
you know, maybe hasn't

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fully manifested yet,

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you know,

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maybe you have some internal bleeding
that is, identified,

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it may be stable
because you're getting healthy

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and you work out, you know,
you may be like that for a while,

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and then you manifest later, 
by somebody, you know,

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getting a history,
determining the severity of the injury.

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And, you know, making the best judgment
as to whether or not

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that needs to be seen in person,

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in an emergency setting
or in the urgent care setting,

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and would also is a risk assessment,
right?

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So if you have a patient
who is a little bit older,

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who has diabetes, heart disease,
those are things that we take into account

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before we make the decision of
we're going to treat you here versus

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we're going to send you out
to the emergency room 100% completely.

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But any assessment requires
a, risk assessment of the patient.

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You know, how old you are, how many,

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comorbidities, how many,
you know, illnesses they might have.

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You know,

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that changes the, presentation of illness

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and the types of diseases
they may be susceptible to.

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So just sounds like it's not like a very

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straightforward decision.

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For the provider,
they have to go through, diagnosis.

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They have to, hear out what the condition
of from the patient and do some tests

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and then maybe make that call, like,
okay, yes, we can treat that patient here.

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Or, you know, it
is, in a, in a stage or condition

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that is advanced diagnosis and so forth.

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Yeah.

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You know, there's a lot of gray, 
and we try to keep this simple, you know,

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if you have, like a ten year old,
they got cut,

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playing with like,
a little, a little knife or something

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and just have a small laceration
to a finger, you know?

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And it's very deep. Right?

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Then you have a high speed,
you know, car accident.

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They have rolled over and the piece
into the hands of the patient

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will have their seatbelt on,
and they lost consciousness.

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You know, those are kind of the examples
where one very easily can be dealt with.

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Yeah. And the other not.

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One thing that I see too, with,
when it comes to lacerations,

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at least from the provider's perspective,
is having, you know, face lacerations.

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At the end of the day,
if you want that to be done by a surgeon

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or, you know, like a plastic surgeon,
you're going to have a scar.

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If you get have done it, we can do it. But

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you might have a little

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bit of a scar
that is not so nice to look at.

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And most cars are not going to have
a plastic surgeon trail

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they can repair,
but they may have some other,

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surgical specialties
that may make the, wound look nicer.

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So that that is true.

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I mean, depends on the complexity
of the illness and the concern

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the patient may have regarding your custom
pieces.

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You know,
you know how much it affected looks.

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One thing that I, also wanted to mention
and just mentioned

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for the patients here is,
you know, your body better than anybody.

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So if you feel like you should go
to the emergency room, do that for sure.

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You know, like you and again, we have,

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people on site, if you're unsure.

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The benefit of urgent care
is, ease of access.

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Yeah. Time. And time is a big one.

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We tend to be able to see patients
within an hour of their arrival,

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potentially even have the patient
discharged within an hour of arrival.

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Obviously,
it, though, depends on how busy it is.

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But either way,
in an emergency department setting

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and then the time of year,
you know, you'd be lucky.

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Happy to see you within two hours,
usually, or ten times longer than that.

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So time, please, will, make sure you know
how much you pay in your copay.

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You know that obviously there are
some motivations from the insurance

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perspective regarding change, a patient's
urgent care versus versus primary care.

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But either way, there's,
a cost, to that, that

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patient depending on the carrier.

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But at the end of the day,
like at our urgent care in West Haven.

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Yes, in this state
and I would say any urgent care

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and, patient's health,

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that interest is the top
and only priority, would have to say.

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Right. Their health is the priority.

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Nothing else really matters
from just a human perspective

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and also from a legal perspective.

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If you have a condition
that's not within our scope,

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we will be in trouble
to try to do anything about it.

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And it would be best served for us as well
as for you.

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When we refer you to a, emergency room

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instead of trying to tackle it
at the urgent care.

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So that's not something bad for you
that we could not or failed,

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quote unquote, to treat.

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You have the urgent care
that we offered you to the emergency room.

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That's for your best interests.

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And we would do that often

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when we see that that's the condition
that needs to be treated.

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And it's you need to recover
and it's for your best interest

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that you should go to an audience,
you know, so you're welcome to come here.

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But then we will also
make the best decision

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that suits your needs to this.

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Yeah. Definitely.

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Health in mind first.

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And this is where we have to, adjust.

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Maybe the patient's expectations. Yeah.

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You know, they,
you know, maybe thought it was minor.

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And then we find out

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that is something that is a little bit
more than we can handle.

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And, you know, we want to make sure
you have the best outcome.

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You know what?

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You, to be able to walk again,
you know, be able to see us again,

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you have to be happy with the care
you receive.

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And it would be, a problem for everyone
if, you know,

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an emergency was attempted
to be treated in a non-emergency setting.

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Yeah.

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Okay. Resources.

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Absolutely.

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And coming from somebody that has worked

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with hundreds of providers
in an urgent care setting,

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I can definitely say that
if we're sending you

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to the emergency room, it's
because that provider really

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can or already did the best
that they could for you in that situation.

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It's not because they don't
want to treat you.

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It's not because they don't want to,
you know,

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do whatever it is that you need to do.

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It's it's really for the best.

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So just just trust
the process is what I'll say.

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Yeah.

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It's always kind of interesting
because, you know,

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it can be a fairly straightforward
evaluation on a patient, you know,

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that depending on the patient

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expectation, and,
you know, it's taken easily or not.

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So, yeah, that's a role to take, you know.

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Yeah, absolutely.

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And, you know, providers are humans.

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So at the end of the day,

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some may have more capabilities
and others do comfortability.

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I think it's a big thing too
within the provider network system.

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So just keep that in mind as well.

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I yeah. You touch on the point.

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The provider some are greater.

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Risk takers.

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I'm not concerned, but I'm willing
to take on more responsibility,

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you know, you know,
and everybody's a little bit different.

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So each provider, you know,

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may make a different assessment
with the same patient

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depending on how much each
wants to be able to have that condition.

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Yeah. You guys are not robots.

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So And actually, one thing
I forgot to mention, the severity

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of the pain, also plays a role, right?

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So one can argue that kidney stones are a,

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a life
threatening condition most of the time,

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but the severity of the pain is difficult
to manage in your care setting.

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So, you know,
if you have, like, severe pain,

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that can be great in your care
setting as well.

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Yeah, absolutely.

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Trust your instincts
and don't hesitate to call.

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Don't hesitate to call your local urgent
care us and say this is what I'm feeling.

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Should I come here?
Should I go to the emergency room?

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We'll do the best to kind of guide
you ahead of time and again.

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We might say, come and see us.

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We'll try to assess you.

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And if it's something that we can't do,
we will send you to the emergency room

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as needed.

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Thank you so much, Felix,
for joining us today.

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That was some really insightful
information.

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I think our patients
will definitely appreciate it.

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Thank you. See you next time.

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Stay informed and stay safe
and subscribe to us and gifted.

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We look forward to seeing you again
for the next episode. Yep.

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And keep in mind we are located at 354
Sawmill Road in West Haven.

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Come see us anytime
you need us. Thank you. Bye.