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The Doctor’s Office, the ER, and the Chinese Restaurant

April 7, 2013

Certain diseases are best seen in the emergency room (ER), while others should be seen in a doctor’s office. I teach patients to associate a sickness with a suitable setting. The example I often use is ordering Italian food at a Chinese restaurant. The chef may be able to accommodate you but his kitchen is not set up to routinely deal with such requests. As a consequence, your order may take longer to complete and your meal might not meet your expectations.

Every community needs a health care system that functions efficiently. In order to sustain an accessible and acceptable service, patients need to use available resources appropriately.

Visits to health care professionals fall into one of three categories.

  • Planned care
  •  Urgent care
  • Emergent care

1)     Planned care is delivered in a doctor’s office. It refers to scheduled appointments for chronic diseases, prescription refills, prenatal visits, pre-operative examinations, annual check-ups, driver’s medicals, and minor surgeries.

2)     Urgent care is when you need same-day treatment for an unexpected health problem that is non-life-threatening and does not require a visit to the hospital emergency department. Walk-in facilities have evolved to deal with ailments of this nature. I provide the same service under the label of ‘Open Access’. Open Access refers to the potential to secure an appointment on the same day or the next day.

Most problems are not emergencies. Despite feeling uncomfortable, nothing bad is likely to happen to you if you wait a day or two. If you go to the ER, the visit will cost 3 to 4 times more than it would at a doctor’s office. This means that there is less money for our health region to spend on recruiting doctors, retaining doctors, luring specialists, building or upgrading our community facilities.

Hospital ER’s are set up to focus on emergencies and not routine health care. If you have a non-life-threatening condition, you often have to wait several hours before a doctor attends to you. Studies report that patient satisfaction rates are the poorest in the ER. This is partly because you will see a doctor that does not know and understand you.

Follow this link to see what kinds of problems are seen in urgent care.

3)     A medical emergency is a sudden and unexpected medical condition (or worsening of a condition) that can threaten your life, your limbs, or your eyesight. It requires immediate treatment.

So, what constitutes an emergency, requiring emergent care?

Try to remember them as the ‘bad B’s’. They include:

  • Breathing problems
  •  Broken bones
  •  Bleeding (includes coughing and vomiting of blood)
  •  Burns (major burns)
  • Brain attack (signs of a stroke)
  • Befuddled (confusion or loss of consciousness)
  •  Blast of pain (any sudden severe pain especially in the chest or abdomen). Click here for the signs of a heart attack
  • Booze (drug overdose or poisoning)
  • Blues (severe depression or thoughts of suicide)
  • Blindness (sudden loss of vision or trauma to the eye)

In order to streamline the flow of health services, help-seeking patients are sometimes deflected to another setting. A triage nurse may redirect a patient from the walk-in clinic to the ER or vice versa. If you have a good understanding of the setting best equipped to serve your problem, you will save time and prevent being diverted to another location.

See you in the clinic, hopefully not in the ER, and may your fortune cookies contain inspiration … not cliches.

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