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In Case of Emergency 

The Rise of Immediate Care Centers

click to enlarge Vassar Brothers Medical Center RN Sarah Ogasian enters updates on an emergency room patient into the hospital’s new electronic medical record system.
  • Vassar Brothers Medical Center RN Sarah Ogasian enters updates on an emergency room patient into the hospital’s new electronic medical record system.


FirstCare Walk-in Medical Center in Highland bears little resemblance to your stereotypical doctor’s office. Missing are the white walls, stuffy feel, and lack of colorful accents. Replacing these medical standbys are wood floors, warm rooms—each with its own TV, a coffee bar, and an art show on the walls that changes regularly and features the work of local artists. “We kind of made it like a spa,” says Dr. Stephen Weinman, the medical director and one of the owners of FirstCare.

It’s all part of FirstCare’s efforts to keep up with a recent trend in the medical industry that favors more patient-friendly customer service. The goal, says Weinman, is to make the experience of going to the doctor’s office as pleasant and as painless as possible. “We use a hotel model of customer service and people like that. People really like customer service,” Weinman says.

But friendlier, more spalike customer service is not the only trend FirstCare is part of. The facility is one of a growing number of urgent care centers that are popping up all over the Hudson Valley and the country. Urgent or immediate care centers are a type of walk-in medical facility that can handle minor emergencies or ordinary medical problems that are not worth going to the emergency room for but are pressing enough that patients want to treat them immediately and don’t have the time to wait for an appointment with a general practitioner. Most urgent care facilities are open late, on weekends, and on holidays. If you hurt your ankle playing basketball on Saturday and want to get it X-rayed and treated immediately, you can go to an urgent care center. Or, if you think you have the flu but don’t want to wait until your family doctor is free, you can walk into an urgent care facility without waiting for an appointment.

“Urgent care is really kind of like the halfway point between the doctor’s office and the emergency room,” Weinman says. “We typically offer more services than a doctor’s office but less services than an emergency department.”

The idea of urgent care is not that new, but in the last decade or so it has taken off. Weinman explains that “the urgent care idea, it’s probably like a 20-year-old concept—that’s when the first urgent cares started popping up—but it’s within the last 10 years that it started to really catch on and grow.”

Weinman adds that the surge in popularity in urgent care facilities has a lot to do with the convenience they offer patients. “One of the things with our culture is people don’t like to wait and that doesn’t seem to be changing. If anything people are getting less interested in waiting. I’ve got a sore throat, the doctor says ‘We’ll see you tomorrow,’ people are like ‘No, I want to be seen yesterday.’ So they just come here.”

He added that urgent care facilities can treat people with non-life threatening injuries quicker than a hospital emergency room.

“In an emergency department you may be seen by a doctor within half an hour but you’re going to be there for a while waiting for tests to come back and the whole process. Whereas in urgent care, typically you’re seen by a doctor, you’re treated by a doctor, you’re discharged by a doctor relatively quickly. Usually you get treated, get your prescription and discharged all within 30 or 40 minutes.”

Dr. Joyce Moscowitz is the medical director of Health Quest-operatedurgent care centers in Lagrangeville and Wappinger Falls. She says going to an urgent care facility instead of an emergency room saves not only time but money as well. “I think ERs—many of them—are overcrowded and over burdened, so the wait time can be very long. Also, what the emergency room charges is quite a bit of money. We are a much more affordable alternative.”

She adds, that for minor problems going to an urgent care facility can be “so much better than going to the emergency room. It’s not chaotic, it’s pretty calm and tranquil but we take care of the problems and we do it in a relatively efficient way.”

Dr. Ferdinand Anderson, the owner and Medical Director of Emergency One, an urgent care center in Kingston, says that facilities such as his have become more and more popular “because people have different levels of problems,” and urgent care centers help get patients with immediate health problems treated right away.

“I think that the health care system is looking for ways to contain cost and yet provide care, and that’s kind of difficult sometimes when you’re dealing with a centralized health care system, [it helps] if you spread it out,” Anderson says. “Urgent care centers are significant because they allow patients to access care without getting into a scheduled visit that might not be appropriate for them. It might be something so simple, they just basically need something taken care of so they can go on with their daily lives. It’s not something where they have a complex medical issue that needs to be managed.”

Danielle Bradt is the practice manager for EmUrgentCare, an urgent care company that has a location in Saugerties and another in Coxsackie. She says that new urgent care facilities will continue to open and existing ones will remain popular because they help meet the demand for quick, high-quality care.

“The urgent care model will continue to grow because it offers ideal accessibility to the services people need including walk-in service, extended hours, and rapid, yet professional treatment. Patients increasingly have a choice in where they will be treated, and facilities like EmUrgentCare will continue to deliver on the criteria that matter: quality care, convenience of service, and customer service,” Bradt says. “Urgent care facilities provide peace of mind to a community. Knowing that an urgent care facility is there if you need it is a real comfort to people. People may not be willing to go to an emergency room for a minor health concern and they may not be willing to wait weeks to see their primary care doctor, urgent care gives them another, more convenient option.”

Bradt adds that people often do not realize how much some urgent care centers can do. “Many times people underestimate how much EmUrgentCare can handle. For example, we have an X-ray on site and can treat broken bones and serious lacerations.”


click to enlarge The children’s lobby at FirstCare Walk-In Medical Center in Highland.
  • The children’s lobby at FirstCare Walk-In Medical Center in Highland.

When You Need an Emergency Room

Despite their capabilities, urgent care centers do not take the place of an emergency room and there are times when it’s appropriate to call 911 or drive straight to the hospital.

Bradt says, “If a patient is suffering a life-or-limb threatening medical emergency, they should call an ambulance, go directly to a hospital’s emergency department, or call 911 for immediate assistance.” She adds,
“Hospital emergency departments are equipped to handle life-threatening medical emergencies. However, they are often called upon to treat minor injuries that may be a better fit for urgent care or primary care facilities. This can result in long wait times, as anyone that has spent time in an emergency department can attest.”

Weinman says that you should go to the emergency room or call 911 when you’re experiencing “severe pain of any kind. So, severe chest pain, severe headache, sudden severe pain in your arm or leg for no real reason, [or] an injury causing severe pain.”

He adds that if you have a severe cut or shortness of breath you should go to the emergency room as well. “We can treat something like mild asthma, but someone who’s ready to collapse because they can’t breathe—they need to call an ambulance.”

Doctors who work in urgent care facilities often have backgrounds in emergency medicine and are generally equipped to recognize problems that are potentially life threatening. When patients do come in with dangerous symptoms, they are immediately sent to the nearest emergency room.

Anderson says that because the staff at urgent care facilities usually have an emergency medicine background, they’re also skilled at recognizing when an apparently minor problem can pose a major health risk. “The back pain that’s not a back pain but an aneurysm, the headache that’s not a headache but it’s someone that’s having a stroke— sometimes things are very subtle and you have to be on your toes.”

Urgent care facilities also don’t take the place of a standard doctor’s office. Weinman says that before patients come to his facility, “we encourage people to call their doctor first and see their doctor first so they have that continuity of care.”

Anderson says, “I feel that we supplement doctors’ offices.” He adds, that a regular family doctor is still the best place to go for health problems that need long term management such as high blood pressure. “The private practitioner is going the way of the dinosaur, which is unfortunate because those individuals have dedicated their lives to their patients.”

Anderson opened his first urgent care facility in the early ‘90s. At that point there were few facilities like it. “We were doing things that weren’t really done except at a hospital,” he says. “I’m glad that urgent care is growing up and doing better.”

Anderson says that in the future he’d like to see more cooperation between hospital emergency rooms, urgent care centers, and general doctors’ offices so that patients can be sent directly to the facility best suited to handle their health problem.

“I think going forward, my hope—and maybe it’s the hope of a dreamer—is that these operations can network together instead of people feeling that ‘I want to own everything or nothing at all,’ he says. Anderson adds that as a result of having more urgent care facilities around, patients have more choices “and when there are choices, then you have a better system. I’m sure hospitals wouldn’t like 100 minor problems coming into their emergency room when they’re trying to give high end care to more urgent cases.”

Health Quest, the organization Moscowitz runs her urgent care facilities for, also operates many other health facilities including standard primary care doctor’s offices and three hospitals—Northern Dutchess Hospital in Rhinebeck, Putnam Hospital Center in Carmel and Vassar Brothers Medical Center in Poughkeepsie. Moscowitz says this network of hospitals, urgent care facilities, and standard medical offices helps her urgent care centers coordinate care. “We have a rapport with the doctors in the hospital and the doctors in the other practices associated with Health Quest,” she says. She adds that although urgent cares don’t replace emergency rooms or doctor’s office they do provide a much needed service to patients. “I can’t say that urgent cares are the answer to everything but I can say that myself and other members of my family have used urgent care for years when it’s been necessary.”

RESOURCES

Emergency One Urgent Care Center Eonekingston.com
EmUrgentCare Emurgentcare.com
FirstCare Walk-in Medical Center Firstcaremedcenter.com
Health Quest Immediate Care Centers Health-quest.org

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