I’ve spent considerable time in emergency rooms, this past week, assisting others in getting care. One person was admitted to the hospital, with the hope of getting home in time for Thanksgiving. Unfortunately, that wasn’t to be. This person’s adult child, who lives out of state, is having a hard time finding out what’s going on with their parent as lots of people are off and those working are over extended.
Today’s post is all about getting the care you or your charge needs on weekends/ holidays and after hours.
Consider the following:
• Prepare for emergencies: The more information you have, the better the emergency care plan you can put in place. If you haven’t done so, discuss the following with your/their medical provider at an office visit:
- Who you should contact in the event of an emergency.
- What symptoms require an immediate trip to the emergency room and when to first call the provider?
- Is your provider connected with a “Virtual Urgent Care” option and/or some form of 24/7 walk in care. Should you pre-register for this service? Will your insurance cover it?
- Can you e-mail them? Do they regularly check their e-mail?
- Do they offer after hours telemedicine?
- Do they have an answering service for after hour calls? If they don’t offer any type of after-hours care, that’s a good indicator that you need another provider.
Know the urgent care center(s) that serves your area, their hours of operation and what type of payment they require.
• Unless it’s an immediate emergency, such as severe chest pains, a call maybe all you need. Only call your provider for urgent/emergent situations. If the question or situation can wait until the next day, do so. When you call you will most likely get their answering service so give concise and relevant information, with a phone number where they can reach you. Call backs are generally less than a half hour. When the call is returned, explain symptoms and ask what your next steps should be. Ask if telemedicine is an option.
• Consider Urgent Care over Emergent. Because emergency rooms are very busy, assess whether you could go to a local urgent care center instead. Waits are generally shorter at an urgent care center and the bill will be less.
Urgent Care centers are capable of treating a wide variety of illnesses, including respiratory illnesses (asthma, pneumonia, cold/flu symptoms, upper respiratory infections), gastrointestinal illnesses (vomiting, diarrhea), open wounds (including those needing sutures or staples), rashes, and minor skin/wound infections. Sprains/strains and even some fractures can be managed by Urgent Care center physicians, which typically have an on-site laboratory and X-rays. Consider where you live as to what may be offered by Urgent Care. Living near a major ski resort, our local urgent care center does high volume orthopedics.
Virtual urgent care can deal with things like acne, allergies, constipation, cough, diarrhea, ear problems, fever, flu, headache, insect bites, nausea, pink eye, rash, respiratory problems, sore throats, urinary problems (UTI), vaginitis or vomiting.
There are a lot of “virtual doc” websites. Talk to your provider in advance to see if it would be appropriate for you to use one should need arise, and if they have a service they’d recommend.
• Take a Friend with a Pen: When you are having an emergency, it’s good to have someone with you that can take notes and help you understand what’s being said. Further, if they know your history, they can provide information that you may forget. Since ERs can be very busy, your friend can also track someone down if there is no response to your call button.
• Understand what a “hospitalist” is: This is a fairly new term, coined in 1996, that refers to the doctor that takes care of you in the hospital. Hospitalists manage and treat a significant range of complex and comorbid disease conditions. Hospitalists typically undergo residency training in general internal medicine, general pediatrics, or family practice. A minority of hospitalists specialize in fields including neurology, obstetrics and gynecology, and oncology.
While your provider may refer you to the ER, they will most likely not be overseeing your care there or in the hospital should an admission be required.
If you want to understand how you, or the person in your charge is doing, get the name of the hospitalist and work with them. Just like your regular provider, if they are off, someone will be covering for them regardless of time of day.
• Use a Patient Portal: Most healthcare services are tied in to “Patient Portals.” These are basically a way for you to access your health information including hospital test results, medical records, and a direct line of communication to your physician's office regardless of time. You access this on-line and can use an app available on your smart phone. Check with your provider about how to access the patient portal for the place where you or your charge receives care.
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