Experts Discuss Medical Options

By Brandy Brubaker

You’ve come down with a nasty stomach bug, but your doctor’s office is closed for the night. Or maybe your son hurt his ankle during soccer practice, but his pediatrician doesn’t have an available appointment for three days. You don’t want to wait it out, but you’re not sure if you should go to the emergency room or a local urgent care facility.

“Urgent care, in simple terms, is an outpatient medical treatment facility that can see a wide range of illnesses and injuries,” said Dr. Victor Starcher, who works at MedExpress on Don Knotts Boulevard. “It is a stopgap between general physicians and the emergency room.”

Starcher said up to 75 percent of emergency room visits were probably not emergencies and could’ve been just as easily treated at an urgent care facility. That leads to long waits at emergency rooms, he said.

Dr. Carmen Burrell, a physician at WVU Urgent Care on VanVoorhis Road, said urgent care facilities treat people with colds, sore throats, sinus infections, sprains and strains, and simple breaks.

It’s not the place to go if you are having chest pains, are bleeding severely, or think you may have had a stroke.

“If you stop to think about if you should go to the ED or urgent care, you can probably be treated by urgent care,” Burrell said.

Most urgent care facilities have the capability to perform X-rays, some bloodwork, give IVs, and can administer basic vaccines such as tetanus. They can wrap sprains and put on casts for patients with broken bones, as long as the break isn’t too complicated and hasn’t gone through the skin, Burrell said. They can do sports physicals and can prescribe medicine to treat colds or sore throats, for example.

According to MedExpress’ website, urgent care is less expensive and less time-consuming than a visit to the ER. An ER visit takes, on average, about three and a half hours (212 minutes). Most patients are in and out of MedExpress or WVU Urgent Care within 60 minutes, the doctors said.

On average, a trip to the ER costs $373 more than an urgent care visit, MedExpress said. MedExpress, however, charges a set fee of $115 for patients who don’t have insurance. If you have insurance, MedExpress bills insurance and patients are responsible for their co-payment.

There are no extra costs for X-rays, simple lab work or crutches at MedExpress. WVU Urgent Care doesn’t have a fixed fee, but charges a deposit of $125 to patients without insurance. It offers the added benefit of being affiliated with WVU Hospitals, which means urgent care doctors can access the patient’s WVUH medical history. FastCare, Monongalia General Hospital’s urgent care clinic at Giant Eagle in University Town Centre, costs $52 per visit and can access patient history of Mon General patients. FastCare, staffed by Mon General physician assistants and nurse practitioners, is appropriate for patients with minor conditions, such as sore throats, earaches, a flu or a cold, the Mon General website says.

The ER

Both WVU Hospitals and Mon General Hospital have emergency departments (ED) that are ready to handle your personal emergency at all times, doctors said.

“We’re there 24/7 all year for anybody who has a serious or life-threatening condition or a health care need that can’t be met elsewhere,” Dr. Owen Lander, vice chair in the WVU Hospitals ED, said. “If someone asks me which place should I go, it’s a question of, if you think it is an emergency, go to the ER.”

Dr. Bob Curtis, medical director of Mon General Emergency Services, agreed.

“A person with chest pain or very short of breath or with a significant ankle fracture will need to be sent to an ED,” Curtis said by email. “In a sense, the ED is one-stop shopping.”

The convenience comes at a price — it is more expensive and the wait can be longer because patients are prioritized by the severity of their conditions.

“In general, the ED is more expensive,” Curtis said. “The hospital bears the burden of more expensive governmental and regulatory requirements that it must comply with. There is an entire menu of charges depending on the complexity of the problem.

Urgent care is able to have more limited and usually lower charges because they are providing care to lower complexity patients.”

A heart attack, a seizure … and a bleeder

Of course, while some people may be reluctant to try out an urgent care facility, there are always those on the flip side of the coin.

“You’d be surprised what walks through the door sometimes because they don’t want to go to the ER,” Burrell said.

She said she’s had a patient have a seizure in the lobby and others come in after injuring themselves with nail guns.

Dr. David Anderson, of Cheat Lake Urgent Care, also has seen his fair share of misplaced patients, but one takes the cake.

“There was a guy who bled all the way through our parking lot, through the waiting room, and into the treatment room,” Anderson said. His friends “brought him to the quickest place they could get him to.”

But the story of the bloody man who sliced open his arm while helping to move a new oven has a happy ending.

Stopping at the closest medical facility “probably saved his life because we were able to stop the bleeding and call an ambulance to get him to the ER,” Anderson said.

Recently, Anderson was working the Sunday shift at Cheat Lake Urgent Care. As soon as they opened at noon, a man walked in.

He was shopping at Lowe’s and started having chest pains.

That was at 11:20 a.m.

“He was waiting for us to open,” Anderson said. “You’ve gotta love that guy. We weren’t even open, and he was sitting in the parking lot.”

Anderson said the man was taken by ambulance to a local hospital — where he should’ve gone in the first place.

That’s not to say, however, that patients with odd predicaments don’t ever go to the ER off the bat.

Lander said one case that stands out in his memory was that of a 23-year-old man with a traumatic neck injury. WVU Hospitals is a Level I trauma center, one of two in the state. According to WVU Hospitals, the designation means that the hospital is staffed 24 hours a day with specialists needed to treat trauma patients.

He was told it was a gunshot wound, but, although the man had been injured by a bullet, no gun was involved.

“We got the facts and talked to him,” Lander said. “He and his friends had been throwing .22 cartridges into a fire to see what happened.”

The man only suffered a small flesh wound and Lander said he was lucky.

“Obviously, it could’ve been very different.”

- The Daily Mail, Charleston, WV

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