WIS Investigates: Non-emergencies better suited for urgent care facilities

COLUMBIA, SC (WIS) - Medical emergencies can mean seconds between life and death, but not all cases qualify as an emergency for a hospital. Those non-emergency cases contribute to overcrowding in emergency departments and long wait times.

Urgent care facilities meet the need for after-hours doctor care, but knowing the types of medical treatment these centers provide will direct patients on where to go for assistance.

"One person's severe pain is another person's not so much," said Dr. Thomas Gibbons Jr., Doctors Care president.

Service differences

Recently in Lexington, when teenager Davon Capers was stabbed in the chest outside of a Cookout restaurant, it was a true emergency. Friends drove Capers to a nearby urgent care facility instead of waiting for an ambulance. That facility was just closing at 10 p.m. A nurse and doctor from the urgent care stabilized Capers until EMS arrived, but Capers later died at the hospital. Some say it was not necessarily the wrong move.

"I think that would have been actually the best course of action just because that facility could have been able to provide some stabilization that could have made a difference," Gibbons said. "It's hard to know."

Ultimately, Capers would have needed an emergency department and surgery.

"We can see every person that comes in, and we do see every person that comes in and has any hint of an emergency," Gibbons said. "In other words, we don't say, 'Oh, we don't do that' and send them away. We're going to do what we can to help stabilize you. Even let's say if it's a shoulder dislocation, sometimes if you can get the person to calm down, settle down, you can do a reduction without anesthesia. But it's not typical, and so they're going to need conscious sedation, which we do not do in our practice."

The South Carolina Hospital Association agrees.

"The emergency department shouldn't be handling everything," said association Vice President James Walker, Jr.

An urgent care facility can handle anything from minor burns to cuts requiring stitches, a suspected broken bone and other typical non-life-threatening injuries.

"Sinusitis, upper respiratory, flu, gastrointestinal disturbances, aches and pain. You know back pain. Things like that," Gibbons said.

When patients can't get in to see a family doctor for these medical issues, it drives business to urgent care centers.

"We get a lot of business because they call their doctor, and it's going to be, I don't know, not today, two or three days, a week before they can get seen," Gibbons explained. "And so that actually drives business to Doctors Care."

In cases of more severe life-threatening injuries, a head wound, chest pain, a stroke or other major trauma trips to the emergency room are warranted.

"For example a heart attack, they're not going to have the equipment that's required to take care of a heart attack in those centers, even though they say we're here to provide emergency services," Walker said.

Emergency departments are required by federal law to care for anyone who comes in, regardless of their ability to pay. The departments are also required to be open 24 hours a day, seven days a week.

In 2012, according to the Centers for Disease Control, 129.8 million visits were made to emergency departments in the United States alone. ER visits have increased at twice the rate of U.S. population, according to the American College of Emergency Physicians. But often times, it's a lack of insurance or the ability to pay that sends patients to the ER.

"If you're sick with the flu and running a low-grade temperature or maybe even a simple cut or something or might need a couple of stitches, an urgent care center, depending on how they're staffed, may be able to take care of any or all of those needs," Walker explained.

For the same reasons a patient chooses an emergency department, an individual should also call an ambulance instead of trying to drive to the hospital.

"They're trained to provide immediate intervention and that means maybe starting an IV and maybe assessing the injury ahead of time, calling the hospital as they're transporting them," Walker said. "It may seem like you're waiting a little while for that emergency service truck to show up, that ambulance to show up. And it may, but it may also be time well spent."

Physicians encourage patients to take time to know the closest emergency facility to your home and what they are capable of handling. Urgent care facilities and emergency departments each have a role.

"Those are important roles, and the more we can help the public understand those roles and how they differ and where they ought to go depending on what their needs are, I think the better off the health system will be," Walker said.

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