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13: How To Urgent Care

Aug 20, 2019

Men will sometimes come in to treat a cold before an STI. Wow. Learn the ins and outs of urgent care with PA Justin Knox. Why antibiotics aren’t always best. When you should go to the ER. And why time isn't the best indicator for your symptoms.

Episode Transcript

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Staying Healthy Can Be a Battle

Justin Knox is a physician assistant who works in urgent care. He knows first hand the importance of younger men not taking their health seriously.

It’s common for men in their 30s to assume they will be healthy forever and put off the life changes they should be doing now. These men typically do not have a primary care provider. They wrongly assume they get enough physical activity in through occasional recreation in the summer and winter. They drink too often and a healthy diet is low on their priorities.

Most of these men will only start caring when health problems start happening when they reach their 40s.

Justin cares about his health, but he admits that healthy lifestyle choices can be difficult. Justin is a socialite, so he often goes out with friends, which means drinks and bar food. It can be easy for him to stray from a healthy diet.

Staying healthy is a battle. Your choices may wax and wane, but it’s important to stay focused and make the best choices when you can.

An Urgent Care as a Source of Reassurance

For most men, an urgent care is the first stop for acute problems like a cough or cold. But often, patients will go to an urgent care just to be told there’s nothing the doctor can do. So when should you go in, when should you wait, and when should you just stay home?

Justin says you should trust your instincts. You will will never be turned away from an urgent care. Even if your symptoms end up being nothing serious, an urgent care doctor can still provide reassurance.

Major part of Justin's job is education and reassurance. Educating patients on when to wait, when to seek help, and what they can do at home makes up a majority of his cases.

Fear is a great motivator for patient. When someone is hurt, bleeding, or scared they seek treatment. And turning to the internet for health diagnosis has a way of scaring people more than anything else.

If you have any major health concern, seek professional help. Even if the doctor is unable to provide treatment, they can provide education and reassure you that everything is fine.

Don’t Approach Your Treatment as a Transaction

You’re suffering from what you believe is a sinus infection. You had one years ago. The doctor prescribed you an antibiotic. The symptoms went away a few days later. Now, the doctor is telling you he’d rather wait than give you antibiotics. What gives?

This is the classic mindset of “transactional medicine.” A patient comes in seeking a medication that has worked to treat their symptoms in the past. They pay the copay and assume the doctor will give them the drug that has worked in the past.

More modern practices and newer providers often take a more conservative approach to treatment. They rely on the latest research and clinical data as a guide for best practice rather than relying on the strategies that anecdotally work in the past.

The over-prescribing of antibiotics and pain medications have had serious consequences. Doctors are now dealing with antibiotic strains of diseases and the impact of the opioid crisis. As such, modern treatments are more conservative. Most colds and sinus infections will go away on their own without antibiotics, so modern best practice is to only prescribe antibiotics if the problem becomes more severe.

Trust your doctor and don’t approach your visit to an urgent care as a transaction for medication.

Look at Your Symptoms, Not the Time Frame

When trying to determine whether or not you should go to an urgent care, it’s easy to think of your symptoms in terms of time. You may assume that if a cough lasts longer than five days, you should seek help. Unfortunately, diseases don’t work that way.

According to Justin, there is no definite time frame for any symptoms to get better. A common cold can last seven to ten days in one patient. It can last up to two weeks in another. A persistent cough may last anywhere from five to ten days before there’s any improvement.

Instead of thinking of your symptoms in terms of a timeframe, look for these signs to determine if you need to seek treatment:

  • Has there been a significant change in your symptoms?
  • Are there any new symptoms forming?
  • Are the symptoms getting worse over time?

If you notice any of these, seek help. At the very least, a checkup with your doctor can screen for any underlying problems and provide reassurance if they detect nothing serious.

ER or Urgent Care?

When is something serious enough for an emergency room and when can an urgent care help?

First and foremost, “remember your ABC’s.” That stands for airway, breathing, and circulation. If you are experiencing any trouble with those three systems, go to the ER immediately.

For other situations, Troy and Justin explain what is and isn’t an emergency:

Asthma attack - Where you should go depends on the severity of the symptoms. If you’re seriously struggling to breathe, go to the ER. An urgent care can handle minor breathing difficulties, but they are limited on medications, specialists, and equipment to treat more serious asthma attacks.

Sprained ankle - Most sprains are easily managed in an urgent care setting. An urgent care is able to take an xray and determine how serious the injury is. They are able to give you a brace and instructions for recovery. If they detect anything more serious with your injury, they can send you to get more help.

Broken bones - Like sprains, an urgent care can handle the diagnosis and treatment for most fractures. If they determine the fracture requires a specialist or emergent care, they will get you to where you need to go. However, if you can see the bone, go to the ER.

Lacerations/cuts - If you are suffering from severe blood loss, you’ve severed a finger, or there’s a chance of losing a limb, go to the ER. For all other cuts, it’s best to start at and urgent care. They can handle a majority of cuts in house. If they determine your injury is more serious, they can send you to the ER.

Stomach pain - Stomach problems can be very subjective, so it’s important to pay attention to you body. If the pain is so severe that you can’t stand up or you feel an intense pain localized to your lower right abdomen, go to the ER. These are potential signs of appendicitis.

For less severe stomach pain, start at an urgent care. They can diagnose your symptoms and decide how best to proceed.

Concussion - If you lose consciousness, vomit, or are severely confused after a head injury, go to the ER immediately. These are symptoms of something very serious that needs emergent care.

For a minor bonk on the head, an urgent care can diagnose and treat your head injury.

Numbness in right arm - It’s best to go to the ER. General arm numbness can be complicated to diagnose. It can be caused by all sorts of things, some more serious than others. It’s up to a clinician to rule out whether or not it’s a stroke. However, most urgent care’s do not have the equipment necessary to diagnose a stroke.

Just Going to Leave This Here

On this episode's Just Going to Leave This Here, Scot can’t help but imagine the worst case scenario when people wear flip flops while riding a scooter. Troy is fostering twelve adorable cats in his home, which remind him of an old YouTube video,

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