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Urgent care or emergency care? Which is right for you?

While the words “urgent” and “emergency” may seem like synonyms in the dictionary, in today’s medical world, there’s quite a difference between the two.

Urgent Care doctors Christopher Olenek and Kathleen Fraga are both emergency-trained but they both now work from Urgent Care facilities here in Vero Brach.

The two agree with the definition set out by New York’s Mount Sinai Hospital saying, “In general, an emergency condition is one that can permanently impair or endanger the life of an individual.”

Examples of situations or conditions requiring emergency care, according to Mt. Sinai, can include: “Severe chest pain or difficulty breathing; compound bone fractures where the bone protrudes through the skin; any kind of convulsion, seizure or loss of consciousness; fevers in infants less than three months old; uncontrollable bleeding; gunshot wounds; moderate to severe burns; poisoning; head, neck or back injuries; pregnancy-related problems and any sign of a heart attack or a stroke.”

Urgent medical conditions, meanwhile, still require care as soon as possible and those might include: Sprains or strains; moderate back problems, some falls, mild-to-moderate breathing difficulties; persistent coughs; congestion, eye irritation; fever or flu; vomiting; sore throat and urinary tract infections.

(There are exceptions. For example, Fraga says even a relatively minor fall or bruise for someone taking a prescription blood thinner such as Coumadin, Xarelto, Pradaxa or Plavix is likely to be a case best treated at the emergency room.)

She adds, “Anything that’s life-threatening or limb-threatening or threatening to the eye should go straight to the ER,” but for just about any other medical problem, she says, Urgent Care facilities like the ones she works at here in Vero and and up in Sebastian usually offer patients more convenience, better hours and much lower prices than emergency rooms.

Olenek’s East Side Urgent Clinic, directly across from the Indian River Medical Center, is also a walk-in facility but it offers its patients on-the-spot prescription refills and, in many cases, medical tests such as MRIs can be performed, read and analyzed before the patient leaves the building.

While Fraga has only been here on the Treasure Coast about a month, (she’s fresh off a five year stint with U.S. military hospitals in Mannheim and Stuttgart, Germany), Olenek has been practicing in Vero since 2005.

Both have their medical roots in New York. Olenek graduated from the New York College of Osteopathic Medicine before serving his internship at Mt. Sinai and his residency at Columbia University and is board-certified in emergency and family medicine while Fraga graduated from Albany Medical College before completing her residency at the Stony Brook Medical Center on Long Island and is a member of the American College of Emergency Physicians.

In any event, it should be – but apparently isn’t – clear to most people that the ER really isn’t for everyone or for every problem.

A study conducted by the National Center for Health Statistics determined almost half of all patients who visited an ER in this country last year did so primarily because their primary care physicians’ offices were closed.

Urgent, Walk-In or “Doc-in-a-Box” facilities can be a better way to seek medical care for non-life threatening problems when your primary care doctor is unavailable.

For starters, Urgent Care facilities generally offer longer hours of service than most primary care physicians. The Pointe West walk-in facility, for instance, where Fraga practices, is open from 8 a.m. to 7 p.m. Monday through Friday and from 9 a.m. to 5 p.m. on Saturdays. Olenek’s East Side Urgent Care is open Mondays through Thursdays from 8:45 a.m. to 6 p.m. And on Fridays from 8:45 a.m. to 4:45 p.m.

Then there’s the issue of waiting time. Emergency rooms see patients based on the severity of injuries. Someone complaining about back pain could quickly become low man (or woman) on the totem pole if, say, multiple victims of a vehicle crash are rushed into the ER.

And, while it’s impossible to put a price on good health, your wallet might still appreciate you choosing Urgent Care over the ER. “Coming here,” explains Fraga, “the average price would be between $70 and $130 whereas the average emergency room bill is $1,300 and it could be much higher.” Olenek cites a slightly higher average patient price in the $150 to $250 range but that’s still appreciably below the cost of an ER visit. Moreover, he says, he bills insurance companies as a primary care provider so if your insurance co-pay is only $20 then that’s what your bill would be at East Side, though he adds that he doesn’t accept HMO insurance plans or Medicaid.

(Generally, walk-in facilities do not treat indigent patients. Those patients usually have no recourse but to go to emergency rooms for all their medical problems, severe or otherwise.)

Sports-related injuries are common reasons for people to visit walk-in facilities according to Fraga and, having spent five years tending to U.S. Army personnel in Germany, she has certainly seen more than her fair share of those.

Olenek cites respiratory problems in general and sinusitis, bronchitis and pneumonia as among the most frequent problems he sees along with “polypharmacy” or patients with multiple prescription drugs from multiple doctors, often for the same condition, that are causing unwanted side-effects.

“Many people here have multiple specialists and no primary care doctor so they may have two different medications for the same thing,” Olenek explains, “I work at getting people off medications or fine-tuning them to make sure there are no duplications.”

There certainly are times and circumstances in which a trip to the emergency room is the best move a patient can make. At other times, however, walk-in Urgent Care facility with highly trained physicians, nurse practitioners and/or physician’s assistants can be a faster, less frantic and far less expensive alternative.

Dr. Kathleen Fraga can be found at either the Walk-In Care Center at 1960 Pointe West Drive in Vero Beach or at 801 Wellness Way, Suite 107 in Sebastian. The Vero phone number is 772-226-4250. Dr. Christopher Olenek’s East Side Urgent Clinic is at 960 37th Place, Suite 102, directly across from IRMC in Vero Beach. The phone is 772-770-6225.

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