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When To Use the ER and When To Use Physician’s Care Express

If you have symptoms of a heart attack or stroke, you must go to the emergency room immediately. 

If your child breaks a finger or you have a bad scrape, do you go to the emergency room or maybe an urgent care center?

Dr. Dan Breece, an emergency room physician with Memorial Health System, is here to help you better understand the different roles of an emergency room and a Physician’s Care Express.
When To Use the ER and When To Use Physician’s Care Express
Featured Speaker:
Dan Breece, DO
Dan Breece, DO is an emergency room physician with Memorial Health System. 

Learn more about Dan Breece, DO

Melanie Cole (Host): We know sickness and minor accidents don't just happen from 8 am from 5 pm. High fevers and earaches at night, headaches after work, sore throats and sprained ankles on the weekend. That's why we're here, when your doctor can't be. My guest today is Dr. Dan Breece. He's the medical director for emergency and urgent care services at Memorial Health System. Welcome to the show, Dr. Breece. Tell us a little bit about the difference between the emergency room and Physicians Care Express.

Dr. Dan Breece (Guest): Well, thank you for having me. You know, the emergency department is an area in the health care system that is open 24 hours a day, 7 days a week, 365 days a year. It is prepared to treat any and all emergencies that cross its threshold at any time of the day, so we e take care of all the life-threatening emergencies, be it trauma, if a patient's having a stroke, a heart attack, but it's also equipped to take care of minor illnesses, such as sprained ankles and sore throats. Physicians Care Express is our urgent care. We have two of those in our system. They are equipped to operate between the hours of 8 AM and 8 PM every day. They will take care of the more minor illnesses, such as if people have upper respiratory illnesses, minor burns, colds, flu, minor lacerations, sprains. They are not equipped to take care of the more intense type emergent conditions that we would take care of in the emergency room. 

Melanie: So, can someone just walk in to Physicians Care Express?

Dr. Breece: Yes, they can. They actually can come in. There are no appointments at the urgent cares or the Physicians Care Expresses that we have. They are open from 8 AM to 8 PM. We take patients from the moment they show up and we never turn anyone away. We'll take the last patient that is there before 8 pm.

Melanie: As far as equipment goes, if someone is having, for example, chest pain, what would you tell them? Would you say, "Go to the emergency room or come on into Physicians Care Express"? Do you have the equipment  such as EKG, and such to find out what's going on?

Dr. Breece: We do have the equipment at the urgent care to run an EKG, but we would prefer the patient, if they're having chest pain, that they would get to the closest emergency department that they could. They could do this by calling, of course, 911 if they need to, or having a family member getting them to the emergency department.

Melanie: What about x-rays, things like that? So, if someone has a sprain or break, or something along those lines, can they also come into Physicians Care Express?

Dr. Breece: They absolutely can. In urgent cares, both locations are equipped to have plain film x-rays with real time reads within 30 minutes by qualified radiologists. We can do musculoskeletal type imaging there. It is just plain films. We also have the ability to run rapid strep tests to diagnose strep pharyngitis. We can also do urinalysis as well as urine pregnancy tests and also diagnose mononucleosis at some of our lab capability as well at our Physicians Care Express locations.

Melanie: What do you tell parents, Dr. Breece, because parents, you know, we get a little bit anxious about even the slightest thing. So, if they are not sure which one to go to, their child's got a very high fever, or a really sore throat, or any of these things kids come up with, how do you tell them to decide what to do?

Dr. Breece: Well, the first thing I'd say is that if any parent has a concern about their child, they should consult their physician. Most of the primary care physicians and pediatricians do have an after-hours number that they can consult. If there's ever a question, they can certainly call our health care system and speak to one of our staff members that is on site. If there's a question that the patient may truly be sick and have an emergency-type condition, I would direct them to the care of an emergency department. However, if the patient is just having fever and is just appearing ill to the parent, it is okay to go to the Physicians Care Express. If they are evaluated in the Physicians Care Express and the providers at those locations feel that the patient would need a higher level of care, they will direct the patient there and will arrange transport, if needed, to get to the closest emergency department.

Melanie: That's good information. I was going to ask you that question, anyway. So, I'm so glad that you cleared that up.  Is Physicians Care Express kind of the same as going to the emergency room as far as your insurance, your medical records, do they transfer back and forth?

Dr. Breece: Well, yes, actually. In Memorial Health System, we have a completely integrated healthcare electronic medical record system and today, for instance, I'm in our emergency department. If one of the patients is being seen at a Physicians Care Express, those records are completely visible to me if I was to take over care of the patient and vice versa, as well as if the patient had been there several times in the past. We can pull up their entire health care history. If the patient is also seen at one of our primary care physician offices throughout the system, those records, as well as imaging and labs, are readily available to us.

Melanie: So, what can they expect? We’ve all seen television and what the emergency rooms look like, Dr. Breece, and people running around and machines whizzing about, and what does it look like at the Physicians Care Express?

Dr. Breece: So, at the Physicians Care Express they are, on both of our locations, greeted by a very nicely decorated lobby and a receptionist at the front window when they walk in. They will immediately get them registered and triage them as appropriate for the next available room to be open to be seen by a provider.  We pride ourselves on getting our patients in immediately, as best we can. There's very little wait time at our Physicians Care Expresses. The nurses will initially start the intake process with the patient and then they will quickly be seen by one of our physicians or nurse practitioners working at the location.

Melanie: Can it be used for vaccinations as well?

Dr. Breece:  We typically do not provide a full range of vaccinations at our locations. We do provide influenza vaccine yearly but most of the vaccinations are taken care of at the primary care physician offices.

Melanie: So then, tell us about follow up. If somebody does come into a Physicians Care Express, an urgent care, then do they follow up with their own physician, or, if they're admitted, does the doctor from the Physicians Care Express keep in touch? How does all that work?

Dr. Breece: Sure, no problem. That's a wonderful question. At Memorial Health System, we really value our patients and we want to provide an exceptional patient experience. So, if a patient comes in and they actually do not have a primary care doctor, we will assign a doctor for them. Although we welcome for them to come back to the Physician Care Express for any of their health care needs, really most patients do need an established physician and we're happy to arrange either an appointment for them, or to give them an outlet to where they can have their own physician within our health care system. If the patient is admitted or carries on anywhere throughout the system, our Physicians Care Express physicians and nurse practitioners can certainly follow up on those patients but we would really like to provide them with the good continuity of care within the system.

Melanie: And what about family members? You know, at the emergency room, sometimes family members get quite concerned and they're asked to step out of the room. What's the deal for family members at a Physicians Care Express or an urgent care?

Dr. Breece: We typically will allow a certain amount of family members back to the room while the patient is being evaluated. We, of course, need to focus on the patient and have enough room to perform our exams that are needed for the patient care. The lobby is well-equipped for all the family members that could be waiting on their loved one that is being examined by one of our providers, but you can expect that they will always be updated by one of our staff members that is involved in the patient's case.

Melanie: Dr. Breece, what conditions do you say “absolutely go to the emergency room”, and if somebody says to you "Well, I'm only having minor headaches or chest pain" or something like that, "Are you going yell at me if I come to the emergency room?"  Give your best advice about when you really need to come to the emergency room and don't hesitate.

Dr. Breece: Sure, great question. We will take, first of all, any patient that presents to any of our emergency departments. A patient should never feel like they're burdening us in the emergency room, whatsoever. We want to make sure that they're adequately seen by a provider and triaged appropriately, and then receive the care that they need. Things that absolutely need to come to the emergency department would be any type of chest pain, especially if the patient is having a heart attack and they may not know that they are, we can provide the services to alleviate the most amount of damage that could happen to a person's heart by having a heart attack. We do have a full range of services for that here.  A trauma patient, people that have been involved in a motor vehicle collision or may have fallen from a significant height, say, off of a ladder, or from a tree stand or, something like that, they should be seen in the emergency department because the mechanism of injury may require a much higher level of service. And then, certainly, another couple of classes of patients would be stroke-type patients. We are a stroke center here at Memorial Health System Within our emergency department, those patients are seen quickly and get the treatment that they need as well as obstetrical care. If there's a pregnant mother or a patient like that that needs to receive care, we would prefer them to come to the emergency department to where we can give them a full spectrum of care that they may need.

Melanie: What a great program you’re running, Dr. Breece. Tell the listeners why they should come to Memorial Health System for their care.

Dr. Breece: Memorial Health System has really established itself as a regional health care system for the Mid-Ohio Valley. We pride ourselves on our patients and providing each and every patient that presents to any of our access points, any of our Physicians Care Expresses or emergency departments, with giving them an exceptional patient experience.  We appreciate the fact that they choose us, so we pride ourselves on giving them the highest level of care. All of our physicians and providers and nurses and all of our staff members on our team hold themselves to the highest level of standards and have the highest certifications that they can achieve within their industry.

Melanie: Wow. Great information. Thank you so much for being with us today, Dr. Breece. You're listening to Memorial Health Radio and for more information, you can go to That's Expect more. This is Melanie Cole, thanks for listening.