With a wide variety of health care options available in Southern Nevada, it’s important to understand the roles of primary care providers, urgent care facilities and hospital emergency departments. When used appropriately, these levels of care can serve an incredibly valuable resources for patients, offering a broad range of services spanning from preventative health care to life-saving treatment.
In certain situations, it can be confusing for patients to decide whether their conditions warrant a visit to a primary care physician, urgent care clinic or emergency room. “These three levels of care address three very different needs for patients,” said Dr. John Onyema, medical director of University Medical Center’s ambulatory care centers.
Primary Care:
The importance of building a strong relationship
While not intended to address emergent or urgent health care needs, primary care physicians play a key role in managing an individual’s health care. Many people do not recognize the value of establishing a relationship with a primary care provider until health issues arise, Onyema said.
Onyema, who also serves as a primary care physician at UMC’s Spring Valley Primary Care location, said primary care focuses heavily on chronic disease management and preventative medicine. This includes identifying and addressing potential health issues before they become more serious concerns.
“Primary care providers work alongside their patients to map out a journey to better health,” Onyema said.
Dr. Frederick Lippmann, who provides care to patients at UMC’s Peccole Ranch Primary Care location, said it is essential for patients to form a strong bond with a trusted primary care provider.
“We take care of the whole patient, from their emotional needs to their physical needs,” Lippmann said, adding that he works to establish relationships built on years of trust, which assists with understanding the various factors that can impact a patient’s health. “As a result of the long-lasting relationships and the comforting care that our nurses and I provide, our patients are more apt to follow my recommendations. They have confidence that I have their best interest in mind.”
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Helene, a 77-year-old patient, said she has relied on Lippmann for primary care services for the past nine years. Lippmann has guided her health care over the years, connecting her with appropriate specialists and providing valuable preventative care. “He knows so much, and he answers all of the questions you give him,” Helene said. “I have all of the trust in the world in that man.”
UMC Primary Care Physician Manager Dr. N.S. Subramanyam also advises patients to establish connections with primary care providers who can coordinate their care with specialists, manage disease processes and ensure that preventative diagnostic screenings are conducted. “Everybody needs to have a primary care doctor, even if they are healthy.” he said. “We keep an overall pictwure of the patient’s health, and we play a major role in preventative care and disease management.”
Primary care also serves as a valuable asset for individuals with HIV and many other medical conditions. Dr. Alireza Farabi, an infectious disease/HIV and hepatitis C specialist, provides primary care to individuals with HIV and their family members at UMC’s Wellness Center. Farabi said patients with HIV should seek primary care services from providers who specialize in HIV care, as the virus can increase the risk of many other serious health issues.
While some patients utilize quick care locations for medical needs that would be better addressed by a primary care physician, Onyema said UMC’s health care system connects patients with highly qualified primary care providers to help ensure they receive comprehensive care. Lippmann he frequently sees new patients who initially visited UMC’s Quick Care facilities, which are designed to provide care on a walk-in basis for a myriad of minor emergencies.
Quick Care:
A valuable resource for urgent needs
Bridging the gap between primary care and the emergency room, quick care locations provide urgent care services for an array of minor emergencies and common conditions, including colds, coughs, minor lacerations, skin rashes, allergy symptoms, most fractures and many other ailments. In addition, many quick care locations offer general X-ray and laboratory services.
Melissa, a 34-year-old mother, often visits UMC’s Rancho Quick Care location to take care of her children’s urgent health care needs. Melissa said she has been visiting the quick care for five years, establishing a strong relationship with Dr. Ron Taylor. She said the location serves as a convenient resource for her family, especially when it is too late in the day for her children to see their usual pediatrician.
“I can honestly say that I’ve never had a bad experience there. That’s why we keep going back,” she said, adding that she requests Taylor when she visits the location. “Dr. Taylor is amazing.
We love him.”
Although quick care physicians do not typically see patients as frequently as their primary care colleagues, Taylor said it is not uncommon for patients to request care from a particular physician during their quick care visits, adding that he takes pride in establishing trust among patients who visit the Rancho location.
“I like to be very up front with patients, and I treat patients like I want to be treated,” he said. “That goes a long way in building trust.”
Taylor said working as a quick care physician provides him with the opportunity to treat a wide range of medical conditions, from asthma symptoms and respiratory tract infections to dislocated joints and ankle sprains.
While quick care locations are equipped to handle many health care needs, they do not offer the same level of care as an emergency department. UMC Quick Care Physician Manager Dr. Keralapura Subramanyam said teams will stabilize patients and transfer them to the ER when needed, but she encourages community members to educate themselves about the warning signs of serious medical conditions that require emergency care.
Emergency Room:
Offering life-saving care
Emergency departments provide a high level of care to community members, offering potentially life-saving treatment from specially trained physicians, nurses and other medical professionals.
Dr. David Obert, assistant medical director of UMC’s adult emergency department, said UMC’s services include a Level I Trauma Center, burn care, pediatric care, surgical services and kidney transplants, in addition to many other services.
“We are here to provide emergency services and acute care for the community,” Obert said, cautioning that the ER should not be used as a continuing care facility. “You want to reserve the emergency department for the people who truly need it.”
It may be difficult for community members to determine when a visit to the ER is necessary, said UMC Chief of Staff and Chief of Emergency Medicine Dr. Dale Carrison. He encourages people to immediately call 911 for transportation to an ER if they experience significant chest pain, severe allergic reactions with difficulty breathing, stroke symptoms or other time-sensitive, potentially life-threatening emergencies. ER visits are also appropriate for emergencies such as severe abdominal pain, coughing up or vomiting blood, pregnancy-related bleeding, head injuries that lead to unconsciousness, black tarry stools and many other serious conditions, Carrison said, urging people to call 911 for assistance when needed. Obert adds that patients experiencing neurological complications, severe respiratory problems and significant trauma should also visit the ER.
While every case is unique, and it is difficult to provide a fully comprehensive list of the conditions that warrant emergency care, Carrison said the definition of an emergency is based on the individual patient’s view of the situation.
“If you think it is an emergency, you should go to the emergency department,” he said. “We are available as a resource for the community, and we don’t want to discourage anyone who thinks they have an emergency from coming to the department.”
However, Carrison said patients with less severe conditions such as a sore throat or flu-like symptoms should consider visiting a quick care location.
“Our goal at UMC is to see every patient as rapidly as possible, but people who visit the emergency department have to understand that patients with the most serious complaints are going to be seen first,” he said. “Patients who have chest pain are going to be seen before patients who have a sore throat.”
For parents of young children, determining the need for an ER visit can be even more difficult, as many children lack the communication skills to explain their symptoms. Dr. Kreg Burnette, a pediatric emergency department attending physician at Children’s Hospital of Nevada at UMC, said children should visit the ER when they have difficulty breathing, severe pain and broken bones. Less severe conditions including coughs, congestion, mild fever and rashes may not require care from ER physicians and can likely be treated by a pediatrician or urgent care physician, but Burnette advises parents to use their judgment when making decisions about emergency care.
“If you’re not going to sleep at night, and you’re scared for your child, then that is a reason to come to the emergency department,” Burnette said. “We would much rather see a patient and send you home than have it become something much more serious.”
For more information about UMC, visit www.umcsn.com.