The Severe vs. Mild-to-Moderate Test: How to Decide the Best Place for Immediate or Same-Day Healthcare

The Severe vs. Mild-to-Moderate Test: How to Decide the Best Place for Immediate or Same-Day Healthcare

How do you decide what type of care you need when you have the choice to go to your primary care provider, urgent care clinic or the emergency department? Associate Medical Director for Valley’s Urgent Care clinics, Telly Russell, MD, shares an easy way to figure out the best place go when faced with different situations. Going to the right place to get care means:

  • You’ll get care in a time frame suited to your care needs.
  • You won’t be paying more than you need for the care you receive.
  • You’ll get the right care without slowing down the health system for others.

Watch Dr. Russell’s six-minute video or read the transcript below.

0:21: What are the care differences between urgent care and the emergency department?
Very good question. So when I try to assess where a patient should be, I think you have to look at—I like the term “severe.” I also like the term “mild-to-moderate.” So, for severe cases of things, such as severe asthma or severe abdominal pain, or a patient who is coughing or vomiting blood, those are all examples of things that need to be seen in the emergency department.

As far as urgent care is concerned, it is for times when we get more of that mild-to-moderate level. So say we have a patient with a cold who isn’t coughing up blood, but has a typical standard cold, or a patient with a broken bone that isn’t poking through the skin—those are things that would be treated in urgent care, along with pink eye, or a simple upset stomach, or stomach pain that is not severe.

1:33: When should a patient schedule with their primary care provider rather than going to an urgent care clinic?
Another great question. I would say it’s always great to first reach out to your primary provider, or your regular provider that you see on your scheduled visits. One, a lot of times things can be taken care of via MyChart messaging with a provider that already has a sense of who you are, what your health status is, and what they’ve been doing to help take care of you and how successful those things have been. Now, if the primary provider can’t be seen when you need to be seen, then certainly urgent care is an option. I always like to say that for chronic conditions such as diabetes that may not be well controlled, urgent care typically isn’t the best place to manage those things. Urgent care providers, such as myself, do shift work, so the same provider is not there daily. So every time that you come in to urgent care, you may see a different provider, and then that provider is trying to piece together your health history—not only with that one particular condition that you’re coming in for, but to see what other risks you may have. And, I think when you have an established rapport and relationship with your regular provider, it’s much easier to manage those things. It’s easier to go through the history of what we’ve done—we’ve tried this medication, we’ve tried that medication, and this is where we are, as opposed to restarting that entire process in urgent care.

3:11: Valley is now offering urgent care video visits or telehealth appointments. What types of conditions are ideal for this type of care?
I would say pink eye, nausea, simple colds, simple UTIs. On the flip side, if you have a cold where you’re experiencing some shortness of breath, or a UTI where you have either fever or upper back pain, then those are the types of visits that need to be seen in person in urgent care.

3:53: What is triage or why would a patient who comes into the emergency department or urgent care have to wait to be seen even if they arrive sooner than others?
Triage, in its simplest definition in my opinion, is looking for the sickest or sicker patients who need care immediately or immediate care. That may look like a person coming in, in either urgent care or the emergency department, with stroke-like symptoms. And a common saying is “time equals oxygen” when it comes to a stroke patient. So we want to make sure that we can quickly assess that patient if they’re in urgent care. If they are truly having stroke or stroke-like symptoms, then we can make sure that we get them to an emergency department where they’re going to get imaging, and possibly life-saving or bodily function-saving treatments.

4:43: What are the current guidelines for seeking care when someone has an upper respiratory infection (that could be a cold, the flu, or even COVID)?
So, with those three conditions: cold, flu, or COVID, if your symptoms have just started, then I’d recommend treating at home. If it’s been a day or two, you can certainly try things such as over-the-counter cough medicines, honey, which has great medicinal purposes for coughs, or a nasal spray, or teas, to see if your symptoms improve. If you find that your symptoms are lasting longer, meaning they’ve been going on five to seven days, then I recommend you come in to be seen in one of our urgent care clinics—or you can even log on and do a telehealth visit. As far as COVID is concerned, if you fall into one of the higher risk groups, such as being 65 years of age or older, having high blood pressure, diabetes, asthma or COPD, then we you to want to get in touch with urgent care sooner—we can do those visits via telehealth or in person—because we may be able to offer treatments such as Paxlovid, which is an oral medication that helps lessen the severity and how long COVID symptoms last.

6:03: What can you tell us about high standards and patient-centered care at Valley’s urgent care clinics?
At Valley, we embody Valley’s mission, which is caring for our community like family, and we try to do that a number of ways: Putting our patient as the highest priority, and we do that by making sure we show respect and compassion to everybody who comes through the door. We make sure that we introduce ourselves and always try to be great listeners and have a team approach when coming up with treatment plans. At the end of our visit, we thank patients for coming in because we do recognize they have a choice and we are very appreciative they chose Valley.

For more details about deciding where to go for the care you need, see our Know Where to Go chart.

Learn more about Valley’s Urgent Care clinics, offering get-in-line-online service, estimated wait times and telehealth.

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