Medical Emergency? Be prepared if you’re the new kid on the block

Both of us recently made major moves—one across town in her adopted city and the other to a city about 300 miles away. We were both very excited about the possibility of a forever home in our later years, but we also knew we had much to learn. We were the new kids on the block.  

Moving to or within a new city is often a blank canvas that permits anyone to craft a new life. But it takes work to adjust and feel settled in. Every move requires big changes, but most importantly, at our current older ages, we need good medical services and practitioners in our area for those just-in-case scenarios, as well as routine procedures and care.  

Before anyone makes a move to another location, it’s smart to line up new doctors, dentists, vets and pharmacies. For referrals, start by asking your real estate salesperson, soon-to-be landlord, doormen and friends or family in your new community. Make a list and then go online to check credentials, whether they are taking new patients and accept your insurance. If you like what you read, call and set up an appointment immediately. As we know, it can often take weeks or months to get into a doctor.  

Once you’ve landed in your new neighborhood, also scout it to find the nearest urgent care centers and the closest and best emergency rooms. Put the information into your phone so that in an emergency, it’s only a click away.  

Consider this part of your “what if” plan. A cut, a serious illness, a broken bone requires immediate help. But where do you turn if new in town? Margaret learned the hard way. When she fractured her foot recently, the urgent care around the corner in her new neighborhood was closed for the weekend.  She found another not too far away. Now she’s in their system just in case there’s a next time. She could have gone to an emergency room but was told by neighbors the closest one was always too crowded and not great. Another was a bit off the beaten path but worth it, many told her. The foot was too sore to start going far. She felt a nearby urgent care would be the fastest and easiest. They could take an x-ray (she thought it was a sprain), and she’d be on her way.  

Not so fast. After the x-ray showed a bad fracture, she needed an orthopedist. Next time, she’d probably skip urgent care and go straight to the emergency room where a doctor could have seen her, treated the problem on the spot and in one stop.  

Instead, once diagnosed, she spent hours on the phone. She enlisted the help of others to try to find a doctor who could see her and hoping to find an orthopedic surgeon who accepted Medicare and could squeeze her in for an appointment. She did, he put her in a boot, and she’s on the mend.  

If you’ve moved to a new location or have lived in your area and haven’t taken these steps, now is the time to do so in case of any medical emergency. Also, write down now—in advance--a list of good questions to ask before choosing and receiving care. It’s also good to have a friend or relative who might be willing to accompany you to hear what’s being said when you’re upset and in pain.  

Urgent Care 

Initially, check out which urgent care places are in your new neighborhood and find out if they’re affiliated with a hospital. These centers are for non-emergency problems such as minor cuts (a slice in your finger), poison ivy, sprain (need an x-ray) or an illness such as flu, a bad cold or mild Covid, a rash, stomachache or mild breathing problem.  

Questions to ask in advance:  

1.     What are your hours and days open?

2.     What services do you offer? X-rays, fix wounds, do stitches? You want the list. Not all urgent care centers do the same procedures. We know someone who went to an orthopedic urgent care center affiliated with the reputedly best orthopedic hospital in NYC. However, you must have a doctor on staff to be treated there in an emergency.  

3.     Who’s on staff? Physician PA assistants, nurses and/or doctors? What are their qualifications? 

4.     Do they take your insurance?

5.     How long is a typical wait?  

Emergency Room

When is it prudent to go to an emergency room? A life-threatening situation such as heavy bleeding, deep cuts in visible places on your face and body needing stitches, a bad break, dehydration, trouble breathing, signs of a stroke such as dizziness, loss of balance, vision change, severe headache, numbness, confusing speech, a fall and a bad bump on the head requiring a CT scan to make sure there’s not a concussion or brain bleed. A possible heart attack might also send you there fast.   

If you go to the emergency room, let your primary care doctor know. It helps if your PCP is affiliated with the same hospital. Perhaps they can call ahead, send your records, and get you in faster. 

Questions to ask:

1.     What is the procedure in the emergency room once you arrive?

2.     Should you have someone with you?

3.     Who staffs the emergency room? This can be hit or miss depending who’s on duty. When Barbara broke both bones in one hand and the wrist, she was seen by PAs, not an orthopedic surgeon who wasn’t available. She went to a hospital close to her home, which, while offering good care, didn’t provide the best service in her case, she later learned, from the orthopedist she saw at a major medical center in New York. 

When she was nervous about what they said, she ended up calling a doctor friend in NY, who recommended a colleague whose credentials were as a trauma surgeon. She felt she was in much better hands for the two surgeries that followed and two years of therapy. Yet, when her late mother had prolonged serious pain over several days, the staff at the same original, smaller hospital diagnosed the problem correctly—kidney stones and not a possibility of a heart attack.

4.     Who will be taking care of you initially and down the line?

5.     Will someone explain your diagnosis in detail in simple terms and then contact your PCP?

6.     What is the patient to doctor/medical practitioner ratio?

7.     How long is a typical wait? You might wait longer than if you go to urgent care first, assuming urgent care can meet your needs.

8.     Does the hospital take your insurance? And if not, yes, then what?

9.     Will there be any out-of-pocket costs and what will they be? 

If you stay ahead of the game, you’re likely to feel very good. It’s always smarter to cover all your bases when you need a doctor or dentist or vet immediately in an emergency? And it’s best not to delay. 

While you’re compiling names and places, also line up a list of certain specialists you might need in the future. Again, ask friends, family, your doctors for names of practitioners such as an orthopedist, podiatrist, cardiologist, urologist, gastroenterologist, eye surgeon, gyn, dermatologist, radiologist, periodontist. If you have an emergency and cannot get into an MD, ask if the physician’s assistant can see you, and then perhaps the doctor can squeeze you into their schedule or see you for a follow-up visit. 

Make sure to log into your phone or write down on paper all your medications and the doses. Keep it with you at all times and if any change, update your list. Always carry your insurance card/cards and an ID.  You might also keep a list of any surgeries, procedures and vaccines you’ve had, with dates listed, whether Covid-19 (and know if it was Moderna or Pfizer), flu, shingles, RSV respiratory and other shots. It might be safe to have a blank check on you and credit card for possible payment.  

Also, try not to panic in an emergency. Having the steps mapped out ahead of time will mitigate some of the fear and eliminate the “OMG, what do I do now?”  Hopefully, you get the help you need, the issue will be treated quickly and you will be sent home to recover and rest. Good care will lead to a better long-term outcome, a very good plan. Margaret, who was a good patient and wore her boot diligently, is now back to wearing shoes and walking everywhere in her new adopted city.