By Michael R. Grey, MD, MPH, Chair of Medicine, Saint Francis Hospital
Patients and family members commonly struggle with whether or not they should seek medical care with their primary care provider or go to an urgent care center or emergency room. Here, general guidance for adults will be offered that may be useful when faced with a decision of where to seek care, using a few common medical issues that many people experience – sore throat, urinary tract infection, and low back pain. It is important to note that these recommendations are intended as broad advice and are not intended to be diagnostic.
Sore Throat
Adults experiencing a sore throat rarely need to be seen in an emergency room. A sore throat can often be handled with very straightforward treatment, sometimes without even needing to see a physician. The vast majority of sore throats are caused by viruses and will get better with over-the-counter pain medications, or by simply gargling with saltwater. While basic, these options can help with pain as the virus runs its course.
There are two exceptions worth noting. First, if you have been around children or work in a setting where you may have been exposed to strep, you should see your primary care provider. If you are experiencing these symptoms in off-hours, like in the evening or on a weekend when the office is closed, you can go to an urgent care center to get a rapid strep test as well as a focused physical exam. Strep and other infections are treated with antibiotics, so these tests will confirm if medication is necessary. Secondly, if you are having very high fevers and/or trouble swallowing due to severe pain or significant swelling in the back of the throat, it would be reasonable to go to the emergency room. Fortunately, these are rare events and most patients with a sore throat will have complete recovery within 4-7 days.
Urinary Tract Infection
Urinary tract infections, commonly known as UTIs, which are much more common in women than men, can be very uncomfortable and become serious if left untreated. If you suspect you have a UTI, you should contact your primary care office. The provider may recommend testing or prescribe antibiotics. If you are having mild abdominal pain, flank pain, or fever, it could be a sign that the infection has moved to the kidney, and an in-office visit to your primary care provider or trip to an urgent care center during off-hours is advised. If you are experiencing shaking chills, moderate to severe pain, and nausea/vomiting with fever, you may need more intensive treatment, such as intravenous antibiotics and fluids, making a visit to the emergency room the best decision.
Low Back Pain
Low back pain is a very common problem, with almost everyone experiencing it at some point in their lifetime. Chronic low back pain is an issue best addressed by your primary care provider. If the pain is sudden in onset, especially if triggered by an injury or trauma and involves shooting pains down your leg – known as sciatica – you might have a spinal disc that is inflamed or being compressed. Discs are cushions and friction pads for your spine. The majority of these ailments can be managed by your primary care provider with medication, exercises, and ice – or again, an urgent care center during off-hours. Usually x-rays or advanced imaging like MRI are not needed unless the pain lasts six weeks or more, but your provider will advise if necessary.
There are some important exceptions to this general rule. First, if you have a history of cancer or have weakness in the affected leg, you may need imaging studies sooner. Also, if the acute back pain is accompanied by newly developed bowel or bladder incontinence, this might indicate a spinal cord compression, and you should go to the emergency room promptly to rule out a more serious diagnosis.
In summary, it is highly recommended that everyone establish a relationship with a primary care provider, as it is one of the best things you can do for your health. In addition to the wellness and preventive role a primary care provider plays in keeping you healthy, they are also able to manage chronic health conditions like diabetes, high blood pressure, or high cholesterol, along with other common health issues. Having a primary medical home can help avoid complications that may arise due to fragmented care. Urgent care centers are good options for off-hour circumstances, while emergency departments should be reserved for serious conditions such as chest pain, shortness of breath, high fever, or a severe injury.
If you are in need of a primary care provider, Trinity Health Of New England can help. View all locations and providers at TrinityHealthOfNE.org/PCP.
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