Urgent care has a role to play


1/11/2018

Going to an urgent care center can be the right choice when an injury — such as a sprained ankle or a serious cut, or symptoms, such as shortness of breath — deserves immediate attention but is not a life-threatening emergency. If it is after-hours or if getting an appointment with one’s own physician quickly is unlikely, area residents are finding that Emerson’s urgent care centers, in Hudson and Littleton, provide what they need.

Corey Cutler found this out last summer after he woke up at 2 a.m. with stabbing pain in his right shoulder. A firefighter who works for the towns of Bolton and Lancaster, he wasn’t aware of straining his arm on the job.

“I took some ibuprofen and assumed the pain would be gone by the morning,” says Mr. Cutler, who is 23 and lives in Clinton. “But I tossed and turned and hardly slept.”

There was no improvement in his pain, so he had a decision to make. “I didn’t need an emergency room, so I went to the Emerson Urgent Care center in Hudson,” he says. “I got right in. It was quick and easy.”

Linda Kintz, MD, an urgent care physician, examined his shoulder and asked if he could have strained his shoulder while sleeping or during work earlier that week. “His pain was so bad that he could barely move his arm,” she notes. “Spontaneous infections do arise, and we don’t want to miss them, because they can become serious. I ordered an x-ray and a blood test. Fortunately, they were both negative.”

On the theory that Mr. Cutler somehow sprained his shoulder, she prescribed an anti-inflammatory medication, steroid and mild muscle relaxant. “Dr. Kintz suggested that I take it easy, and the shoulder became progressively more comfortable,” says Mr. Cutler. “By day five, the pain was gone.”

He returned to Emerson Urgent Care at Hudson a week later. As a result of not moving his shoulder, his neck — specifically the trapezius muscle — became progressively painful. “Because Corey essentially had a mild frozen shoulder, the nearby muscles compensated by going into spasm,” Dr. Kintz explains. “He was prescribed a stronger muscle relaxant, which helped.”

Mr. Cutler is pleased with the care he received. “I need both arms for every aspect of my job — not just putting gear on to fight a fire, but to stabilize a ladder, operate the jaws of life, which weighs 100 pounds, haul a 50-foot hose line and carry a patient on a stretcher.”

Acute musculoskeletal injuries, such as the one that brought Mr. Cutler in that morning, are a good fit for urgent care centers, says Dr. Kintz. “We can perform an x-ray to rule out a serious condition, evaluate the patient and start getting them better. We send a full report to their primary care physician and counsel them to follow up with an appointment there.”

“Dr. Kintz was professional and upbeat, which I appreciated,” says Mr. Cutler. “Best of all, I’ve been great ever since — no pain, despite doing plenty of strenuous work.”

Relief in the form of an urgent care visit

Sam Goldgar, 11, started to think his big toe must be broken. “He stubbed his toe running upstairs,” says his mother, Erin McBee. “After a few days, it was still bothering him. He was limping and continued to complain about it.”

She knew an x-ray would quickly rule out her main concern: that he was causing damage by walking on a fractured toe. Ms. McBee called Emerson Urgent Care at Hudson and brought Sam after school. Dr. Kintz examined the toe and ordered an x-ray, which was quickly reviewed by an Emerson radiologist. The imaging test revealed a subtle fracture; fortunately, the bone was not displaced.

Joseph Palomba, MD, medical director, saw the radiology report and referred Sam to John Cahoy, MD, PhD, an Emerson pediatric orthopedic surgeon, for a follow-up appointment. “Toe fractures typically require minimal care,” he notes. “We suggest people wear shoes with hard bottoms to protect the foot. Our concern was the slight fracture could affect normal growth of the toe.” A few days later, Sam saw Dr. Cahoy, who determined his toe was healing normally.

Three months later, Sam developed a low-grade fever, unrelated to his toe injury, that caused concern. “A lot of the kids at school had strep throat,” Ms. McBee recalls. “The school has a protocol stating that students who have a fever should stay home for 24 hours. I kept Sam out of school for one day.”

But his fever continued, and he was listless. “When he came home from school, I said ‘let’s get you tested,’” says Ms. McBee. It was May, and the Littleton Urgent Care Center had recently opened just a few miles from their home in Harvard, where Ms. McBee also has a law office.

Samuel Sockwell, MD, examined Sam and performed the throat swab that is required to perform a rapid strep screening. “They made it easier than the other times I had it done,” says Sam. “They told me to relax, and it wouldn’t hurt so much.” After an easy throat swab, there was good news: he was negative for strep throat.

“It takes less than ten minutes to get an answer,” says Dr. Palomba. “When someone is positive for strep throat, we begin them on antibiotics immediately. And when it’s a child with a negative rapid strep screen, we also send out a throat culture for another check to be sure they are fine.”

Sam had cold symptoms for a few days, and his mother had something else: a sense of relief. During each urgent care visit, Sam’s problem was taken care of quickly by a physician who sent a report along to Christopher Cooper, MD, his pediatrician at Acton Medical Associates. “Having an urgent care center nearby is so convenient,” says Ms. McBee.

At Emerson urgent care: physicians, labs and x-rays

They are the conditions that require prompt attention but don’t pose an immediate or serious health threat. Ear infections and sprained ankles are two examples. At each of Emerson’s urgent care centers in Hudson and Littleton the staff is trained to evaluate, provide a diagnosis and, where appropriate, get treatment started.

Patients see a physician, and both centers have an x-ray suite and on-site lab. “We perform various procedures, such as closing lacerations, removing foreign bodies and draining abscesses,” says Dr. Palomba.

“We often serve as a conduit to Emerson clinical services — specialists, such as hand surgeons or ear, nose and throat physicians, or centers, such as the Center for Advanced Wound Care and the Cantu Concussion Center. I’m happy to call ahead and explain why the patient needs to be seen quickly.”

Urgent care staff emphasize follow-up care. “We provide instructions to patients before they leave, and we send a full report to their primary care physician,” says Dr. Palomba.

Those who have visited Emerson’s urgent care centers appreciate the convenience — the ability to get in for an appointment quickly, to request an appointment online and the extended hours, from 8 a.m. to 8 p.m. on weekdays (9 a.m. – 5 p.m. on weekends and holidays).

“Most people are choosing wisely,” notes Dr. Palomba. “They understand the difference between emergency care and urgent care.”

Emerson Urgent Care at Hudson is at 38 Highland Commons East in Hudson, near Party City and Cabela’s. The Littleton Urgent Care Center is at 830 Constitution Avenue in Littleton in The Point shopping center. Emerson is at the top of the hill behind Tavern in the Square restaurant. Visit emersonurgentcare.org or call 978-287-8990 to reserve an appointment.