A look around the business landscape of Brevard County shows an advancing trend in medical service providers: Urgent Care facilities and Walk-In clinics seem to be springing up all over.

Whether the demand is in response to overcrowded emergency rooms or to patients unwilling to wait for doctors with tightly and over-scheduled appointment books, subtle and pronounced differences exist among emergency departments and urgent care facilities.

National Health Review researched these different facilities and offers information and tips on which to use and for what type of medical situations.

Hospital Emergency Rooms
Hospital ERs - or Emergency Departments as they're commonly referred - are staffed with highly trained professionals who can assist in any type of medical emergency. These departments are accessible year ‘round, 24 hours a day and, legally, cannot turn away patients, regardless of their ability to pay.

While these facilities, connected or part of a larger hospital-backed campus, are designed to accommodate serious and life threatening injuries and illnesses, they often are overcrowded with patients who could have received care from a primary care physician or in an urgent care facility.

According to one study by the Centers for Disease Control, approximately 40% of visits to hospital emergency departments are for non-urgent or semi-urgent problems.

The same is true in Brevard, according to Dr. David Williams, who serves as Medical Director of Emergency Services for Wuesthoff Health Systems and as the Medical Director of Med-Fast Urgent Care Center in Viera.

To help alleviate the problem, Wuesthoff Medical Center-Rockledge in March implemented a new medical screening procedure that will clear its emergency departments by redirecting non-emergency patients to area outpatient facilities.

“There is a critical need to get people who don't belong there out of the emergency rooms,” Williams said.

Across America, emergency department funding has diminished the level of care available while emergency facilities are shutting down due to hospital closings. In the 10-year period from 1993 to 2003 more than 2,000 emergency departments nationwide were closed.

In Florida, though, hospitals may not be opened without attached emergency departments. But that doesn't mean emergency care in Florida is routinely available.

We still have backed-up emergency departments, said Williams, who also works for the cities of Rockledge, Titusville and Cocoa Beach as Director of Emergency Services.

“Urgent Care facilities are a direct response to the diminished response in emergency care facilities,” he said.

Urgent and Walk-in Care Facilities
According to the Urgent Care Association of America, Urgent Care is defined as the delivery of ambulatory medical care outside of a hospital emergency department on a walk-in basis without a scheduled appointment.

Often, these facilities have evening and weekend hours, allowing more access than with a doctor's office, which typically is open only during normal business hours. Most accept major insurance and some accept Medicaid, but call first to be sure.

Dr. Jasen Kobobel operates Brevard Family Walk-In Clinic in Rockledge, attending to both walk-in patients and those with previously-arranged appointments.

Although services might not be immediately available to walk-in patients if Kobobel is seeing a scheduled patient, the wait time is considerably less than a hospital emergency department and the customer service and follow up is one-on-one, he said.

“I'd estimate the average wait here for a walk-in patient at about 30 minutes,” he said.

Quite a contrast from a 2006 study by the Centers for Disease Control which estimates emergency department waits at around two hours in hospitals across America.

The same is true for Med-Fast, a new urgent care center in Viera.

“For $110, patients can walk in and be seen within a half hour for non-emergency medical needs,” said Dr. David Williams, who is board certified in emergency medicine. The center accepts most health insurance carriers.

Both clinics can handle conditions that require immediate - though not life-threatening - care such as the flu, severe colds, dehydration and minor traumas - such as minor stitches, simple fractures and minor surgeries. Additionally, screening services for various tests such as bone density, diabetes and hearing are offered as ancillary services in these facilities. If someone presented at one of these facilities with a life-threatening condition, the patient would be stabilized until emergency responders arrived to take over.

Kobobel says that of the 40 or so patients per day who access his clinic, about one-third (or 13) are walk-in clients.

“When you're sick today, you need to be seen today and this is a service we can offer when doctor's offices cannot accommodate [patients] and when the services of an emergency room are not needed,” Kobobel said.

Dr. Steven Badolato, who runs Premier Urgent Care/Badolato Family Services in Suntree, estimates that his clinic assists about 100 to 150 patients on a regular day. The response has been so tremendous, he said, that the group is planning to open two more facilities - one in North and one in South Brevard - in the coming year.

“We get a tremendous amount of walk-in traffic and even referrals from other urgent care facilities and we see the importance of addressing this need in the community,” he said.

Mentioned in this Article:
Brevard Family Walk-In Clinic is located at 1260 US Highway 1, Rockledge. Hours of operation are from 8 a.m. to 5 p.m. Monday through Thursday, with lunch from noon to 1 p.m.; from 8 a.m. to noon on Friday and from 9 a.m. to noon on the first and third Saturday of each month. For more information, call (321) 636-0005.

Med-Fast Urgent Care Center is located at 7970 N. Wickham Road, Viera. Hours of operation are from 9 a.m. to 7 p.m. seven days per week. For more information, call (321) 751-7222.

Premier Urgent Care/Badalato Family Health is located at 6300 N. Wickham Road, Suite 101, Suntree. Hours of operation are from 8 a.m. to
7 p.m. Monday through Friday and from 8 a.m. to 5 p.m. on Saturday. For more information, call (321) 253-2169 or visit www.premierurgentcare.com.

When to Visit an Emergency Room
The American College of Emergency Physicians offers this list of symptoms or warning signs indicating a medical emergency:

• Difficulty breathing, shortness of breath
• Unusual chest or upper abdominal pain or pressure
• Fainting, sudden dizziness, weakness
• Vision changes
• Any sudden or severe pain
• Uncontrolled bleeding
• Severe or persistent vomiting or diarrhea
• Coughing or vomiting blood
• Suicidal feelings
• Difficulty speaking

If you do need to visit an emergency room, a personal health record could help avoid loss of time and service by attending professionals. The record should contain the following information: current medications and conditions, recent and serious past surgeries, last time visited a hospital and for what reason, list of current doctors and any history of family illness that might impact your health such as cancer, diabetes or heart disease.

When to Visit an Urgent Care Facility
The following is a list of conditions where an urgent care/walk in facility could help:

• Inability to schedule a timely appointment with your primary care physician
• Early stage flu
• Cold
• Sore throat
• Pink eye, ear infections
• Simple screenings or scans
• Minor stitches, lacerations or burns
• Dehydration
• Stomachache or headache
• Ingrown toenail