The Doctor Is In: A primary care provider is important

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(KPLR) – Where do you go when you have a medical problem? Dr. Sonny Saggar talked with Elliot Weiler about when you should go to the emergency room and when you really shouldn't, and why having a relationship with your primary care provider is important.

Connect with Dr. Saggar, the Medical Director at St. Louis Urgent Cares at:
• Twitter: @DoctorIsInSTL
• Facebook: DoctorIsInSTL
• Blog:


1. So what’s wrong with not having your regular doctor, and just going to the ER whenever you`re sick or injured?

Absolutely nothing, if you don`t mind waiting a few hours, paying through the nose with a copay and seeing someone who doesn`t know anything about your past medical history.

Let me first be sure that I do think many people should ALWAYS be seen in the Emergency Room, and these are the patients who have real emergencies. Things like:

●     An unconscious person

●     Suspected heart attack or chest pain

●     Difficulty breathing or choking

●     Severe bleeding

●     Serious burn

●     Seizures

●     Gun shot or stabbing

●     Suspected stroke

●     Altered mental status or confusion

●     Suicide attempt or plans

●     Drug overdose or poisoning

●     Trauma, serious limb/sight/life-threatening injury

●     Near drowning or electrical shock

●     Anaphylaxis

●     Imminent childbirth

●     Any emergency in which you are unable to safely get to hospital on your own

But for those people who don`t have an emergency, or perhaps a chronic medical condition, there are far better, far cheaper, far quicker and far more efficient ways to get seen and treated.

2. Are you talking about urgent cares again?

Actually no. I`m not here to talk about urgent cares. I want to encourage people to get set up with a primary care provider. I say `provider` because it might be a doctor or a nurse practitioner or physician assistant. Basically someone who knows everything about you and whom you can reach by phone, text or email. Someone you can go and see whenever you have a problem. If it`s not an emergency, then it can wait until the office is open.

What I`m emphasizing here is getting yourself established with a general internist or family physician, or even an OBGYN or pediatrician for the kids. That way, we will have the best care available to people, who might otherwise just think they have to go to the Emergency Room, whatever their illness or injury may be.

3. But what if you need stitches or an x-ray? Don`t those patients need to go to the Urgent Care at least, if not the ER?

There are some primary care groups that actually have arrangements set up with urgent care clinics, so that their patients can go and be seen, get the x-ray, the suturing, the breathing treatment and so on, and not have to go through the costly process of registering as an ER or Urgent Care patient. is just such a group, which has a presence in both the City and County. If you really want to have access to all those procedures and tests, ask your primary care provider if they have such an arrangement.

4. So, people can be seen at an Urgent Care, for the cost of a Primary Care copay?

It`s the best of both worlds. You get the more expensive urgent care management (which is the same as the even more expensive ER management), but at a primary care price, which is a fraction of the copay and wait time. Not only that, you have continuity of care.

5. You mean your primary care provider will know what happened when you came in?

That`s right. It`ll be documented in the same EMR, or Electronic Medical Record, software that your primary care provider is using, so he or she just has to login and read the chart, knowing exactly what happened to you when you went to the urgent care clinic the previous day. has done exactly that, resulting in An Affordable Alternative to Expensive Emergency Room or Urgent-Care. Now your primary care provider is fully equipped to treat any non-emergency problem. Doesn`t that make you feel better already?

6. Why do so many people have this knee-jerk reflex to go to the ER or Urgent Care, whenever they`re sick or injured?

I think it`s human nature to see red, in this case blood from a wound, and panic, not caring at all about the cost or the wait time, and head straight for the ER, or worse, call 911 when they don`t even have an emergency. Over 85% of ER patients can easily be managed in the Urgent Care, thereby drastically reducing the cost and the wait time.

And now, with the walk-in primary care arrangement with urgent care clinics, we can reduce the cost even more, but now also have some continuity of care.

7. What other advantages are there to having a primary care provider?

You have a relationship with someone who can help control your high blood pressure, diabetes, high cholesterol and other chronic medical conditions.

You also have someone who will protect you from being exposed to unnecessary doses of dangerous radiation. Many emergency physicians, and less so, even urgent care providers, will be a little more hasty to get a CT scan for a headache or a tummy ache, than that patient`s own doctor might.

There`s a disturbing trend of people getting far more CT scans (equivalent to the radiation of 500 x-rays) than they should, often because the ordering physician is afraid of litigation or sometimes because there`s money to be made. If you`re ever in doubt about getting a CT scan or other test, at an ER or Urgent Care, don`t be afraid to question the physician who is suggesting it, and be sure it really is a good idea. Having your own primary care provider on speed-dial is a great way to prevent such unnecessary testing.

8. A primary care provider is really like having a medical advocate?

Exactly. The primary care provider is, by definition, the first person in the medical field who should be looking out for your wellbeing as well as your safety. It`s like having that family member who is also a doctor, but you can ask him anything you want about your health and he`ll be totally honest with you.

- - - partners with St. Louis Urgent Cares which presently has 4 urgent care clinic locations around St. Louis.

Connect with Dr. Saggar, the Medical Director at St. Louis Urgent Cares at:
• Twitter: @DoctorIsInSTL
• Facebook: DoctorIsInSTL
• Blog:

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