W.O.W. program explains urgent care services

Fallbrook Healthcare District's first Women of Wellness (W.O.W.) presentation, on April 2, featured Dr. Graydon Skeoch and Dr. Donald Kimes, the owners and operators of A+ Urgent Care, which opened that same day at 617 E. Alvarado St. They explained "Urgent Care vs. Emergency Care" to about 150 women and a few men.

Skeoch, who worked in the emergency room of Fallbrook Hospital from March 1995 until it closed on Dec. 20, 2014, said he found out that a community cannot have a freestanding emergency department without a hospital within 10 miles of it. So, he had been working with the healthcare district since the hospital closed to find a way to bring an urgent care facility to Fallbrook.

Kimes, an internist and a friend of Skeoch, started his first A+ Urgent Care in 2000 in Murrieta. The Fallbrook clinic is the fifth one Kimes has opened; the others are in Southwest Riverside County.

Kimes explained that urgent care is a developed specialty, "we take care of low acuity ailments that are not immediate life threatening." Unlike at a doctor's office, urgent care patients do not need an appointment and it is open on weekends, seven days a week, 365 days a year. The hours are 8 a.m. to midnight Monday through Friday and 9 a.m. to 5 p.m. Saturday, Sunday and holidays.

Kimes added, "That doesn't mean we won't be open 24 hours a day in the future; our desire is to meet the needs of the community."

The life threatening cases they cannot handle are strokes, heart attacks, severe lacerations (cuts) and large foreign body penetrations. He said if a person is "uncertain, come down and we will assess it." If necessary, they will call for emergency medical transport.

What they can handle are, colds, coughs, influenza, sinus

infections, pneumonia, bladder and yeast infections, and most orthopedic injuries (like a broken arm). Since 85 percent of emergency room patients are not admitted to the hospital, the urgent care is capable of performing triage and stabilizing those cases with close follow-up care provided.

The doctors will not take over the role of a primary doctor who oversees routine medical exams and preventative care. In case of an acute or chronic illness, a patient who cannot get an appointment with her own doctor can go to the urgent care where the doctors will help her decide if she needs an emergency room visit or if they can help her there.

At the urgent care, Kimes said, "You're in a doctor's environment; we can start an IV, start care and stabilize you." While not an emergency room, it is a "safe place to seek healthcare in a pinch."

Skeoch further explained, "If there is a little voice that says I could be dying, call 911. If you are not sure, we can do an EKG and call 911 if necessary." He said that unless someone has something life or limb threatening, they can go to the urgent care where they have an x-ray machine and will soon have full laboratory services.

Skeoch saw the first patient at the urgent care the night of April 1 when a man came in with a scalp laceration. On the first official day of the facility, he saw seven patients.

When asked how they get paid, they said that they take Medicare, virtually every PPO and Medicare supplemental and most HMO's besides cash, check and credit card. Kimes said they want to work with all insurance companies, as well as medi-cal, to get their services covered. "Our mission is bringing Christ-centered healing to evidence-based medicine," he said.

If it is determined a patient has an emergency, he or she would be sent to the closest hospital, if not quite as serious, the facility that the patient's insurance contracts with. Skeoch said that Palomar is the closest stroke certified hospital while Palomar, Temecula Valley and Tri-City all have catheter labs to treat heart attacks, but the faster the patient can get to a hospital, the better the chance of survival.

He advised, "Know your insurance" and which hospitals it is contracted with before an emergency happens. If a patient prefers to have someone drive her to the hospital from the urgent care, Skeoch said they will tell the hospital what her condition is before she gets there.

Kimes said that healthcare supplies are incredibly expensive so they are working with philanthropic groups, the healthcare district and the Fallbrook Community Clinic.

If someone cuts herself when the urgent care is not open, she can go to a paramedic station for treatment, but most cuts can be treated with basic first aid. Skeoch said that pressure should be put on a cut for 10 minutes; most cuts will stop bleeding at that point. If it doesn't, pressure can be kept on the cut until the urgent care opens. However, most heart attacks happen early in the morning so if someone thinks they are having one then, they should call 911.

The doctors plan on having webinars on their website, http://www.AplusUrgentCare.com, with seasonally appropriate subjects to choose from. Summer topics will include sunburns and mosquito bites.

When asked if a doctor will be at the urgent care all the time, they said a doctor will be there 80 percent of the time. The rest of the time will be covered by a skilled nurse practitioner and a physician's assistant with one of the doctors always on call.

A+ Urgent Care can be reached at (951) 397-4240. They are in the process of getting a toll free phone number.

The next W.O.W. event will be on Thursday, May 7 at 6 p.m. with Ms. Smartplants from the Water Conservation Garden in El Cajon speaking about "Gardening and Well-Being with Butterflies." For more information, email [email protected], or call Fallbrook Healthcare District at (760) 731-9187.