It is not possible to give every answer to every situation, but we’d like to give some general guidance and suggestions.

If you feel that you are extremely ill and in danger, it is always recommended to go the nearest emergency room. However, many problems of an urgent nature are often more easily handled in the office. We do set aside several appointments each day with each doctor for same day visits, so you can usually be seen the same day or next day for an urgent problem.

If the office is closed (night or weekend/holiday), there is always an internist covering our practice, who can be called if there is a question. They can advise if it is ok to wait until the office re-opens, or if emergent care is needed. Urgent care during an off hour can also be provided at the Emergency Medical Offices (EMO) in Berkeley Heights, Greenbrook MediMerge, or Springfield Care Station.

Here are some examples and guidelines:

• Chest pain that is severe (you feel like an elephant is sitting on your chest); call 911, this may be a heart attack. If the chest feels sore when you press on it, or is worse when you twist your upper body, this is probably muscular, and we can see you in the office.

• Shortness of breath that is severe and you feel that you are not getting enough oxygen, you need to be in the emergency room. If you get more winded with exertion than is usual, or can’t quite take a normal deep breath, we can see you in the office.
• Most cases of cough, sore throat, ear pain, or sinus pain and congestion can be handled in the office.

• A severe injury or accident where you are unable to walk or move, or think a bone is broken, needs to be seen in the emergency room. If you are able to walk and move, but are in pain, either we can see you in our office, or recommend that you see an orthopedic doctor at their office.

• A problem such as fatigue, rash, or joint pain should almost always be seen in the office, and not the emergency room.

• If there is significant weakness of one side of your body, difficulty with speech, or significant confusion, that may be a stoke, and needs to be seen in the emergency room. Less severe symptoms can be seen in the office.

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These are basic suggestions for how to approach common urgent problems. We are trying to limit the emergency room for “true emergencies” only, and keep our office as available as possible to see you when needed. If you are not sure where you should be seen (office or emergency room), please do call us.

For more information, see:

• http://www.webmd.com/a-to-z-guides/better-care-at-lower-costs-do-i-need-to-go-to-the-emergency-room and

• http://www.emergencycareforyou.org/YourHealth/AboutEmergencies/Default.aspx?id=26018