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Aug 1, 2014







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Local urgent care facilities
Here are some of the local urgent care facilities that do not require appointments:

CMC Urgent Care, 5 Washington Place, Bedford, 314-4567

Hours: Monday through Friday, 11 a.m.-8 p.m.; Saturday and Sunday, 10 a.m.-6 p.m.

Concentra Urgent Care,
1 Pillsbury St., Concord, 223-3000, gourgentcare.practicevelocity.com/concord_nh

Hours: Monday through Friday, 8 a.m.-5 p.m.

Concord Hospital Walk-in Urgent Care,
60 Commercial St., Concord, 230-1200, concordhospital.org

Hours: Monday through Friday, 9 a.m.-8 p.m.; Saturday through Sunday, 10 a.m.-5:30 p.m.

Elliot Hospital at River’s Edge
, 185 Queen City Blvd., Manchester, 663-3000

Hours: Daily, 7 a.m.-10 p.m.

Elliot Urgent Care Londonderry, 40 Buttrick Road, Londonderry, 552-1550
Hours: Daily, 9 a.m.-8 p.m.

Immediate Care of Southern New Hampshire, 29 Northwest Blvd., Nashua, 577-2273, immediatecareofsnh.org

Hours: Monday through Friday, 10 a.m.-8 p.m.; Saturday through Sunday, 9:30 a.m.-5 p.m., and holidays, 9:30 a.m.-5 p.m.

Immediate Care of Southern New Hampshire, 300 Derry Road, Hudson, 577-2273, immediatecareofsnh.org

Hours: Monday through Friday, 10 a.m.-8 p.m.; Saturday through Sunday, 9:30 a.m.-5 p.m.

Immediate Care of Southern New Hampshire at Merrimack Medical Center,
696 DW Highway, Merrimack, 577-2273, immediatecareofsnh.org

Hours: Monday through Friday, 10 a.m.-8 p.m. Closed weekends.





Quick fix, less waiting
Urgent care fills a gap

01/19/12



Two more urgent-care centers popped up in southern New Hampshire in 2011: Elliot Hospital at River’s Edge in Manchester in April, and Catholic Medical Center Urgent Care in Bedford in July. Elliot Hospital also has an urgent-care facility in Londonderry.

Dr. Richard Marcucci, an emergency and urgent-care physician at Elliot, said the need for such centers stems from long wait times for people with “urgent care-type illnesses” at emergency departments, as trauma patients and those with the severest illnesses get top priority.

“There was a need to try to offload some patients from the emergency department and make an option to see patients in an urgent care setting in a timely manner, at a price point that is a little bit cheaper, less expensive than a true emergency center.”

A good candidate for urgent care is “a patient who basically can walk into an urgent care center with symptoms and illnesses that can be treated without perhaps a bunch of expensive lab tests,” Marcucci said.

At both centers, proof of insurance must be shown upon check-in. Symptoms should be presented at that time to determine whether you have any “priority symptoms” (chest pain, shortness of breath, bleeding). Those with priority symptoms will receive attention sooner, said Paul Mertzic, director of community health services at CMC Urgent Care.

Medical evaluations at urgent-care centers begin with a check of vital signs. A nurse then comes in to record symptoms, medical history, medication and allergies. A doctor will conduct a physical exam and determine the next steps in the care process.

Both the CMC and Elliot urgent-care centers also have a lab on premises where they can get quick results on cultures and basic blood work. At CMC Urgent Care, blood work that cannot be done at the center is sent to the hospital using a courier service and the results can often be received within an hour through the hospital’s electronic records system, Mertzic said. Both urgent-care facilities have radiology capabilities for extremity or chest X-rays; CT scans and MRIs can also be conducted at the Elliot River’s Edge location.

“We can pull up the image almost immediately,” Mertzic said, adding that at the CMC Urgent Care center films are also read by radiologists at the hospital’s main campus. Catholic Medical Center patients in need of X-rays only can be seen without an appointment at CMC Urgent Care, he added. “Probably a little over 30 percent of our patients are seen for radiology study,” Mertzic said.

All doctors at the Elliot Hospital Urgent Care center are also emergency department certified to be able to provide the same level of care “only hopefully a lot more quickly and [at a] slightly different fee structure,” Marcucci said. The two Elliot Urgent Care centers and emergency departments share staff members, he added. Physician assistants and nurse practitioners also work at both Elliot centers. One doctor and one mid-level provider (a physician assistant and nurse practitioner) are on daily at CMC Urgent Care, as are a medical assistant and registered nurse.

The CMC Urgent Care facility, less than three miles from the main campus of the hospital, is modeled more after a family practice than after an emergency department.

“We’re proud of this facility,” Mertzic said. The CMC Urgent Care center boasts seven private treatment rooms, some adorned with decals of jungle animals to put younger patients at ease. An ambulance bay is tucked in the back of the facility for quick transport for those needing emergency services at the hospital’s main campus. There is a room at CMC Urgent Care dedicated to ear, nose and throat issues, and another to minor procedures such as suturing.

Waiting times at the Londonderry and Manchester Elliot Urgent Care centers are posted on digital billboards in both areas (there is one above Murphy’s Taproom on Manchester’s Elm Street).

“What we wanted to do was give people out in the community an option to think about. Whether to go to River’s Edge if the time was short or Londonderry…. We gave our community the option to think about the various sites we have and make a decision about where they want to go that would fit into their day,” Marcucci said. The posted wait times are based on an average and wait times may still vary but they represent a better estimate than an emergency department would have, he added. The hours of operation at the River’s Edge Urgent Care are “pretty generous” compared with most facilities, Marcucci said. The River’s Edge center is open 7 a.m. to 10 p.m. daily. Londonderry is open 9 a.m. to 8 p.m.

“We have a broad timeline of hours of operation so we can do the best we can for the community,” Marcucci said. The earlier hours are for those unable to get an appointment with their primary care doctor and the later are for those needing medical attention when their doctor’s office has closed, he added. Patients should not use Urgent Care as their primary care provider, but the hospital’s physician finder services can match them up with one, Marcucci said.

CMC Urgent Care opens later in the mornings (11 a.m. on weekdays, 10 a.m. on weekends) and Mertzic said the facility sees a steady flow of patients through its posted closing times. Mertzic said he has mixed feelings when it comes to posting wait times because they are likely to change quickly. Patients at CMC Urgent Care wait an estimated 15 minutes to be seen and Mertzic said his staff strives to discharge patients in an hour’s time.

Urgent Care at Elliot Hospital is only closed on Thanksgiving and Christmas. The center at CMC offers limited hours on both holidays, New Year’s Eve and New Year’s Day.

Marcucci said most insurance companies use two different charge structures for urgent-care services, a facility fee and a provider fee. Insurance co-payments can total between 60 and 75 percent of what a visit to the main emergency department would cost, he said. Patients may also be billed for additional lab work.

Uninsured patients are not turned away at either urgent-care center. Patients at Elliot Hospital can apply for the Charity Care fee structure, which can sometimes result in free care, Marcucci said —  “It’s something we feel is important for the community,” he added. Catholic Medical Center offers a self-pay option to patients and applies a 20-percent discount to those able to pay the bill in whole at the time of service.

“[Urgent care] is convenient, it’s quick, it’s a nice environment, it’s comfortable … we are prepared for any emergency that comes through the door,” Mertzic said.






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