Experiencing ear pain doesn't always mean you have an infection. While antibiotics are effective for treating bacterial ear infections, they are not a solution for all types of ear pain. Here are some common non-infectious causes of ear symptoms:

• Cerumen (Earwax) Impaction: Wax build-up can lead to a clogged sensation and an unpleasant smell, but it will not leak thin fluid from the ear. Often, individuals notice symptoms after using Q-tips or when water becomes trapped after swimming or bathing. Treatment typically involves professional wax removal.

• Eustachian Tube Dysfunction: This often feels like clogged ears or pressure changes, sometimes accompanied by popping sounds. It is commonly triggered by upper respiratory infections or changes in air pressure, such as during flights. Temporary relief may be achieved through yawning, swallowing, or performing a Valsalva maneuver, and treatment can include decongestants or nasal sprays.

• Temporomandibular Joint (TMJ) Disorders: Pain in the TMJ, located near the ear, can mimic ear discomfort. This is commonly caused by jaw clenching, teeth grinding, or other dental issues. Management includes warm compresses, NSAIDs, and dietary adjustments with soft foods.

• Middle Ear Effusion: Often following a cold or during allergy season, fluid can accumulate behind the ear drum. This condition is not always infectious and may clear up on its own. However, persistent unilateral effusion should be evaluated to rule out more serious conditions.

• Eczematous Skin Conditions: Itchy, irritated ear canal skin, often flaking, can result from underlying eczema rather than infection. Mineral oil or topical steroid drops are usually helpful in managing these symptoms.

• Sudden Sensorineural Hearing Loss: This rare condition involves a sudden drop in hearing ability without any visible abnormalities in the ear exam. It requires urgent treatment with oral steroids and consultation with an ear specialist.

If you are unsure of the cause of your ear pain, consult a healthcare provider for an accurate diagnosis. Remember, symptoms such as facial paralysis, severe headaches, liquid soaking your pillow, or swelling around the ear should be treated as emergencies and evaluated immediately in an ER. Understanding the underlying cause ensures appropriate treatment and quicker relief.

Looking to learn more, reach out to Freedom Doctors or schedule a Meet & Greet Zoom visit to see how you can benefit from Direct Primary Care.

Other topics you’re interested in hearing about send us an email. Contact Us.

By: Deborah Palmer

When you’re feeling congested and unable to breathe with ease, one of the first things you may reach for is a decongestant. Decongestants are drugs that are specifically designed to provide relief from nasal congestion by reducing inflammation and promoting the opening up of air passages. However, not all decongestants are created equal, with some being proven to be ineffective. Let us discuss decongestants, their effectiveness, and what your options are this cold & flu season.

Decongestants are drugs that help to alleviate nasal congestion by constricting blood vessels in the nasal passages, reducing inflammation, and allowing more air to flow through the passages. These drugs can be taken orally or applied topically (via nasal sprays or drops).

There are two types of decongestants: adrenergic and anticholinergic. Adrenergic decongestants, such as phenylephrine (found in Sudafed PE and many over the counter Sinus formulated cold medications) and pseudoephedrine (found in Sudafed available from the pharmacy), work by stimulating the sympathetic nervous system to constrict blood vessels in the nasal passages. Anticholinergic decongestants, such as ipratropium bromide (available by Rx), work by blocking the action of acetylcholine, a neurotransmitter that is involved in the constriction of blood vessels.

Phenylephrine and pseudoephedrine are the only oral nasal decongestants available without a prescription. However, Phenylephrine is the only oral decongestant available “over-the-counter” (aka outside the pharmacy) after products containing Pseudoephedrine moved "behind-the-counter" in the early 2000s due to federal regulation aimed to combat illicit manufacturing of methamphetamine.

Have you ever said to yourself the “real” Sudafed just works better, well you were right. Phenylephrine has been found in a study done by the Cochrane group found to be no more effective than a placebo in treating congestion. As such, phenylephrine is being pulled from some retail pharmacy shelves.

While Phenylephrine may not be effective, Pseudoephedrine is still effective in treating nasal congestion, this drug, however, due to its regulation is only available only behind the pharmacy counter. In addition, anticholinergic decongestants such as ipratropium bromide have also been shown to be effective in treating nasal congestion.

It is important to note that decongestants should be used judiciously as they can have side effects. Adrenergic decongestants can cause rebound congestion if used too frequently, while anticholinergic decongestants can cause dry mouth and throat, dizziness, and blurred vision. In addition, decongestants can interact with certain other medications, especially those used to treat high blood pressure and depression.

Decongestants are designed to provide significant relief from nasal congestion, but not all of them are created equal. While phenylephrine may be commonly used as you can get it over the counter, it has been found to be ineffective than other decongestants such as pseudoephedrine and anticholinergic decongestants. Patients should discuss the use of decongestants with their healthcare provider, especially if they have underlying medical conditions or are taking other medications. Decongestants should be used only as directed and with caution to avoid adverse effects.

Looking to learn more, reach out to Freedom Doctors or schedule a Meet & Greet Zoom visit to see how you can benefit from Direct Primary Care.

Other topics you’re interested in hearing about send us an email. Contact Us.

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]]>What’s in Your Medicine Cabinet - Common Decongestant Proven IneffectiveFreedom DoctorsMon, 26 Jun 2023 15:12:07 +0000https://www.freedom-doctors.com/blog-1/accesstocare6299368a205dbb5856795cdd:62b2172548cac22aabf60b14:6478ea045c01bb25cdb114ee

By: Deborah Palmer

Health insurance is only half of the equation when it comes to accessing healthcare. Many people, even those with health insurance, struggle to access the healthcare services they need. While having health insurance is necessary for most Americans, it won’t guarantee immediate access to healthcare. In fact, there are many factors that can impact a person’s ability to receive necessary care. Depending on the insurance plan, patients may be subject to high deductibles, limited coverage, and other restrictions that could make accessing care difficult. Even those with comprehensive health insurance may have trouble getting an appointment with a primary care provider or a specialist due to long wait times, especially if they live in more rural areas.

1. What is Health Insurance? Health insurance is a form of insurance that helps to cover the cost of medical and surgical expenses. It is a way for individuals to protect themselves from the financial burden that comes with unexpected health issues. Health insurance can be purchased through an employer or privately and can cover a range of healthcare services, such as doctor visits, hospital stays, and prescription medication. While health insurance is often a necessity in our society, it does not automatically ensure quality healthcare.

2. What is Access to Healthcare? Access to healthcare refers to a person’s ability to obtain medical attention when they need it. This includes physical accessibility to medical services, financial affordability of healthcare, and overcoming social, cultural and linguistic barriers. A lack of access to healthcare can result in delayed or inadequate treatment which can worsen a person’s health or lead to more severe medical conditions. It is important to note that access to healthcare can exist independent of health insurance.

3. How Does Health Insurance Impact Access to Healthcare? While health insurance can be a valuable tool in obtaining healthcare services, it does not guarantee access. For example, high out-of-pocket costs such as copays, deductibles, and coinsurance can make healthcare unaffordable for some individuals, even if they have insurance. Additionally, some insurance plans have restrictions on the types of healthcare services they cover or limit the number of visits a person can make to a healthcare provider. Some health insurance plans (notably HMO plans) require referral from an in-network PCP in a time where PCPs are already in short supply. These limitations create barriers to accessing healthcare even for those with health insurance.

4. What Can be Done to Improve Access to Healthcare? It is crucial to recognize the impact that access to healthcare has on a person’s overall health and wellbeing. Steps can be taken to improve access to healthcare such as improving affordability, increasing the number of primary care physicians available, implementing preventative programs to reduce healthcare disparities. Advocacy and policy changes can also have a significant impact on improving access to healthcare for those who are currently underserved.

Another option is that of “Direct Primary Care”, an alternative practice model that’s removes insurance from the equation, allowing for access to care that is more personalized and at a reasonable upfront price. With direct primary care, patients pay a flat monthly fee for their care and direct access to their doctor when they need them. Services include routine checkups, chronic disease management. Direct primary care providers work to build a strong relationship with each patient, which allows them to provide more customized care.

The accessibility and availability of healthcare services is another major benefit of direct primary care. Because direct primary care providers have fewer patients and don't have to deal with the complexities of insurance billing, they’re able to offer same-day or next-day appointments and extend their hours beyond regular business hours. This makes it easier for patients to get the care they need when they need it, without having to wait days or weeks for an appointment.

Direct primary care also can help patients save money on healthcare costs. Since direct primary care providers charge a flat monthly fee, patients don’t have to worry about the high deductibles and copays associated with traditional insurance plans. Additionally, direct primary care providers are able to spend more time with each patient, which means that they can offer more personalized care and help prevent health problems before they become serious.

While health insurance is important for financial security in the event of unexpected medical issues, it is not the same as access to healthcare. Having health insurance does not necessarily guarantee that a person will be able to obtain the medical attention they need. In order to address health disparities and improve health outcomes, it is crucial to focus on both health insurance and access to healthcare, we can work towards a more equitable and just healthcare system for all. If you’re looking for a more accessible and affordable way to manage your health, direct primary care is definitely worth considering.

Looking to learn more, reach out to Freedom Doctors or schedule a Meet & Greet Zoom visit to see how you can benefit from Direct Primary Care.

Other topics you’re interested in hearing about send us an email. Contact Us.

By: Deborah Palmer

So what if my child needs medication to help bring down their fever?

Let us define “fever’. A fever is an abnormally high body temperature, we use >100.4 degree F as the marker. Fevers are your body’s normal response to fighting an infection or illness. Though fevers, especially in children, can be scary know that you child’s immune system is doing its job.

Fever Reducing Medication in Children

First thing first there are multiple OTC agents we use to bring down your child’s fever. Acetaminophen (Tylenol) and Ibuprofen (Motrin) are you over-the-counter options.

Use of medications in children used 6 months of age should be used under the guidance of a physician. Fevers in children <2 months old are considered medical emergencies and should not be ignored.

When to Call your Doctor

• Their fever is higher than 104 degrees F.

• Medications such as ibuprofen or acetaminophen don’t break the fever.

• Their fever lasts more than five days.

• You’re concerned they aren’t behaving normally.

Seek Immediate Medical Care

• Infant is under 2 months old (this is considered an emergency)

• Lethargic or non-responsive

• Continuous crying

• Excessive drooling

• Difficulty breathing

• Difficulty eating or swallowing

• Difficulty urinating

• Severe abdominal pain

• Neck stiffness

• Seizure

• Fever rash (small bleeding spots under your skin)

• Shows signs of dehydration (decreased urination, AKA fewer wet diapers, dry mouth, no tears with crying, or sunken soft spot on the head)

It children, especially newborns, it can be difficult to differentiate between a simple virus (like the common cold) or a more serious infection (like meningitis, pneumonia, or a UTI ). Sometimes your doctor will need to order further testing, such as blood or urine tests, chest X-ray, or spinal tap, in order to determine the cause of an infant’s fever.

Children’s Tylenol (Acetaminophen)

 Dose based on weight. Doses may be given every 4-6 hours as needed or as directed by your provider.  Do no exceed more than 5 doses in a 24 hour period.  If your child is less than 8 weeks old and has a rectal temperature of 100.4F or greater, please call your doctor. 

Children’s Motrin (Ibuprofen)

Do not use Ibuprofen under 6 months of age unless specifically directed by your doctor.  Dose based on weight. Repeat every 6-8 hours as needed or as directed by doctor.  Do not exceed more than 4 doses in 24 hour period.

Your doctor may suggest you alternate doses of Acetaminophen and Ibuprofen to help control your child’s fever.

Medications to Avoid in Children

#1 Aspirin - NEVER give children aspirin because of the risk for a rare but dangerous condition called Reye's syndrome.

#2 Ibuprofen - DO NOT give infants under age 6 months any medicines that contain ibuprofen.

Above are pediatric dosing charts for both Tylenol (Acetaminophen) and Motrin (Ibuprofen). This information is not intended to be a substitute for professional medical advice. Please consult your doctor’s office or call to schedule a visit with Freedom Doctors today, if you have any questions or concerns

By: Deborah Palmer

Direct primary care (DPC) is a model of healthcare delivery which focuses on patients receiving primary care from an individual physician or practice. This system of healthcare delivery differs from traditional fee-for-service models in that it eliminates the middleman from everyday delivery of medical care. As a result, patients are able to receive medical care at a lower cost, with fewer barriers to access.

In direct primary care, the patient pays the doctor directly for services, rather than the doctor seeking reimbursement from an insurance company. A typical DPC membership will involve an initial enrollment fee, followed by monthly payments for ongoing care. These payments can be made via cash, check, or credit card. In exchange for these payments, patients are granted direct access to their physician and can receive unlimited visits without additional fees or co-payments.

Direct primary care provides numerous advantages to both patients and physicians alike. For patients, this model offers superior access to quality healthcare providers with greater convenience than traditional fee-for-service models. Patients typically benefit from shorter wait times as well as lower overall costs for treatment than what is found in other healthcare systems. Physicians benefit from direct primary care by avoiding expensive overhead costs associated with billing insurance companies and other third parties. They also have more time available to provide personalized services and build relationships with their clients.

In summary, direct primary care is an affordable alternative to traditional fee-for-service models that allows patients to enjoy quality medical services while avoiding high costs and lengthy waiting periods associated with the delivery of traditional medical care.

Looking to learn more, reach out to Freedom Doctors or schedule a Meet & Greet Zoom visit to see how you can benefit from DPC.

Other topics you’re interested in hearing about send us an email. Contact Us.

By: Deborah Palmer

Welcome to our second edition of “What’s in your medicine cabinet?.” It’s important to know what medications you're taking, just because a medication is over-the-counter does not mean it’s without risk. All medications have potential side effects and some medications (prescription and/or over-the-counter) should not be taken together. Please always disclose any over-the-counter medications you’re taking with your doctors. If you have questions about your medications please reach out to a physician or local pharmacist.

This week is all about pain medications (analgesics). An analgesic, or pain reliever, is a medication that reduces pain.

There are three main types of analgesics:

1. Acetaminophen

2. NSAIDs

3. Opioids

Today we are focused on those medications (Acetaminophen and NSAIDs) that are readily available for purchase over-the-counter.

By comparison opioids are powerful painkillers that are derived from opium and are available by prescription. They can cause addiction and respiratory depression, so they should only be used under the guidance of a physician when other options have failed.

What is Acetaminophen?

Acetaminophen is a pain reliever that is found in over-the-counter medications like Tylenol. Acetaminophen is a type of medication that is commonly used to treat pain and fever.

Acetaminophen is generally considered to be safe and effective. However, it can also cause some serious side effects, such as liver damage.

What is an NSAID?

NSAIDs, or Non-steroidal Anti-Inflammatory Drugs, are a type of medication commonly used to treat pain, inflammation, and fever.  These medications include Ibuprofen (Advil, Motrin), Naproxen (Aleve) and Aspirin (salicylates). 

NSAIDs are the most commonly prescribed medications in the world. NSAIDs that are only available by prescription include Celecoxib (Celebrex), Etodolac (Lodine), Fenoprofen (Nalfon), Indomethacin (Indocin), and Ketorolac (Toradol). Prescription NSAIDs are more potent than over-the-counter NSAIDs and can cause more serious side effects. It's important to talk to your doctor about the risks and benefits of taking any of these medications before you start taking them.

Are over-the-counter medications safe?

While over-the-counter medications are generally considered safe, they are not without risks, they can cause serious side effects in some people. So it's important to talk to your doctor about the risks and benefits of taking any over-the-counter medications, including acetaminophen and NSAIDs. Always ensure you take medications as directed.

When are NSAIDs contraindicated?

Although NSAIDs are effective for treating a variety of conditions, they can also have some serious side effects. NSAIDs can increase your risk of gastrointestinal problems such as heartburn, stomach ulcers and bleeding. They can also increase your risk of heart attack and stroke.

NSAIDs are contraindicated in patients with active gastrointestinal (GI) bleeding, peptic ulcer disease, kidney disease, those with a history of heart attack or stroke or those taking high-dose aspirin or other NSAIDs (this including the prescription medications as listed above).

Avoid taking NSAIDs on an empty stomach.

When is Acetaminophen contraindicated?

Acetaminophen is metabolized but the liver, so if you have liver problems or heavy alcohol use you should not take acetaminophen without talking to your doctor first. Even normal doses on acetaminophen in those with liver disease can have serious side effects.

What other medications to look out for?

Cold medications are a big culprit for hidden pain medications.  Many medications will contain acetaminophen for pain/headache/fever relief, though there are a growing number of cold medications that now have ibuprofen instead. Always be sure you read labels and follow dosage instructions carefully.

Please note that care for acute vs. chronic pain differs, if you are looking for personalized recommendations for your symptoms give Freedom Doctors a call and we can schedule a visit.

Other topics you’re interested in hearing about send us an email. Contact Us.

What Is an Online Doctor?

Online doctors, telehealth, virtual visits, video visit although different names they essentially describe the same concept, medical care provided outside of the traditional brick and mortar doctors office. In light of a recent pandemic and ever growing time spent daily interacting online, from social media to emails and remote work from home it is evident that our interaction with technology is here to stay. The medical industry is evolving and digitizing, most everyone seems to have an EMR (electronic medical record) and patient portal. So it's not surprising that online doctors have gained traction over the last few years. Availability to an online doctors has allowed better access to care in areas that may have poor access to in person visits or for those patients who have difficulty, for whatever reason, making into the office for a visit. There is no replacement for a traditional office visit especially when a physical examination is needed, but there are areas that excel in this respect, take mental health care for example.

Online doctors have become popular, but you might have a lot of questions regarding online doctors. Although online doctors have become popular with the aim of providing better healthcare accessibility, there are restrictions.

Telehealth requirements

Policy changes during COVID-19 made it easier for those providing and receiving telehealth care, many of these policy changes were only temporary measures under the COVID-19 public health emergency declaration and are constantly changing. Telehealth policies and regulations are dictated by the individual state, during the pandemic many states allowed providers to deliver telehealth services across state lines.

How does an online doctor work?

Telehealth services allow access to professional medical advice in the comfort of your own home. Providers can choose to provide telehealth (phone or video visits) as part of the their regular office schedule, there are insurance regulations in regards to this. Additionally are specific telehealth companies that help connects doctors to patients through their platform. Once you setup your account, you will have the option of selecting the available provider or time based on your preferred preferences. Those who are new to the online care system should contact an agent via online contact. If your chosen online doctor is covered by your insurance you may input these data before confirming your appointment. Frequently Asked Question

What online services are available?

Primary care physicians and specialists in many areas of medicine now have incorporated some sort of virtual doctor service; patient portal messaging, telephone and video visits. The services vary greatly back on the online doctor you see. Online doctors can offer many of the same services as the medical provider you see for your in person appointments, but not all online healthcare professionals are created equal.

Common virtual services include primary care, urgent care, specialist consultations, chronic care follow-up, medication prescribing.

Mental health services has really flourished in the last few years, including psychiatry consultations and therapeutic services for individuals, couple and families.

What can online doctors treat?

The list of conditions that online doctor services treat is expansive. Medical care of minor illnesses and injuries, routine care, prevention are easily provided by telehealth.

How do online doctors treat & diagnose?

Online doctors work a little different than in-person consultations since the physical examination is limited; taking a good history is important and physical exam as appropriate. The ability to order further testing including labs and imaging studies or schedule a follow-up appointment or provide referrals is dependent on the provider or telehealth platform. You may be directed to seek further care in person when more information, testing, or further evaluation is needed.

Can online doctors prescribe medications?

Yes, online doctors are able prescribe medication, as appropriate.

Most doctors are able to send prescriptions electronically to your authorized pharmacy, unless there are restrictions on the kind of medication prescribed. Online doctors can prescribe medications that including antibiotics, antivirals, prednisone, inhalers, topical creams.

Certain medications that you may need to inquire about before you see an online doctor; these commonly include anxiety/depression medications, pain medication, sedatives, muscle relaxants, medications for erectile dysfunction, birth control, injectable medications. These medications usually require routine follow-up thus your primary care doctor or mental health provider is usually the one that should fill these medications.

Controlled substances?

Controlled substances are closely regulated, these medications include medications for pain and sedatives. Many online doctor platforms don't prescribe any controlled substances.

Prescription refills?

In some instances an online doctors may prescribe medication refills depending on the medication for specific condition. Refills will be for short supply unless ongoing care in provided by a licensed physician on the platform.

Scheduling an appointment with an online doctor

Most online doctor service allow you to schedule an appointment via phone or online.

First you will need to create an account and complete some basic questionaries include medial history, current medication, allergies. You will have an electronic medical record created, similar to your doctors office, which keeps your medical information securely accessible to both you and your provider. Depending on the platform your provider may be able to access noted from previous visits also. If your chosen online doctor that is covered by your insurance you will have to input your insurance information or payment method prior to the visit.

Once you setup an account, you will have the option of selecting the available provider or time based on your preferred preferences. When it's time for your online doctor appointment you will have to check in online and you will normally wait in a "virtual" waiting room until the doctor is ready to start your visit.

Where can I find a good online doctor?

If telemedicine is something your current doctor or specialist already offers, great, look no further! Unfortunately, it isn't always that easy to get into see a doctors, even your own primary care physician.

When looking for an alternative healthcare provider for urgent or ongoing care, doing homework is essential. Check out online doctors reviews. You want to see someone with the appropriate medical and state licensing, certification and compliance with all HIPAA requirements to ensure your privacy.

Check out our previous blog about how to choose a good doctor for you and your family.

Wait times?

One of the big selling point for telehealth is quick availability of an online doctor. Many companies offer same-day appointment booking and minimum waiting times. Most of the time you can schedule an appointment for your preferred visit time similar to your regular doctor office. Many telehealth companies provide access to video and phone consultations 24 hours a day, allowing unlimited access to care.

Online doctor cost?

The cost of online doctors visits are dependent on lots of factors, including what platform you use, your condition, do they accept your health insurance. If they don't take your insurance ask about what the cost would be if you self-pay. Flexible spending (FSA) and health savings account (HSA) should be able to be used to pay for services that may be out of network, but ask your insurance company to be certain.

Freedom Doctors accepts anyone regardless of their health insurance, call to inquire about pricing today.

Is an online doctor right for you?

At minimum you need to have access to reliable phone and/or internet connection. If you cannot access in person care for whatever reason (inability to leave work, transportation issue, difficulty with child care, etc..) accessing an online doctors can be a good choice for you

When is an online doctor not the right choice?

Telehealth is not intended for emergency calls; concern for heart attack, stroke, breathing difficulties, call 911 or proceed immediately to the emergency room. Check out our previous blog on when the emergency room is the right place to be.

Pros vs. Cons of online doctors:

Pros:

• Doctor on demand

• Speak with someone much more qualified at answering your health concerns than Dr. Google

• Certain specialities really thrive in the online work, such as behavioral health care, since often times a physical exam in not needed

• Same and next day appointments may be more generally available

Cons:

• Lack of medical records including previous care plans, labs, imaging and specialist notes

• Limited physical examination, for certain conditions an in person visit is required

• Limited primary care services, inability to complete comprehensive annual exams

• Lack of access to in office testing

Final verdict

Telemedicine isn't going anywhere anytime soon, online doctors have their role, but it is important to understand the limitations.

Ensure that you're seeing a doctor your trust or a company with a good reputation; ensure any medical provider is licensed and board-certified in the field they are practicing in and that they are able to provide care in the state where you are in at the time of the visit.

Other topics you’re interested in hearing about send us an email. Contact Us.

It's best to be prepared, know where to go before you need to go before you need to seek treatment. Urgent care vs. emergency room?

What is the difference between Urgent and Emergency?

A medical "emergency" is a serious, sometimes deadly condition which requires immediate treatment. Alternatively "urgent" medial conditions should receive timely, but not emergent medical care.

Why choose an Urgent Care?

Urgent care helps to fix the gap when you cannot get into to see your regular doctor in a timely manner (or don't have a primary care provider), but don’t have a life threatening condition requiring a trip to the emergency room. If you personally haven't experienced the frustration of not being able to get a same day/next day appointment with your primary care, I'm sure you know someone who has. The goal to allow affordable, non-emergency access to care. Urgent care clinics provide care for minor illness or injury and have available appointments outside the 8-5 hours of most doctor offices and offer weekend hours.

Urgent care centers are still relatively new; prior to the 1970s urgent care didn’t exist, your only option was the Emergency Room or your primary care doctor.  Unlike urgent care centers, emergency room visits are more expensive with longer wait times.

Urgent care clinics are not intended to replace your primary care physician or a the emergency department.

Medical Emergency - When to Skip the Urgent Care?

Medical emergencies are those that put you at risk of death or longterm disability if not treated in a timely manner. Listed are health issues that require immediate emergency treatment:

• Chest pain

• Difficulty breathing

• Trauma due to accident or fall

• Severe abdominal pain

• Worse headache of your life

• Sudden vision loss

• Sudden weakness or numbness of face or body, especially one-sided 

• Coughing or vomiting blood

• Severe burns

• Severe bleeding

• Suicidal or homicidal feelings

If you are having a medical emergency, do not delay, dial 911 or proceed to the nearest emergency room.

How are patients prioritized?

Emergency rooms wait times are based on severity of illnesses, life threatening situations (see above) requiring immediate medical attention will be seen first. Since emergency departments treat conditions more serious than those found in walk-in clinics and this affects wait times, for the worse.

What sets Freedom Doctors - Mobile Urgent Care apart from most Urgent Care Clinics?

When you’re looking for an urgent care near you; what’s closer than your own home? Freedom Doctors Mobile Urgent Care is different because we're "mobile", so we bring the doctor to you when you're sick.

Freedom Doctors Mobile Urgent Care is a house call urgent care serving Southern-central Massachusetts including Holland, Wales, Brimfield, Sturbridge and Northern-central Connecticut including Union.

We also offer virtual visits (telemedicine) throughout MA and CT. We do no provide emergency care, if your concern if more serious you will be directed to go to the emergency department.

What can an Urgent Care treat?

Urgent care can treat a variety of non-life-threatening conditions including strep throat, ear infections, urinary track infections, minor asthma attacks, skin conditions, minor broken bones, lacerations requiring stitches, and much more.  See a full list of Freedom Doctors - Mobile Urgent Care services.

An urgent care center can administer medications and do basic procedures, say you require stitches, need a boil lanced or a nebulizer treatment.

What’s different about a Retail Clinic?

Retail clinics located in drug stores and grocery stores came into existence in the early 2000s, these are staffed by nurse practitioner and physician assistances (not physicians).  Although not actually urgent cares, they can diagnosis and treat minor illness such as strep throat, urinary tract infection, pink eye, ear infections, skin conditions, and minor injuries such as joint sprains, minor wounds and prescribe medications when medically appropriate.   However, if you need stitches, a retail clinic isn't appropriate. 

Who will treat my injury or illness?

Freedom Doctors is staffed by a compassionate board-certified physician.

By comparison most traditional urgent cares are staffed by a combination or physicians (MD or DOs), physician assistances (PAs) and nurse practitioners (NPs).  Retail Clinics are staffed by physician assistances and nurse practitioners.

Do I need to make an appointment or do you accept urgent care walk-ins?

Since Freedom Doctors - Mobile Urgent Care does home visits we do require you to make an appointment ahead of time, you can schedule an appointment for yourself or a family member by giving us a call or online.  Since we don't have a physical office location we cannot offer walk-ins.   Think of us as a walk-in clinic without the waiting room.

Urgent Care hours?

Unlike your emergency room, urgent cares do not provide 24-7 access to care, but have evening and weekend hours.

Freedom Doctors is open Monday through Friday 8 a.m. to 8 p.m. for home visits, and limited Saturdays and Sundays, so call to check availability.

How much will a visit cost?

The decision about where to get medical attention may help you save on the cost of your medical bill. Overall urgent care clinics are less expensive compared to the emergency department.

Prices charged at urgent care clinics are not actual standardized between clinics, cost of your visit will vary on location, insurance and medical complexity. The standard cost in urgent care where insurance cover is not involved ranges from $50 to $200; this price is generally the standard price of a visit before any extra services. There are a couple of additional care services that could make your appointment to an urgent care costly including x-rays and lab tests, medications, nebulizer treatments, and injections (such as immunization), stitches and splints. If you have a high deductible plan you may be paying for these services 100% out of pocket until you hit your deductible (which could easily be $2,000), so only after you reach that $2,000 threshold does your health plan pays its share of the cost. Every plan is different so we always encourage people to talk to their insurance and know what things actually cost.

Freedom Doctor - Mobile Urgent Care focus is on transparency in pricing, we do not bill insurance, so regardless of insurance you know from the start exactly what your visit will cost.

Urgent Care facilities provide care for illness or injury that don’t necessity Emergency Room level of care.  If you believe you are having a medical emergency, do not delay, dial 911 or proceed to the nearest emergency room.

Other topics you’re interested in hearing about send us an email. Contact Us.

When you need a physician you can trust; try these tips to find the perfect physician for you and your family.

The best time to find a new doctor is now!

When you're sick, the last thing you want to do is spend hours researching doctors and making appointments. Having a primary care physician (or specialists) you trust can improve your overall health. Unfortunately, not all doctors are created equal and choosing the wrong medical professional can make you feel even worse. In this blog post, we will give you 8 quick tips to help you choose the right doctor for your needs. Keep reading to learn more!

1. Recommendations are an important factor

Ask your friends or a family member for recommendations. Chances are, they know someone who has a great doctor that they would be happy to recommend to you.

• How long have they been seeing this doctor?

• Do they have a good doctor patient relationship?

• Do they feel like the doctor is a good listener, makes them feel comfortable, and takes their concerns seriously when making decisions?

• Do they feel like they are in good hands and doctor understands their medical history?

• Did the doctor prescribe medications that made them feel better, or did they make them feel worse?

• Would they recommend this current doctor to a loved one?

2. Location location location

Make sure the doctor's office is conveniently located near your home or work. This will make it easier to schedule appointments.

Does the Doctor offer house calls?

The average person drives about 18 miles to see a primary care doctor. However, this varies depending on the doctor's location and the patient's needs. Some patients may only need to drive a few minutes, while others may have to drive further away.

Make sure the doctor is licensed in your state. You can check the license status of doctors on the website of your state's medical board, this especially important if your doctor provides telemedicine visits.

• Massachusetts Board of Registration in Medicine

• Connecticut Department of Public Health

• New Hampshire Board of Medicine

3. Medical Expertise

Ask the doctor about their experience treating your specific condition. Some doctors may be more experienced in treating certain conditions than others.

• What is your knowledge and experience managing my specific condition?

• Do you have any patients who have responded well to treatment for my specific condition?

• Have you ever had a patient with my diagnosis or specific condition who did not respond well to treatment?

• What are the possible side effects of treatment for my specific condition?

• What is your plan for treating my specific condition?

• How often do you refer patients out to specialist care? Remember a good doctor doesn't need to know everything, but it's important to know where a specialist consult can be helpful

4. Check Reviews

Check out the doctor's reviews online. Patients often leave reviews of their experiences with doctors on websites like Google and Yelp.

Reviews = Trust

• Google

• Yelp

• Facebook

• Healthgrades

• Vitals

Is the office part of a larger healthcare system or hospital, are the doctors incentivized to keep you in the system or getting you to the best specialist care.

5. Accepting new patients?

Make sure the doctor is accepting new patients. Not all doctors are taking new patients, so you'll need to make sure that the one you choose is currently accepting new patients.

• Are you accepting new patients?

• Do you have any openings in the near future?

• What is your fee schedule?

• Do you accept any insurance plan, HSA, or FSA?

6. Office Hours

Consider the doctor's hours of operation and how easy it is to get an appointment with your doctor. You don't want to be waiting all day to see your doctor! Most doctors' offices have weekday hours from 8am to 5pm, and some may offer Saturday hours.

• What are your hours?

• If I need to be seen can I get a same day appointment?

• What is your cancellation policy?

7. Do your Research

Check out the doctors website, health topics on an originally published blog, and read their bios online. This can give you a good idea of their qualifications, quality of health care provided, and what type of practice they have.

When looking for a new doctor, you should consider their qualifications. Some important qualifications to look for include:

• Medical degree from an accredited medical school

• Board certification in their specialty

• Experience treating your specific condition

8. Schedule a meet & greet with your new doctor

If you have the time before you switch doctors consider scheduling a visit for a meet and greet with your future physician. This is a good way to see if a doctor is the right fit for you, the doctor-patient relationship is very personal, you need to feel comfortable. This is especially important if you have a complex medical history or you have multiple specialist managing your care as your primary care doctor can help coordinate you treatment.

What are you waiting for?

The search for good doctors can be difficult, but following these 8 tips will help make the process easier. Your friends and family are a great source of information, so start there when looking for recommendations. Make sure the doctor is licensed in your state and practice has good reviews online. Consider their hours of operation and how accommodating they are for same day appointment. Read their bios online to get a better idea of their qualifications. Following these tips will help you choose the right doctor for your needs!

Other topics you’re interested in hearing about send us an email. Contact Us.

By: Deborah Palmer

It can be tricky to determine when cuts and other injuries need the help of a doctor. Freedom Doctors, offers Mobile Urgent Care services and is here to help treat minor injuries. Most people get a paper cut or a skinned knee at some point in their lives, these minor injuries usually don't require any further attention, but what if a cut more serious? Certain injuries require stitches or more intervention for proper healing. How can you tell the difference?

At home care

For a minor cut you can most likely treat at home. So lets review basic wound care:

1. Clean the cut: Unless you cut yourself with a sterilized object (which lets be honest your kitchen knives are dirty) you're introducing germs into an open wound. Start by running a cut directly under tap water. You can use a small amount of hydrogen peroxide to clean a extra dirty wound, but this should be used sparingly as it can slow healing.

2. Stop the bleeding: Wrap in a clean cloth and apply direct pressure to stop bleeding

3. Apply dressing: Apply topical antibiotic ointment and .cover with a clean bandage. 

4. Monitor for infection

Do I need to see a doctor for further treatment?

If the wound is superficial, the edges of the wound stay together and you can stop the bleeding this will likely heal well on its own. If you're unsure whether you may need stitches, consult a doctor sooner than later.

Signs that you need to seek further medical attention

When choosing whether you need to seek further medical care things to think about include: mechanism of injury, location, size and depth of a cut, and risk of infection. When to seek help:

• Injury involving dirty, contaminated or rusty object (like stepping a rusty nail)

• Deep cuts - if a cut exceeds a quarter inch deep

• Bleeding not controlled through direct pressure and elevation (above the heart if possible)

• Visible fat, ligaments or bones

• Joint involvement

• Injury due to animal or human bite

• Concern for any foreign object(s)

Do I need stitches?

Although obtaining a medical opinion may prove helpful when determining if the wound requires stitches a few characteristics should be taken into consideration. The following should prompt you to seek medical attention:

• Deep cuts

• Gapping wounds

• Bleeding profusely despite applying pressure

Animal or human bite?

Bites are a special case, immediate medical attention is advised for further evaluated, as prophylaxis antibiotics are commonly prescribed to prevent infection. Rabies shots may also be a consideration.

Do I need a tetanus shot?

Tetanus shots are ideally given every 10 years, for most minor cuts if you had a tetanus shot in the last 10 years you're set. However, for some wounds including wounds contaminated with dirt, feces, soil, saliva having a tetanus shot within the last 5 years is advised.  If it's been more than 10 years (or >5 years in some cases) a tetanus booster shot is advised.

Stitches vs. Sutures

Although stitches and sutures are used interchangeably, they are essentially two separate entities. Sutures refer to actual thread used in the closure of wounds. Stitching describes the an actual closure technique.

Sutures, staples and glue; What’s the difference?

Suture, staples and wound glue are all ways to repair a cut; however, there are lots of factors playing a role in what your doctor will use to repair a cut.

Can I go to the Urgent Care if I need stitches?

Yes, an urgent care center or emergency department have the ability to stitch up a cut. Urgent care centers tend to have shorter waits and are cheaper than the emergency room. Freedom Doctors Mobile Urgent Care functions as urgent care with the benefit that medical treatment is provided in your own home.

What about wound glue?

Yes, if appropriate, wound glue can be used repair a cut.

How much does it cost to get stitches?

Cost for stitches in the urgent care is on average $200-$300, but this cost varies based on location and complexity of your injury.  The cost increases greatly if you have visit the emergency room. Freedom Doctors Mobile Urgent Care charges a flat fee for evaluation of a cut and stitches or glue for laceration repair if needed.

Best time to get stitches?

The ideal window to repair a laceration is <12 hours; fresh wounds are easier to repair, heal better, and are at reduced risk of scarring. Unless you can get into your PCP same day, the recommendation is an urgent care or emergency room.

How long do stitches stay in?

Timing of sutures removal is important. If they’re taken then out too soon there is a risk that the wound may open back up, but waiting too long increases risk of scarring. The train track appearance of the skin after suture removal is more common the longer stitches stay in place.  The timing of removal varies according to multiple factors, including location, shape and severity of a cut. Sutures may need to remain longer to ensure proper healing, ares of the body that have higher skin tension (overlying a joint) as wounds in these areas are at increases risk of opening up. If you have a deep cut you may require some dissolvable sutures under the skin to ensure proper closure, these will dissolve with time and do not need to be removed. 

Monitor for infection

Signs to suggest infection include spreading redness, worsening pain or pus, if concerned seek medical attention.

Aftercare

Once your wound has healed massage the scar with a moisturizer to help soften the scar. Apply sun protection.

Since kitchen knives are a major culprit for these injuries, you may be interested in some local history...

Are you familiar with the Dexter-Russel Cutlery, formally the Harrington Cutlery Company out of Southbridge, Massachusetts? The Harrington Cutlery Company was the first cutlery manufacturing company established in the United States, now well known for their high quality knives. When it was established in 1818 by Henry Harrington the company also manufactured surgical equipment, shoe knives and firearms.

Harrington Memorial Hospital which opened in 1931 in Southbridge, gets its name from the Harrington family which during the Great Depression made a large contribution that helped fund the construction of Harrington Memorial Hospital.   In 1933 when the Harrington Cutlery Company merged with the John Russel Cutlery Company, also out of Massachusetts, the name changed to the Russel Harrington Cutlery Company.  The name changed again in 2001 to Dexter-Russel Cutlery (Dexter reflecting the name of one of Harrington’s son Dexter Harrington for whom the Dexter line of knives was named). Dexter-Russel Cutlery is still in business today in Southbridge.

Other topics you’re interested in hearing about send us an email. Contact Us.

We are doing a series on “What’s in your medicine cabinet?”.  This week is all about allergy medications (antihistamines).

So before we can explain what an “anti”-histamine does we should explain the role of histamine.  Histamine is a substance that our body releases as part of its immune response with the goal of removing invaders. This is normally a good thing until your body starts sees seemingly harmless substances like pollen or peanuts as alien invaders, If you have allergies your body starts sends excessive histamine to the rescue when you really don’t need saving.

This excessive release of histamine leads to inflammation and typical allergy symptoms including watery eyes, nasal congestion and runny nose, sneezing, swelling, hives, itching.  The most worrisome is when histamine causes a severe, potentially deadly, reaction called anaphylaxis, in this case you develop swelling of the airway making it hard to breathing and inflammation of the blood vessels making them leaky causing a huge drop in blood pressure making it difficult to get blood your your vital organs.

So antihistamines do the opposite, they counteract histamine by competing for the sites where histamine wants to bind, if histamine cannot bind then the body cannot see the histamine, so your body doesn’t overreact and you decrease the allergy symptoms listed above.

Antihistamines are divided into two categories:

#1 First-generation Antihistamines

These include diphenhydramine (Benadryl), Chlorphenamine (Chlor-Trimeton), Promethazine. This generation of antihistamines are known for causing sedation as is crosses the blood-brain barrier.

#2 Second-generation antihistamines

These include Loratadine (Claritin), Desloratidine (Clarinex), Levocetirizine (Xyzal), Certirizine (Zyrtec) and Fexofenadine (Allegra).  The second-generation antihistamines are less sedating than the first-generation agents as they don’t cross the blood-brain barrier. These are preferred over the first-generation antihistamines because they have similar efficacy with less side effects.

What about Benadryl cream you ask?

Not a fan, if you’re looking for a topical agent to help bring down skin swelling, itch and pain (maybe help your poison ivy, check out our last blog post) topical steroids would be my first go to to calm the inflammatory skin reactions.  Topical Benadryl (though not sedating like the oral version) have been know to cause side effects such as sun sensitivity, rashes, hives

There are other allergy tips, tricks and treatments for specific allergy symptoms give Freedom Doctors a call and we can help come up with a plan for you.   If you develop any airways symptoms (itchy/swollen tongue, throat swelling, wheeze, shortness of breath) you may need a medication called epinephrine (aka epipen), so do not delay you need urgent evaluation ideally in an Emergency Room setting.

Other topics you’re interested in hearing about send us an email. Contact Us.

Yes, you heard right we don’t take insurance.  Intrigued? Perplexed? You’re not alone.

When in comes to health insurance it’s not you or your doctors that are really benefiting. At the end of the day the Medicare rules all, they are considered the standard for care, but they love paperwork and don’t like paying those who are actually trying to care for you.  Medicare premiums are generally cheaper than your health insurance plan you get through your employer, but they have restrictions (a lot of restrictions). How do you get away from their control, well you stop accepting insurance.

Thankfully these restrictions do not impact health savings plan or flex spendings plans, for this reason we accept HSA and FSA payments.

Patients are frustrated because they don’t understand insurance (monthly premiums, deductibles, coinsurance, and copays), the cost isn’t upfront, they get surprise bills weeks after appointments or test.

Doctors are frustrated because they are constantly having to deal with the insurance companies, and doing paperwork that is different for each company.  We’ve be becoming glorified paper pushers than see patients on occasion. Paperwork should be done in order to serve the patients better, not please the insurance company. Your doctors shouldn’t have to argue with insurance companies who do not want to pay.  Tests are ordered because there is a clinical suspicion that needs to be investigated, your doctor should be able to order this test, no questions asked. The price for a tests should be clear whether or not your have insurance, so we can alleviate the stress of waiting and wondering if your insurance company will pay, and if they don’t cover it you should be confident what the cost out of pocket would be.  Before the test is even preformed you should know wether you’re going to be getting a $100 or $600 bill in the mail, end of story.

Right now you get the test and next month you figure out how much it costs…. In what other industry would we accept not knowing how much something costs before we buy it?

Navigating the healthcare world would be so much easier for everyone if insurance companies weren’t involved.

We are removing the middle-man so we can provide good old-fashioned house calls like your parents/grandparents may remember.  What’s better than the doctor coming to you when you’re sick?

We are bringing back the home call to Holland, Wales, Brimfield, Sturbridge, MA and nearby locations.