Not all emergencies are equal!

Doctor offers alternatives to hospital emergency visits for medical issues

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Many treatment avenues available for less urgent issues - even after hours.


WITH more than one million covid cases in Australia, nearly 4000 patients in hospitals and more than 300 in ICUs at the time of writing, the health system is under enormous strain.

Combined with staff shortages and record-breaking hospitalisations, there are fears the sheer weight of numbers will see patients being turned away.

One doctor says Australians should be informed about alternatives to emergency departments, to ensure all patients receive the treatment they need and to avoid burnout among hospital staff.

Andrew Thompson is a registered doctor at InstantScripts, a telehealth and prescription service that has helped more than 300,000 Australians access their primary healthcare needs.

"There are medical issues and injuries for which patients should go to emergency, as they could be potentially fatal or quickly escalate in severity," Dr Thompson said.

"Examples are suspected concussion, breathing problems, blood loss, accidents and chest pain. Patients should seek immediate treatment for these by calling 000 or, if they can travel, going direct to the nearest hospital.

But Dr Thompson said for less urgent issues, there is a plethora of effective treatment avenues available - even after hours.

"I recommend Australians compile a list of alternatives, from late-night dental surgeries, pharmacies, and walk-in after-hour medical centres with x-ray facilities, to online telehealth services that offer fast consultations and prescriptions.

"Keep the list easily accessible and if you don't have a regular GP, consider finding one in your local area who can be up to date on your medical history and conditions."

He added that Ambulance Victoria recently issued a code red alert as its services grapple with an unprecedented volume of calls, many of which could be tended to by GPs.

The government-funded service HealthDirect offers a dedicated helpline (1800-022-222) that allows Australians to speak to a registered nurse to gauge whether they require a hospital visit.

"This could reduce the strain on 000 call operators and ambulance services, allowing them to tend to patients in need of critical care."

Dr Thompson offers 10 ways to get fast treatment for 10 medical and health issues without visiting the emergency department.

  • Suspected sprain, fracture or broken bone. Uncomplicated breaks and other bone injuries don't always require a trip to a hospital. Walk-in medical centres with integrated services, such as x-ray, pathology and surgery facilities for simple procedures are a good option. Some operate after hours, particularly in metro areas. X-rays referrals can be obtained from telehealth services such as InstantScripts, where a doctor provide a consultation followed by a referral.
  • Acute dental pain. Oral pain can often point to a dental infection, which will need to be treated before a patient can see a dentist. A doctor can recommend pain relief or prescribe antibiotics for the infection and once treated, a dentist visit is the next step. For those who need immediate dental work, after hours and emergency dental clinics - some of which have dental surgeries - are also readily available in major metro areas. Emergency medical centres can also assist with dental pain, and some are also equipped with dental surgeries.
  • Migraine. Severe ongoing headaches and migraines can be a source of concern and stress, particularly if they occur late at night when many local medical centres are closed. Consider an after-hours doctor consultation through an online telehealth service before heading to an emergency department. Services such as InstantScripts offer $40 flat-rate consultations from 7am to midnight and allow callers to access a doctor in as little as 15 minutes. Telehealth and prescription medicine services can diagnose first-time presentations and recommend treatment plans, as well as direct severe cases to an ED. Be aware, though that that severe migraine symptoms such as confusion, trouble speaking, numbness, vision changes or fever require a trip to an ED. For symptoms that don't subside in 24 hours or worsen, visit a doctor in person.
  • Fever. A fever can point to a number of ailments and are rarely harmful. But when a fever occurs in a baby under three months, lasts more than three days or is accompanied by other symptoms, such as trouble breathing, drowsiness, a stiff neck, ongoing vomiting or diarrhoea, hallucinations, muscle spasms and sensitivity to light, immediate medical attention at an ED. However, in all other cases, and in children over three months and adults, a fever can be effectively treated at home. If it occurs late at night, visit a late-night pharmacy for medicine to break the fever. Those who are unsure if a fever is serious can use an online telehealth service for an after-hours consultation or speak to a registered nurse by calling the HealthDirect helpline (1800 022 222). Also, fever can be one of the first symptoms of COVID-19 and, in the current climate, it may be wise to seek a covid test.
  • Severe flu, COVID-19 or suspected pneumonia. Babies, young children and over-60s with suspected pneumonia, and anyone who has a virus that comes with sustained fever, difficulty breathing, and severe chest pain should be taken to an ED. Anyone else suffering any viral infection can seek immediate doctor consultations through an online telehealth service or walk-in medical centre. Dr Thompson usually recommends an in-person doctor consultation. Those with respiratory symptoms should also seek a covid test or source a rapid antigen test, and self-isolate while awaiting results.
  • Severe and sudden pain. Those experiencing constant, severe and worsening chest or abdominal pain should visit an ED. Those who choose to visit a doctor in-person may be directed to a number of tests to rule out severe issues. For lower back pain or any other pain associated with muscles or joints, treatment can be sought at a walk-in medical centre or a late-night pharmacy can provide pain relief. For those who still want reassurance quickly, helplines such as National Home Doctor (13SICK) provide after-hours in-home doctor services within four hours.
  • Urinary tract infection. One of the most common reasons Australians visit an ED is for UTIs. Dr Thompson says UTIs are a relatively common concern that can be treated with antibiotics. He recommends seeking a telehealth consultation with a doctor, particularly for those experiencing UTI symptoms - such as a persistent urge to urinate, a burning sensation when urinating, passing frequent and small amounts of urine and cloudy urine - late at night, as these services are often available after hours. Some doctors may seek a test to confirm a diagnosis, and in these cases patients could visit a walk-in medical centre for a urine test, while some pharmacies offer at-home tests.
  • Major rashes or other skin concerns. If a rash covers the entire body, or is accompanied by other symptoms, such as pain and fever, it warrants an ED visit. Cases with isolated rashes can be seen by a GP, and a walk-in medical centre is a good immediate option. Particularly for mild rashes or skin concerns. GPs can try some treatment options before recommending a dermatologist.
  • Allergic reaction. Severe symptoms such as anaphylaxis, light-headedness, difficulty breathing, wheezing, confusion and anxiety - and even first-time presentations of allergic reactions - should be tended to in a hospital ED. Minor allergic reactions can access treatment through an online telehealth service or medical centre. Some mild cases may simply require an over-the-counter antihistamine.
  • Mental health symptoms or concern over the mental health of a loved one or friend. There are numerous mental health services for help and advice. Those experiencing suicidal ideation or who have attempted to self-harm should seek immediate help, either at an ED or through a helpline such as Lifeline (13-11-14). For prolonged mental health issues, telehealth services can provide numerous strategies to tackle mental health concerns. If it will help the patient to access therapy, a GP can develop a comprehensive Medicare-covered mental health plan that provides access to a psychologist. People who have a serious concern for the wellbeing of another person can also request a police welfare check to ensure they are safe and healthy.
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