Q&A With Dr. Paul Gast
By Elaine Porterfield
Dr. Paul Gast, MD, shares why he enjoys working in urgent care.
Why did you choose to work in urgent care?
It was not what I thought I was going to do back in medical school. I did a residency in primary care, but then started doing this work in 2001. I felt like it was a good fit for me. We care for patients who are acutely ill, and we need to consider many possible problems. But we have quite a few resources available to understand fully what is happening to them. It's also interesting because you catch people in crisis, and it's a privilege to help people during those times.
I'm a little confused about when I should go to urgent care and when to go to the emergency room. What's the difference between them?
Urgent care facilities generally have many of the same capabilities as emergency rooms, and are usually the best place to go for non-life-threatening conditions. In some of the Group Health Medical Centers urgent care departments, like Bellevue or Capitol Hill in Seattle, there are even observation beds for patients to spend the night when it's appropriate.
What if I'm having symptoms that seem very serious — like chest pains?
With some symptoms — such as chest pain, uncontrolled bleeding, breathing problems, or feeling like you're going to pass out — the decision of where to go is more complicated. Then it's a good idea to call the Consulting Nurse Service. They're specifically trained to help you decide next steps. The best place to go is determined both by the symptoms you're having, and the capabilities of the facility where you would be heading.
Give me a sense of the kind of cases you'll see on a typical day.
We see everyone who walks through our door, so no day is really typical. That said, most of my day is spent taking care of patients with chest and abdominal symptoms, and patients with concerns about a stroke or who are feeling lightheaded. We see minor emergencies, and minor medical traumas. There is almost always someone waiting to be seen, and I'm usually caring for several patients simultaneously. It's pretty intense sometimes.
How do you feel at the end of a shift?
Usually pretty satisfied. I've been able to help patients understand why they are having problems and what to do about them. It's highly rewarding.
I imagine you see a lot of kids in urgent care. What are some of the common problems that turn up?
Common problems are fevers, respiratory and gastrointestinal infections, cuts, and rashes. Many of these problems can be handled by the child's primary care provider. If it is possible, a visit to your own doctor is often quick and effective, plus builds rapport with your doctor.
So what are your busiest times?
Afternoons and evenings, and weekends.
Why do you do this work?
I love the variety! I love being able to focus on one thing and follow a problem to its resolution.
So where are the TV shows about urgent care? They're always about emergency rooms.
(Laughing.) It's true. But there's good material here too.