Original Research Emergencies in the Office Why Are 911 Calls Placed From Family Medicine and Urgent Care Offices? Urgent message: New data indicate that calls to 911 from family medicine and urgent care offices and subsequent transport to ED occur for a wide range of reasons, with the distribution varying to a large degree based on the age of the patient and the practice setting. Robert J. Dachs, MD, FAAFP, Ephraim Back, MD, FAAFP, Brian Glick, PA-C ife-threatening emergen- cies have been reported to occur in primary care medical offices. 1,2 How- ever, the type of med- ical emergencies that occur remains unclear. Previous studies that have attempt- ed to evaluate emergencies taking place in physician offices have been hindered by recall bias and what defines a medical “emer- gency.” 2-8 Heath et al demonstrated this problem when seven members of the same pediatric office staff were asked how many emergencies occurred dur- ing one year; one member estimated four, two estimated 50, and four reported 100 emergencies. 3 One would expect that the type of medical emer- gency encountered in the office setting would vary based upon the type of patient population cared for by a specific practice. For example, a prospective study of 38 pediatric practices in Vermont demonstrated that three- L w w w. j u c m . c o m quarters of the emergencies were respiratory in origin. 3 However, no data exist for any other patient popula- tion or practice setting. The goal of this study was to evaluate what types of medical emergencies occur in family medicine and urgent care offices from a mix of urban, suburban, and rural practices in northeast- ern New York. By directly reviewing calls from these offices to the regional 911 system, the problem of recall bias and defining an “emer- gency” can be eliminated. An understanding of the types of emergencies that present to these practices may better prepare the family medicine and urgent care physician for such emergency situations in the future. © Lightscapes Photography, Inc./CORBIS Introduction Methods Thirty-four family medicine office locations and nine urgent care centers from Albany, Schenectady, and Saratoga counties of northeastern New York were iden- JUCM T h e J o u r n a l o f U r g e n t C a r e M e d i c i n e | J a n u a r y 2 0 0 7 19