Sponsor And Welcome

SPEAKER_02 0:00

This episode brought to you by Kathy Lwall, State Farm Insurance Agent. Visit her at Kathylwall.com. Welcome to the Bubble Lounge. I'm Martha Jackson and today we have two very exciting guests. We have a motocross and a rock star here today joining us. Not really. We actually have two doctors, Dr. Pettit and Dr. Allen with Advanced ER. Gentlemen, welcome to the show.

SPEAKER_00 0:31

Thank you very much.

SPEAKER_02 0:33

Well, I had the pleasure of touring your facility a few weeks ago, and I was very, very impressed. You have two locations, one on Lovers Lane, one on Inwood. And I was blown away just by the staff and the setup and everything. And I want to know more about you

Why They Built Advanced ER

SPEAKER_02 0:47

too. Can you introduce yourself and tell us how you got into the ER business?

SPEAKER_00 0:51

Hmm. Okay. Um, I'm Dr. Allen. I've been doing emergency medicine for 27 years, uh, mostly working in level one, level two uh trauma centers, uh, board certified. Um, also the co-founder of one of the co-founders of Advanced ER in the Dallas area. Um I have a big interest in longevity and uh regenerative medicine, in addition to emergency medicine. And uh it's a pleasure to be here.

SPEAKER_01 1:24

And I'm Dr. Lori Pettit. Yes, I worked with uh several of the healthcare facilities here in the Dallas area for nearly 30 years, uh uh board-certified emergency possession as well. And uh I think we saw that there was such a need for kind of a concierge-level care on the west side of the toll way, and this was our vision probably 11, 12 years ago, and wanted to be able to create more of an intimate, relaxed private experience. And I think especially for that uh population that did not exist in the Dallas area at that time, and so I think that was kind of our mantra that we wanted only board certified year doctors, salty captains, you know, 15 years experience, being able to treat every patient and uh have the whole full access of CAT scan, x-ray, ultrasone, labs without without the weight.

SPEAKER_00 2:19

Yeah, yeah. So I mean that's the I mean, both both me and Larry, we worked in you know level one, level two trauma centers before we came to advanced ER. And we realized that there was a lot that could be improved with that experience. Most, you know, hospital-based ERs, I mean, sometimes the wait is four or five hours. So you get back to the room, they're so busy that it's just the doc's just in and out. You know, you're you're not getting holistic care, you're not getting concierge care. Um, and so the whole experience can be somewhat frustrating. You know, advanced ER, there's no wait. You know, we not only uh get you in, but we spend a lot of time with you, you know, explaining what's going on with you, explaining your prognosis, explaining how to treat you. You just don't get that in a hospital-based ER in the way that we deliver that. Well, I'm so we wanted to do a better product.

unknown 3:18

Yeah.

SPEAKER_02 3:18

I'm definitely sold. The whole no wait thing sounds great

Summer Illnesses And Testing

SPEAKER_02 3:21

to me. Well, we're really here to talk about back to school and all the things that happen when the kids get back together. But we've actually had a really busy summer this uh this year with the World Cup and with the whole lettuce thing, which I can't pronounce. Tell me what it's called again.

SPEAKER_01 3:35

Uh cyclospora.

SPEAKER_02 3:37

Thank you, thank you. And we had some freezer outings in our local grocery stores that people were concerned about. Lots happening this summer. What did you guys see as a whole this summer?

SPEAKER_00 3:48

Um, I mean, just a lot of typical stuff. Um, we do see a lot of chest pain, a lot of abdominal pain. Um, we see a lot of gastroenteritis, you know, with the diarrhea, nausea, and vomiting. We've had several patients come in, you know, and ask about cyclospora that does require a special test, which we can order. Um and uh and then just you know, lots of sprains and orthopedic injuries, fractures of ankles, um, and pretty much any kind of uh emergency or kind of minor emergency we see at advanced ER.

SPEAKER_01 4:30

Yeah, I agree. I just you know, I I think everybody is, you know, is there a common denominator? I think predominantly a lot of chest pain and uh uh you know nausea, vomiting, diarrhea is uh kind of our staple because we have the ability to do CAT scan and ultrasound and labs. You know, one of the I think pluses that we have is uh we have a special stool cultures that can address this, you know, concern, although we really have not seen that present in the DFW area. Um, you know, we also have PCR testing, which is a very accurate testing for RSV, flu, AB, and COVID, uh, which is a great adjunct, you know, to our treatment, so we can understand exactly what entity we're pursuing or whether antibiotics are necessary. So I think that is a that is a great plus at our facility.

SPEAKER_02 5:21

Yeah, that's good to know that you're not seeing very much cyclospora. Did I say that pretty well?

SPEAKER_01 5:26

Yeah, yes, yes. I, you know, really I think southern Texas and up, I don't know, Michigan and Northeast has many more cases of this, but I think, you know, as a general rule, I think it's uh you need to be cognizant and make sure you're you know washing vegetables, wiping down your fruits just as uh being proactive. Right, sure.

SPEAKER_02 5:48

Well, for most of us, school starts next be next week and we're getting back to sports, the germs are back, the kids are getting hurt, all the things that seem to happen once school gets back started.

Back-To-School Germ Prevention

SPEAKER_02 5:59

Tell us what parents should know before school starts to be ready for all this.

SPEAKER_00 6:04

Yeah, uh there's a lot you can do. Um they kind of help keep kids, you know, safe when they return back to school. So um, yeah, when they go back to school, you know, they're in close proximity with all the other students, the other teachers. So there is an increased risk, you know, of a contagion or getting an infection. You're gonna see RSV, COVID, influenza, strep throat, gastroenteritis, and just a bunch of other kind of viral bacterial infections. Um, so what can you do about that? I mean, I think it's important to understand how, like the majority of these are transmitted, it's either through respiratory droplets or contact. You know, you touch something that somebody just got done touching that was sick. You take your hand, you put it to your face, your eyes, your nose, your mouth, and you've just introduced that infection into your system. So, you know, washing your hands, using um, you know, sterilizers on your hands, not touching your hands to your your eyes or your nose or your face, those are all things that you can do to kind of reduce your risk of becoming infected. Um, in terms of like respiratory stuff, if you you know, if you see somebody coughing and you can't, you know, create a little distance between them and you, and then you know, if if you got a mask and they're just coughing, coughing, coughing, or you know, then you can put the mask on. Other things that parents can do to help is if you see signs that your kid is getting sick, you know, be aware that it's probably contagious, you know, keep them home, watch them carefully, and uh, and then just basically go from there.

SPEAKER_02 7:53

Are there any specifics that parents should actually be worried about when they should take them to the doctor, anything that they need to be looking for?

SPEAKER_01 8:01

I think, well, I was gonna say uh fever, I think, is probably the hallmark of if your child is, you know, number one, I guess if you're having a fever over 101, um, you know, if your child is not drinking fluids or maybe a lack of wet diapers, that all are kind of concerning signs that require a further evaluation by somebody in a white coat.

SPEAKER_00 8:22

You know, with most viral things, you're gonna get some like initial symptoms. You're gonna get a little, you know, runny nose, a little congestion, maybe just a minor cough, um, a little teeny bit of nausea, maybe a mild headache, you know, with all those kind of symptoms, just long as your child is hydrating well, activity level is good, they're they're eating, you know, decently, um, you can you can kind of wait and watch. Now, there's a couple of caveats. Like if you have a sore throat, that could be strep throat. So you even if the kid appears relatively well, that's something you want to get evaluated for because strep, if you have it, can have complications with your kidneys and parts. So even though the kid might look relatively well, it's still important to see a doctor. The rest of it, you can you can kind of watch and wait and see if they get sicker. And if they do, if you become concerned, then you can go to your pediatrician, or you could go to an urgent care. Both the pediatrician and urgent care um are set up, you know, to kind of take care of some of these minor issues. We do a lot of teamwork with them. A lot of times, patients will go there uh to an urgent care, and the and the doctor or the pediatrician will think, well, I don't have the lab work, I don't have the imaging, I don't have the things that I need to do to work you up because you look a little bit more concerning. Um, we do have all that stuff. We have all the labs, imaging, ultrasound, CAT scan, and everything to where we can work these patients up. But basically, what you look for in terms of symptoms that would indicate just going directly to an ER would be chest pain, abdominal pain, high fever, um, lethargy or just extreme fatigue, you know, severe headaches, uh, shortness of breath, you know, dizziness, you know, and then there's just a whole other list of things, you know, seizures and other things that could happen that weren't basically going to the ER.

SPEAKER_02 10:17

Okay,

Park Cities Parade And Giving Back

SPEAKER_02 10:18

great. Well, let's switch gears for a minute and talk about your involvement with the Park Cities community because I love that you guys are involved with us. And I happened to see you in the Fourth of July parade, which is one of my favorite days of the year in the community, and you had the rest band and all the things. So thank you for being involved. But uh, tell us what all you do with us.

SPEAKER_00 10:38

Uh yeah, well, we like to be involved in the community. We like to kind of give back. Um, we uh just feel like we have uh something to offer, you know, in terms of concierge care and really treating patients the way we think that everybody, you know, should be treated. So we like to uh get out there in the community and shake hands and make friends with everybody and let them know, you know, that we're here for them if they need us. And uh and we love the parade too. The parade is amazing. Uh we've, I think two years in a row, I think we've won uh the best float, and a big uh part of that was due to the Rust Band. The Rust Band. And uh yeah, and and Dr. Pettit is uh drummer with the Rust Band. And man, I tell you, the parade, it's amazing. So we you know, we throw candy, we we follow around the float, and people, it's so rewarding to be there because people are like, Oh, I came to your ER, you know, you saved my grandpa's life. I mean, you you hear these things as you kind of go through the parade, and it's so heartwarming, you know, it's really a beautiful experience. Love the parade and the energy that the Rust band brings, it's amazing. I mean, you come around the corner, you can see people, they're kind of like, yeah, it's just sitting there. But the minute that they hear the band, they just start moving and dancing, and we dance with them, and we love it.

SPEAKER_02 12:06

That's so fun. Well, I love that.

SPEAKER_01 12:08

Well, I have to say, you know, kudos to our uh marketer because I think you know it was kind of a mutual vision from years past that we were like, can we put a rock band on a parade float for the Spark Cities parade? Because there's a lot of logistics that have to go into your power, your PA, a generator, plus you have a moving float that you have, you know, five members on that are kind of rocking and rolling around. And uh it was uh it was a miracle last year because I think that was the first time that this was, you know, put the vision was put into reality and it was raining up until nine o'clock, and the band was assembled, and we were all kind of looking at either each other's is this going to happen or not? And the sun came out, the part, the clouds parted, and we were able to roll. And I have to say that was one of the most eclectic experiences of my career playing on the uh parade float in front of this audience. It was like a Mardi Gras experience with you know, six people deep on either side, and everybody's cheering and the band's playing and the energy, and it was just a uh fabulous. And we were able to repeat that performance this last year and take home a first place uh parade float trophy, which was really honorable and exciting for both Advance and the Rust Band.

SPEAKER_02 13:25

Well, way to go, and congratulations.

SPEAKER_01 13:27

Thank

Urgent Care Versus ER

SPEAKER_01 13:28

you.

SPEAKER_02 13:28

So when I'm driving around the neighborhood, I notice a lot of urgent cares. I would say I see that more than I see ERs. And so I actually don't know what the difference is and why you would go to one versus the other. Can you guys educate us on the difference there?

SPEAKER_00 13:43

Yeah, I'll tackle that one. So um urgent cares um are basically for kind of very minor um urgent medical issues. So runny nose, cough, you know, maybe sprained ankle, sore throat, things like that. The big um the big difference between them is and and advanced ER is advanced ER, you're seeing board certified emergency medicine doctors, and that's really key. Um, the hospitals used to not be staffed uh by board-certified ER doctors. This was many, many years ago. Uh, and they used to have a lot of issues because the doctors that that were working in the ERs were not trained in every specialty to understand every emergency that happens in that specialty. So what happened is they missed a lot of emergencies. There was increased mortality, increased morbidity to those patients that went to the ER. So that's one of the big differences. We are trained um for four years to really understand even those subtle emergencies. Um, now the urgent care, of course, they have uh a lot of medical training, um, but they're not quite at that level that we are. That's why they're really set up just to do minor, you know, kind of minor urgent medical issues. They also do not have the same lab facilities or imaging. So we have the capabilities of doing IV fluids, doing IV medication, of you know, diagnosing appendicitis or cholecystitis, problems with, you know, internal organs in your body, because we have ultrasounds and CAT scans, which uh you basically don't have, you know, at urgent care. So we work together, you know, kind of we help each other out. Um, and they they send us a lot of patients, you know, if they think that it's beyond their scope. Um, but yeah, I would say, you know, for urgent cares, if you think it's something really minor, then that's a good place to go. We also do minor stuff. So we don't just do major stuff. If you have the sore throat or congestion, we will take care of you also.

SPEAKER_02 16:02

So okay. Well, that's good

Sports Injuries And Red Flags

SPEAKER_02 16:04

to know. Well, let's talk about sports. Fall sports are starting, football, and all the things are coming up, and that's when we see a lot of these bigger injuries. And I just wanted to find out from you guys, you know, what's one of the most common things that you see and what should parents look for? When should they weigh? When should they come in?

SPEAKER_01 16:22

There was uh I think you know, in the fall, we always see uh with uh the sports-related injuries, wrist and ankle, I think are probably the predominant issue. There was a uh back, I think it was in the early 1990s, there's there was something called the Ottawa Ankle Rules that came up and they talked about when when is an X-ray required? And I think this is just kind of a helpful guide. But if you're unable to take more than four steps, if you have tenderness around your ankle on, you know, either the inside or outside of your ankle, if there's tenderness on the top of your foot or your fifth uh metatarsal, your pinky toe, uh those all are high probability of a fracture. And I think that maybe that's an easy little guide. I think, you know, especially in children like zero to eight, if they are not using their extremity or kind of persistent crying or fussiness, uh, I think that requires you know further evaluation as is there something going on there, especially after an injury if they can't walk or if they're only able to crawl, crawl. Uh, I think that definitely warrants an x-ray valuation.

SPEAKER_02 17:33

What about playing through pain? I uh have had a child that had a concussion, and then I've ended up talking to so many people who's who have had concussions, and a lot of these kids aren't really telling their parents or their coaches their symptoms because they want to keep playing.

SPEAKER_00 17:49

Yeah. Uh we see way too much of that. Um there in athletics, there is this mentality that you need to win, you need to be a team player, you know, you can't step out. But I from all these years in the ER and being a doctor, I can tell you the best coach you have in terms of telling you what to do and not to do is pain. If you're having pain, that's your body telling you you should not be doing what you're doing. And your body is this beautiful, miraculous, miraculously designed, you know, creation that I mean, you really got to respect what it's telling you, you know. And if you don't, you can turn what would be a minor injury into like a worse fracture or a worse sprain. You can go from what would have been a few days of recovery to like several months. So I mean, you can't ignore, you know, these early signs that something's going on with your body. Now, there are, you know, some coaches that are pretty adept at kind of knowing, you know, when to kind of push through an injury and and when not to. Um, but on the other side of the coin, we've seen a lot of coaches and talked to a lot of kids that probably would have had a professional career, except their coach told them, keep playing, you'll be fine. And then, you know, they ended up having a career-ending, you know, injury. So, I mean, I I the best advice I can give to athletes, you know, if if uh you feel like something's wrong, then you uh and you want to have longevity in sports, then you should probably go sit on the bench or see a doctor.

SPEAKER_02 19:35

Well, what is something that you want every parent to know? Because if they are having a scenario like what you just described where the coach is encouraging them to keep going, what should the parent look look for and not ignore?

SPEAKER_00 19:48

Um I I think that the the I mean the parents get pretty wrapped up in in these games too. But I I I think that the important thing to remember, and and me and Larry can tell you this, we've seen a lot of kids that got the talent to basically go all the way, and they didn't because he got injured. So so you just have to tell the coach, you know, you got to keep it real, you gotta talk to the coach, you gotta talk to your kid, you gotta be empathetic with them, you know, and let them know that you understand, you know, how important the game is, but you gotta just be real and just say, hey, if you want to take this and you, you know, all the way to the pros, to college, whatever your goal is, then you gotta pay attention to this stuff and you need you need to step aside and rest and everything.

SPEAKER_02 20:38

Well, perfect.

Google Symptoms And AI Anxiety

SPEAKER_02 20:39

Well, I want to end with the internet and of course now AI. A lot of us are looking up our symptoms and diagnosing ourselves. I mean, who knew we had so many uncertified doctors out there, right? Yeah, right, yeah. What is your advice on that?

SPEAKER_01 20:56

Well, I think it is definitely a guide. I think this is where advanced really has a lot of, we have the full advantage of again 24-7 CAT scan, x-ray, ultrasound, on-site labs, and Ivy antibiotics. So we can kind of rule out your anxieties and you know, do the appropriate testing to determine what kind of is or is not going on. I think sometimes you don't necessarily have an answer as to what it is, but perhaps we can rule out the obvious appendicitis or uh uh heart attack or some type of pneumonia. So I think in a lot of ways it's kind of the easing of the when you start Googling, you go down a dark rabbit hole, and I can really you know keep you up at night and then you're concerned that you've got something incredibly serious.

SPEAKER_00 21:47

But I think that's where the the testing is a necessity to rule out the Yeah, I think um advanced CR is like the perfect place for the the Google Doc. You know, they're they're not a doctor, you know, in real life, but they are a Google doctor. And the reason that we interact with them so well is because we love that they're becoming their own uh patient advocate, you know, and we will sit there and we will explain to them, you know, in a medical fashion, what the differential diagnosis is, why, you know, what they're thinking the diagnosis is is either, you know, potentially right or potentially wrong. And we'll go into great detail. And we have a lot of patients with them because we like the fact that they're seeking out knowledge and be, like I said, becoming their own best friend, you know. Um, so we do do concierge care. We do enjoy talking to them and helping, you know, reduce their anxiety, especially like Larry said, when they go down that rabbit hole and they basically pick out the worst possible thing, you know. So we're there for them, you know, to kind of relax them, like take a deep breath, you know, things like

A Different ER Experience

SPEAKER_00 23:00

that.

SPEAKER_02 23:00

Well, gentlemen, like I mentioned earlier, I toured your facility several weeks ago. And what really got my attention was how close your location at Lovers and Inwood is to Highland Park High School, which of course is where so many sports are played and a lot of these injuries are happening. So tell us a little bit more about the facility because I personally was blown away and I want everyone to know about it.

SPEAKER_01 23:21

I think our Park Cities is our kind of flagship facility. We've got two locations, one across from uh Jesuit High School and our other one across from kind of Lover Seafood. Uh, but I think again, as our vision 11 years ago, we wanted a, you know, kind of no-weight, intimate, luxurious atmosphere where you can be seen by a board-certified ER physician 24-7 and be able to ease your anxieties, run the lab test, provide you the IV antibiotics, all without the four-hour wait of a large healthcare facility. And the beauty is we, you know, if if you do have something, we can hook you up with a orthopedist, specialist, cardiologist, all within probably a 72-hour time frame, because I think all of us doctors are well connected in the community. And that provides, I think, higher patient satisfaction, just the ability, the ability to connect you so quick quickly with a specialist versus sometimes you're having to wait two weeks before you can get in with a specialist.

SPEAKER_02 24:27

Well, like a lot of people out there, I have kind of a negative perception of ERs because one time I was having some uh issues. It turned out to be appendicitis, and I went to the ER at one of the major hospitals in the area, which is the only place I knew to go at the time, at 3 a.m. And I mean, it took hours to get in there, and I was sitting in the lobby in the worst pain you could imagine. But it sounds like at advanced ER, perhaps I wouldn't have waited so long.

SPEAKER_00 24:52

Yes, that is true. So, um, like I had mentioned a little bit earlier, we all worked in these busy ERs that did not really have the resources or capabilities to just take care of the huge influx of sick people that were coming in there. And yeah, I mean, if you understood the truth of that, I mean, we literally would get so busy, we would have no rooms, we would not have staff, and we would have patients that literally could have been having a heart attack and we couldn't bring them back. I mean, it is really sad out there in a lot of these really busy ERs, and they're doing everything they can, you know. I'm not saying they just have limited resources, but that was very frustrating for um for all the ER docs because you have a lot of empathy, you have a lot of compassion. You don't like to see somebody wait in the waiting room sick, you know, for four or five hours, and and you're not able to reach out to them to really understand how sick you are. Now, there are protocols, you know, to that are in place to try to manage that as much as you can. But that was one of the most frustrating things as an ER doc, just to know there were people out there. You can't get to them, you're not really sure if they're really ill or not. But so when we designed advanced ER, we set it up so there's pretty much no weight. So you come to Advanced ER, you fill out a little bit of paperwork, and you get immediately back and you see a doctor pretty much right away. And I think out of, and we we have a lot of great stuff. I mean, we our Google reviews are one of the places is 4.9, probably the highest in the Dallas area. But I think probably the favorite thing for everybody is just the fact they can get in right away. You know, it's it's it's very user-friendly. So they get in right away. We they're seen by a doctor right away. And then uh the other big thing about us is you know, our our setting is very nice. You're not walking into a crowded, you know, germ-infected, sitting next to like a patient with coughing up C B or whatever. It's just it's a much friendlier, much germ-friendlier environment.

SPEAKER_02 27:10

Well, it looked like a hotel lobby when I walked in with this beautiful chandelier that has a funny story behind it.

SPEAKER_00 27:16

So yes, that's hilarious. We did not always have the chandelier, but one of our doctors, uh, his parents gave him that chandelier and he was kind enough to like put it in the lobby. And and you know, I I love chandeliers. I mean, I love the way the light reflects off them. I just love them. So it's a real pleasure for me to come in. But I, you know, weirdly enough, um, you know, when you're sick, anything you can do to kind of make you feel a little bit better. I mean, if you have a beautiful setting um where the doctors are are catering to you and bringing you warm blankets and you have no weight. Um, and if you're able to like get a little snack or whatever, that's also provided for you. All those little things just help you feel a little bit better when you're sick. And that's our whole goal is to make that you already feel lousy, and we want you to feel good. So any little thing we can do to push you towards that. Right.

SPEAKER_02 28:12

And I feel remember you offer warm blankets and private rooms too, which I think is key. And you accept most major insurance, all commercial insurance, yes. Okay, well, I'm sold. The next emergency I have, I'm right there. Can't can't wait to visit you guys. Thank you. Thank you.

SPEAKER_01 28:28

We look forward to making you better.

How To Find Advanced ER

SPEAKER_02 28:30

I hope no one out there needs you, but tell us how they can find you.

SPEAKER_00 28:34

Okay, yeah. Um, I mean, obviously, if they can just Google us advanced, and it's A D V A N C E. There's no D on it. Advance E R, um, then they'll be taken to a website where they can get directions really easy. Another really unique thing about advanced ER, if you call us, um, our front desk is really, really friendly. They will give you directions. They will, you know, if you have a medical question, we will actually connect you with a doctor to give you advice on your medical question, whether you need to come in, et cetera, et cetera. Or so um, so yeah, it is very easy to find us. It's very easy to get directions either from the internet or just calling us and asking.

SPEAKER_02 29:22

Perfect. Well, as always, I will include that link and the phone number so you guys don't have to remember it. And Dr. Allen and Dr. Pettit, I appreciate you so much. I've had so much fun talking with you, and thank you for joining me today.

SPEAKER_00 29:34

Thank you. We loved it. Thank you.

SPEAKER_02 29:35

That's been another episode of the Bubble Lounge. I'm Martha Jackson, and I'll see you next time.