Emergency Room? Urgent Care? Doc’s Office?
All illnesses and injuries are not the same. Know where to go, when.
Have you ever gone to the emergency room? The emergency room (ER) does not go by appointment or first-come first-served. In the ER, patients are seen by the seriousness of their condition. If you had to wait, you might have been at the wrong place.
We asked Perla Acevedo Tran, a licensed physician in Mexico working on getting her license in the U.S., to shed some light on where to go and when. Her insights might surprise you!
But first, let’s put the facts on the table. The Centers For Disease Control and Prevention statistics show there were about 130 million emergency room visits in the U.S. in 2018. About 13 million of these ER visits were considered not urgent. Medicaid patients used the emergency room twice as much as people with private insurance.
Studies show a visit to the emergency room can cost 10-12 times higher than the cost of care provided by a PCP or urgent care. The estimated average cost of a visit for a Medicare patient to the ER in the U.S. in 2017 was $660 (not adjusted for complexity of care).
When you put all these numbers into perspective, you can understand why federal and state governments, which pay all Medicare costs, want to pare down the nonemergency ER visits. But it’s more than that. When you go to the right place for your healthcare, you get the best care available. And believe it or not, it’s not always the ER.
Primary Care Provider
Your most important health connection will always be your doctor primary care provider (PCP) otherwise known as your doctor. You do have one, yes? If not, this is something you want to set right because many of you and your family’s health concerns will probably be best taken care of in your doctor’s office.
Your doctor is where you go for minor illnesses (such as a cold, earache, flu and mild Covid-19 symptoms) and injuries, women’s services, physical exams and sports physicals, preventive care, chronic conditions, stress and anxiety.
“Things like migraine or low-grade fevers should be treated at home,” Tran added. “We should reach out to family to help with controlling symptoms or even a pharmacist in our local pharmacy. They are very knowledgeable and can direct us about what over-the-counter meds would aid our symptoms.”
If your doctor’s office is not open and you have a minor illness or injury that can’t wait for care, urgent care is your place to go. This includes wounds with minor bleeding that need stitches, urinary tract infections, moderate back problems, sprains, strains and minor broken bones (toes and fingers).
A trip to the emergency room is often a life-or-death situation or one that requires special equipment or an operation to treat. This is where you go if you broke a bone and the bone is sticking out, if you’ve been severely burned or have an injury with uncontrolled bleeding.
“Things that are critical in nature,” Tran said, “like chest pain, seizure, blunt trauma, severe motor vehicle accidents.”
For other life-threatening symptoms, think poisoning, a bad blow to the head, loss of consciousness, uncontrolled bleeding, difficulty breathing, sudden change in vision, sudden weakness or trouble speaking, and severe abdominal pain.
“If you have nonstop severe pain for six to eight hours,” Tran said, “go to the ER because there could be a chance there is something very wrong like appendicitis, gallbladder problems or something rupturing.”
This includes chest pain after a heavy meal.
“Symptoms should not be taken lightly,” Tran advised. “Whether it’s chest pain or acid reflux, we don’t know. If we don’t know what it is, and it is a heart attack, we are losing heart muscle by waiting.”
Back to Square One
If you go to the emergency room, keep in mind you will be instructed to make an appointment with your doctor once you leave the hospital.
“The doctor will be able to provide refills on medication prescribed in the ER or additional testing that needs to be done,” Tran explained.
And your doctor may very well be able to help you prevent the problem from causing another visit to the ER. In our article later this month, we’ll take a look at how to avoid the emergency room if you can and why you may get better care if you do.