When faced with a sudden serious medical situation, many people tend to rush to the nearest emergency room. But that’s not always in your best interest. Studies show that emergency room use for non-emergencies can result in increased costs and unnecessary testing and treatment. Sudden or serious medical situations, that aren’t emergencies, are often better handled by urgent care centers. How do you know which treatment center is best for you?
Reserve the ER for Emergencies Only
In general, you should think of the emergency room as the place to go in a real emergency. “If you have a very serious injury or illness – that’s when the emergency room has great value,” says Matthew Burke, MD, an urgent care physician in Washington, DC. “Severe chest pain, any symptoms of a stroke – including facial droop or slurred speech – a fever higher than 103 degrees, major injuries with lots of bleeding, or severe pain are all good reasons for an emergency room visit,” he says.
Good reasons to go to the Emergency Room may include:
- Heavy bleeding
- Large open wounds
- Sudden change in vision
- Chest pain
- Sudden weakness or trouble talking
- Major burns
- Spinal injuries
- Severe head injury
- Difficulty breathing
- Major broken bones
Most studies have found that at least 30 percent of emergency room visits are not urgent. A 2011 survey found that about half of the people who had visited the ER did so because their doctor’s office was closed. Many of these visits can be handled by urgent care centers.
Studies find that uninsured patients are more likely to visit the emergency room because they have nowhere else to go. Emergency rooms are required by law to care for anyone who comes in, regardless of their ability to pay. But if you have insurance, avoiding the emergency room could save you time and money. “If you are not having a life-threatening condition, it’s often to a patient’s benefit not to seek emergency care,” advises Burke.
For starters, wait times are usually long in the ER, especially if you don’t have a dangerous condition, because life-threatening conditions get priority. A 2014 survey conducted by the Urgent Care Association of America (UCAA)(opens in new window) found that 90 percent of urgent care centers reported that the wait time to see a doctor was less than 30 minutes. This beats the average four-hour wait in emergency rooms.
Emergency rooms are also more expensive than urgent care centers. Consumer Reports estimates the average out-of-pocket cost of an ER visit to be $400, compared with about $120 for urgent care. Even if insurance covers the visit, your co-pay will probably be higher for the ER. One study estimated that the health care system could save $4.4 billion per year if people went to urgent care centers or retail clinics instead of emergency rooms for non-life-threatening conditions.
One other benefit of avoiding the ER is avoiding potential infection. “At the ER you are in hospital setting,” says Burke, “so the likelihood of being exposed to someone with a contagious illness is higher.”
Still, if you are unsure whether you are facing a real emergency, Burke recommends you play it safe. “If you believe it might be an emergency or a life-threatening event, I wouldn’t waste any time trying to research it,” he suggests. “I would call 911 and go right in.”
Urgent Care Centers Treat More Than You Think
Long waits for both emergency room treatment and primary care appointments have given rise to the popularity of urgent care centers around the country. These centers cater to patients who need to be seen quickly, often after-hours, for non-life-threatening medical issues. Urgent care centers treat a wide range of conditions – from pink eye to broken bones.
Consider urgent care for:
- Minor broken bones (example: finger)
- Minor infections
- Small cuts
- Sore throats
“Although urgent care is more expensive than primary care, it is probably safer and cheaper than the emergency room for non-emergency issues,” says Burke. “But you don’t want urgent care to ever become your usual source of primary care. It’s for occasional acute illnesses.”
Urgent care centers are different from retail clinics, which are often located in pharmacies or big box stores and treat minor acute illnesses. Urgent care centers typically have doctors on staff and can address more serious issues – like a broken bone – than retail clinics.
“It’s always a good idea to check with your insurer to make sure your urgent care visit is covered,” says Burke. “It’s my experience that most acute conditions are covered, but some screening and testing is not.”
Coordination of Care
If you do seek urgent or emergency care, it is important for that information to be shared with your primary care provider to ensure proper follow-up and recordkeeping.
If the hospital or urgent care center is part of your health system, it can probably forward the information for you. But if it isn’t, ask for a complete copy of your records and deliver it to your primary care doctor yourself.
It’s also important that you inform the ER or urgent care clinic of any medications you are taking, advises Ada Stewart, MD, a family physician in Columbia, SC. “I treat HIV and Hepatitis B, and many times I’ve had patients who have gone to the ER or other quick access providers, and have not let them know about the medications they are on for fear of stigma,” she says. “This can be very harmful because a lot of medications can have bad interactions.”
This is why it’s best – when you aren’t facing a true emergency – to try to get in to see your primary care physician first. “Most family physicians have after-hours service,” notes Stewart. “In my practice we also have someone on call 24/7. We really want our patients to be able to access the care that they need from their primary care provider, who knows them and can provide continuity of care.”
So if you find yourself with an immediate medical need, ask yourself whether it is a true emergency. If you’re certain it’s not an emergency, consider an urgent care clinic. If you think it might be life threatening, or if you aren’t sure, go to the emergency room right away. You don’t want to be the one to play down chest pain that signals a heart attack, when a matter of seconds can mean life or death.
“Urgent Care: What You Need to Know(opens in new window),” Consumer Reports on Health, April, 2009.
Lori Uscher-Pines, et al., “Deciding to Visit the Emergency Department for Non-Urgent Conditions: A Systematic Review of the Literature(opens in new window),” American Journal of Managed Care, January 2013.
Renee M. Gindi, et al., “Emergency Room Use Among Adults Aged 18–64: Early Release of Estimates From the National Health Interview Survey, January–June 2011(opens in new window),” Centers For Disease Control and Prevention, May 2012.
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