Which do you need?
It’s 10:00 p.m. on Friday night. You felt a little “off ” all day. A little achy. A little tired. But you figured the weekend would take care of everything.
Your doctor’s office has put a message on the answering machine that says, “Sorry you’re sick. Call 911 for an emergency; otherwise, suck it up Buttercup.” Unfortunately it’s beginning to feel like a demonic parrot with a handlebar mustache is trying to peck its way through the back of your throat. What are your options if you don’t want to suffer in silence?
In the old days, your only other option was the emergency room (ER). In the old, old days, you dispatched a farmhand to roust the doc in the holler to get in his buggy, and hope the crick was fordable. That is why mortality was high.
Today, we have a variety of options: emergency room, urgent care, a walk-in clinic, telemedicine, Doctor Google, the local pharmacist, and Aunt Mildred. We will discuss the pluses and minuses of choosing an urgent care vs an ER. I don’t have the space to address Aunt Mildred.
ERs are accessible 24/7, and capable of handling nearly any level of illness. They are staffed around-the-clock with highly trained personnel, and are equipped with the latest technology. The medical professionals there deal with heart attacks, strokes, fractures, internal bleeding, meningitis, pneumonia, blood poisoning, and many other serious health conditions.
ERs tend to have higher costs, longer waits, and care that may not be coordinated with other healthcare the patient has received. The average cost of an ER visit for a sore throat is around $600, versus $100 for an urgent care visit. Plus, the wait can be long if your illness is not classified as life threatening. The ER will likely not have any access to your records, unless you have previously visited the hospital. They won’t have your history, or list of allergies, so doctors are more likely to run tests and prescribe medication if they are unfamiliar with the patient.
Urgent care centers may provide faster, cheaper services for non-life-threatening problems. But again, if they are not familiar with the patient, it can add to the number of tests and drive up costs. The best option is an urgent care, or extended hours clinic, run by your primary care practice, a concept which is becoming more common.
So where should you go? There is no one particular answer, but the best general guideline is the “Prudent Layperson Standard,” which defines when an ER visit is required: “Any medical or behavioral condition that would lead a prudent layperson, possessing an average knowledge of medicine and health, to believe that the severity of their condition would result in death or harm to a physical organ.” So if a reasonable person thinks their life or a limb is in danger, they should drive by the urgent care and go directly to the ER. Insurance companies are starting to deny coverage for some ER visits based on this standard.
Your demonic parrot pecking at your throat is best removed at an urgent care. Your chest pain, labored breathing, broken bone, severe tummy pain, or crossbow mishap is ER material.