Become aware of the important differences between these two vital medical services

It’s late evening, and you’re feeling too sick to wait for the doctor’s office to open the next day. Or it’s Saturday and your child just fell off his bike and hurt his ankle. Or you’re pretty sure you have a urinary tract infection but don’t have a primary care physician. When in doubt go to the ER as they have more resources available.

First, always call 911 for a severe medical emergency with life- or limb-threatening issues, if moving the patient could cause further injury or if a paramedic or EMT with equipment is needed immediately.

Otherwise, you will need to evaluate the severity of your symptoms to decide. If you’re not sure, call your primary care provider (most have after hours service) or your insurance company’s nurse telephone advice line, if available.

When choosing where to seek treatment, one consideration is cost. Is the facility covered by your insurance? If so, is it considered in network or out-of-network? Some states have freestanding ERs that look like urgent care facilities but provide full ER service with ER costs, so be sure you verify it. Check with your insurer and find out if some facilities are considered preferred facilities. Gather this information when you’re not hurt or sick to avoid having to investigate when you’re not feeling well.

EMERGENCY ROOM (in hospital, hospital affiliated or freestanding)

The ER is better suited for severe illnesses and injuries, or illness and injury for which severity is unknown. They are open 24 hours a day, 7 days a week and 365 days a year, and are required under the Emergency Medicine Treatment and Labor Act (EMTALA) to accept all patients for at least a screening to exclude life-threatening conditions. Fully equipped, they provide the highest level of care but usually at a higher cost than a clinic.

  • Loss of consciousness
  • Choking
  • Difficulty breathing or significant shortness of breath
  • Facial drooping or weakness in an arm or leg
  • Difficulty standing, walking or speaking
  • Fainting, sudden dizziness or weakness
  • Significant allergic reactions
  • Chest pain
  • Severe or unusual abdominal pain or pressure
  • Severe and uncontrolled bleeding, or bleeding that does not stop after 10 minutes
  • Head trauma
  • Seizures
  • Heat stroke or heat exhaustion
  • High fever, especially with headache and stiff neck or if the fever does not come down with OTC medication
  • Poisoning or overdose
  • Significant burns
  • Electric shock or lightning strike
  • Significant eye injury

Note: The signs and symptoms listed are examples of some common conditions requiring emergency care, not a comprehensive list.

According to the American Academy of Urgent Care Medicine, in addition to routine and wellness services, urgent care centers provide “medically necessary services which are required for an illness or injury that would not result in further disability or death if not treated immediately, but require professional attention and have the potential to develop such a threat if treatment is delayed longer than 24 hours.” If you go to an urgent care facility but actually have a medical emergency, the personnel there will send you to the ER — but in a true emergency situation this could cost valuable time and delay your care.

URGENT CARE

For urgent but non-emergency situations, these are stand-alone clinics that usually have evening and weekend hours. They’re good for common, non-serious, well-understood medical ailments or conditions when a regular physician’s office is unavailable. Services vary by facility — some perform lab tests and X-rays while others don’t. They have less equipment and staffing than ERs which makes them less expensive, but patients should be careful about verifying costs and coverage. Wait times tend to be shorter than the ER, and payment is usually made at the time of service.

  • Flu
  • Low-grade fever
  • Earaches
  • Nausea, diarrhea, vomiting
  • Minor coughs, congestion, sinus infections, upper respiratory infections
  • Sore and/or strep throat
  • Rashes and minor skin conditions — e.g., ringworm, rosacea, dermatitis, sunburn, swimmer’s itch, warts, poison ivy, poison oak
  • Non-severe, non-reactive animal or insect bites
  • Sprains
  • Burning or soreness with urination
  • Minor bone fractures
  • Minor lacerations requiring stitches
  • Minor burns
  • Migraine
  • Muscular (not neck or spine) back pain
  • Non-severe eye injury or irritation, pinkeye, sties
  • Wellness care such as physical exams, vision and hearing screenings and basic screenings and monitoring of established conditions