Where do you go when you need help?

One of the duties I have as a Certified Care Manager is to, prevent avoidable trips to the hospital, to include ED (Emergency Department)/ER (Emergency Room) visits. Many people do not have a clue how this is possible, but it is, but it takes work on the part of the patient, all MDs involved in care of the patient, home health, care managers, and truly any person who has contact with the patient and could impact their health or conditions for better or for worse (sounds like marriage, right 😊).

It's important to understand the differences between emergency rooms (ERs), urgent care, and Primary Care.

Life-threatening conditions (loss of limb or unconscious) would indicate need for the ER; non-life-threatening conditions (cough or mild allergic reaction) would indicate need for urgent care or even primary care. A PCP (Primary Care Provider) is a doctor (even a Nurse Practitioner, under the supervision of a MD, for state of SC) you select to be your general source for addressing your health care needs.

In the specialty of Care Management, we see the PCP as the “gatekeeper”. Meaning they should know everything about you, your conditions, and your health status; nothing goes without them knowing. Your PCP, should coordinate and collaborate with your specialists. Your PCP is the first one you should contact when you need “urgent” care. PCPs often leave time in their schedule for “sick visits,” and can see you within 24 hours or help problem solve over the phone. If the symptoms you share warrants your PCP can refer you to the ER or if he or she has privileges to admit, they can admit you to the hospital from their office. However, and unfortunately, we live in a time where PCPs are scarce and over booked. So many of the things described above, rarely occur.

Urgent care has been proven to be quicker than the ER, less costly than the ER, and hours are more flexible than PCPs offices (now many urgent cares can be used as PCP offices). Urgent care centers are typically around seven times cheaper (averaging a cost of $200) than a visit to the emergency room (averaging a cost of $1,400). At an ER, you may also have multiple charges, higher co-pays, and you may be left to pay the medical bills yourself if your insurance company determines that the event that brought you to the emergency room was a non-medical emergency.

Here are some additional examples of when to head to an ER:

Signs of heart attacks, including chest pain
Signs of stroke, like sudden onset of numbness in the arms or legs
Severe shortness of breath
Poisoning
Suicidal or homicidal feelings
Head injuries
Severe abdominal pain
Spinal injuries
Uncontrollable bleeding
Seizures
Drug overdoses
Severe burns
Severe allergic reaction

Here are some additional examples of when to head to an Urgent care:

Fever
Ear pain
Painful urination
Persistent diarrhea
Sore throat
Vomiting
Mild asthma
Minor burns
Rashes and other skin irritations
Animal bites
Dehydration
Lacerations
Infections
Simple fractures and sprains

Emergency rooms operate by treating patients with the most serious and demanding conditions first, this is called triage. So being seen first is not a good thing, hence the long wait times.

As a RN and Certified Care Manager, having worked in insurance, in the hospital setting, and in the community. I would love for us to get back to a time where the PCP was not booked and overworked and the ED/ER was used for true emergencies. Now there are many reason why patients used the ER/ED, which would take several blog posts to discuss. But for this post, I wanted to ensure there was some basic knowledge on the differences between emergency rooms (ERs), urgent care, and Primary Care. As a Certified Care Manager, I get asked this question often and it is a great question to ask, because urgent cares are now “popping” up everywhere.

To summarize:
If it is not a true emergency, try to contact your primary care physician. This is the most affordable option.
If it is not an emergency and your PCP is not available, try an in-network urgent care center. This option is still more affordable and helps you to avoid the longer wait times in the emergency room.
In case of an emergency, go to the nearest emergency room. If you are unsure if you can get there on your own, call 911.

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