When should I go to the emergency room?

So you’re feeling sick and need to see a doctor: where should you go? The emergency room? An urgent care? Schedule an appointment with your primary care doctor?. Each of these places can help you take care of acute problems, but one will be more appropriate than the others depending on what is going on. It is important that you go to the right place not only to make sure you get the care you need, but also to make sure you don’t get a huge unnecessary bill. So how do you decide where to go?

The emergency room: In the United States emergency rooms are required by law to medically assess every patient who comes in for care to make sure they are stable regardless of their ability to pay, so even if you don’t have insurance, if you are having a true emergency you should go to the emergency room. However, this is the most expensive place to go to get care, so you should only go here if you are having a true emergency. If you go to an emergency room when you are not having a true emergency, you are most likely going to have to wait for a while because other people who are sicker than you will take priority. Emergency room doctors are excellent at taking care of people who are very sick- they save lives every day. However, they do not have the time or the resources to spend on working up chronic symptoms, and treating minor illnesses is not the best use of their time. They are focused on deciding if you need to be admitted to the hospital, to have emergent surgery, or if you need intensive care. If you don’t need any of those things, they are going to refer you to follow-up with your primary care doctor. Reasons you should go to the emergency room include: chest pain, difficulty breathing, weakness/numbness on one side of the body, slurred speech, fainting/losing consciousness, confusion or a change in mental status, serious burns, head or eye injury, broken bones or other serious injuries, seizures, severe abdominal pain, vaginal bleeding while pregnant, or any other situation in which you feel your life is in immediate danger.

Urgent care: Urgent cares are not emergency rooms and do not have the ability to manage a true emergency. They are much cheaper than emergency rooms. They may have some additional services such as an x-ray machine and they don’t require an appointment so you can walk-in and be seen the same day. They are also usually open for longer hours than your doctor’s office. Urgent cares are great for treating cold and flu symptoms, urinary tract infections, minor injuries or cuts that might require stitches, or any other minor issue that is not life-threatening or a true emergency, but that you want taken care of quickly. Many of them are staffed with nurse practitioners and/or physician assistants as well as doctors, so you may not necessarily see a doctor when you are there. Similar to emergency rooms, they don’t have the time or resources to diagnose chronic problems, they will take care of one acute issue and then refer you to your primary care doctor to follow-up.

Your primary care physician or PCP: Your PCP should be your first stop for any concern about your health that is not an emergency. In their office they can do your routine check-ups, manage chronic diseases, handle minor acute problems, do minor procedures, and they can also help diagnose the cause of chronic unexplained symptoms. They will get to know you over time and become your best ally in taking care of your health and preventing you from getting sick in the future. Many PCPs offer same or next day appointments for their patients for acute problems, which can help you avoid an urgent care visit. If you can see your PCP, this is always preferred to an urgent care because they will have a better understanding of your health as whole than someone you have never met at an urgent care. PCPs who practice under a direct primary care model take it a step further and offer direct access to your doctor when you need them, so you can text them with questions or even give them a call after hours if you have an urgent concern. They will spend longer with you at each appointment and often can take care of minor issues for you virtually because they know you and your history so well, so you may not even need to take time out of your day for an appointment. Sadly, a recent study in the Journal of the American Medical Association showed that 25% of Americans do not have a primary care physician. Having a PCP has been shown to reduce your risk of premature death because they help you be proactive about your health rather than reactive when a problem shows up. Even if you have chronic problems and see a specialist, you still need a PCP because specialists are best trained to focus on the specific condition they are treating, not your health as a whole. Your PCP is also the most affordable place for you to get your care. Even if you don’t have any insurance, you can get excellent primary care through a direct primary care practice to not only keep you healthy, but keep your wallet healthy too!

If you are looking for a primary care physician in the Houston area, our members offer direct primary care and specialty care services for patients of all ages. We strive to be accessible to our patients when they need us and focus on preventive health to keep you healthy and out of urgent cares and emergency rooms. Find a doctor for yourself and your family here.

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