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How to decide between urgent care, your PCP or the ER

January 22, 2019

Should a sprained ankle or chest pains send a person to the emergency room, or is an urgent care center more appropriate? The choice is difficult, to be sure, particularly for someone like me, who travels a lot.

But you don’t need to be a road warrior to realize the benefits of using an urgent care center: the wait is typically short, out-of-pocket costs are low, and the care is usually excellent.

So, to get some clarity on this matter, I reached out to an expert. Dawn Landis, manager of urgent care and occupational health at Indiana Regional Medical Center in Indiana, Pennsylvania, provided me a clear-cut description of where to go for the urgent or emergent care one may need — whether close to home or far way.

An urgent care center is a medical clinic with expanded hours that is specially equipped to diagnose and treat a broad spectrum of non-life- and non-limb-threatening illnesses and injuries.

IRMC’s urgent care centers in Indiana and Blairsville are staffed by board certified doctors in emergency medicine, family practice and occupational health. Services are enhanced by on-site radiology and laboratory services and operate in locations distinct from the freestanding or hospital-based emergency department. IRMC’s urgent care centers accept unscheduled walk-in patients seeking medical attention during all posted hours of operation, 8 a.m. to 8 p.m., seven days a week.

The economic factor

An urgent care visit is billed to a patient’s insurance, just as if one saw a specialist. An emergency room visit is billed with a higher deductible, co-pay and cost.

“Money talks,” Landis says. “People look at their insurance policies and see a $300 deductible for the emergency rooms and a $50 deductible for urgent care and say to themselves, ‘I may as well try my luck at the UrgiCenter.’”

Urgent care centers provide easy access to quality health care when your primary care physician’s schedule is full, or the office is closed. They are not, however, a replacement for a primary care physician, so don’t go looking to get a flu shot or regular check-up at the UrgiCenter.

“We’re in that gray area,” Landis says. “So, people who no longer have primary care physicians tend to wrongly look at us as a replacement, which we are not.”

Which to choose

Urgent medical conditions are ones that require care within 24 hours but are not life threatening.

Examples include:

Accidents and fallsCuts that don’t involve much blood, but might need stitchesBreathing difficulties, such as mild to moderate asthmaDiagnostic services, including X-rays and laboratory testsEye irritation and rednessFever or fluMinor broken bones and fractures in fingers or toesModerate back problemsSevere sore throat or coughSkin rashes and infectionsSprains and strainsUrinary tract infectionsVomiting, diarrhea or dehydration

By contrast, an emergency condition is one that can permanently impair or endanger one’s life. Dial 911 immediately for any medical problem that appears life-threatening.

Examples of conditions that need emergency medical care include:

Compound fracture, which involves a bone protruding through the skinConvulsions, seizures or loss of consciousnessDeep knife wounds or gunshot woundsFever in a newborn less than 3 months oldHeavy, uncontrollable bleedingModerate to severe burnsPoisoningPregnancy-related problemsSerious head, neck or back injurySevere abdominal painSevere chest pain or difficulty breathingHeart attack symptoms, such as chest pain that lasts longer than two minutesStroke symptoms; such as vision loss, sudden numbness, weakness, slurred speech or confusionSuicidal or homicidal thoughts

The bottom line: Emergency room visits are necessary for true emergencies, such as chest pain and severe injuries. For regular check-ups, see a primary care physician. Minor injuries and illnesses should be examined by urgent care physicians.

If greater care is needed than an urgent care center, IRMC’s staff will greet patients in front of the Indiana UrgiCare Center and direct them to the emergency room or proper provider.

“This way, we avoid multiple co-pays,” Landis says.

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