Do you understand the difference between a Primary Care Provider, an Urgent Care clinic, and an Emergency Room? The differences can cost you money, and potentially bypass the most appropriate treatment for you and your family.
Medical expenses take a large bite out of many peoples’ monthly budget. They’re also the leading cause of bankruptcy in this country. Even health insurance may not help you if your deductible is high or the insurance company denies your claim.
So where should you go if you need medical care? It depends on what services you need and how urgently you need them, which in turn can depend on how severe your health problem is. With the many options available in the American medical system, it pays to know when something is routine, urgent or emergency.
Here are some useful guidelines for the services that may best help you:
- Primary Care Provider
Your Primary Care Provider (PCP) is typically a general practitioner with whom you build a long term relationship. Your PCP service keeps regular office hours. It offers invaluable continuity of care by keeping a medical chart, by monitoring how you respond to treatment over time, by following up, and by offering yearly checkups and referrals to specialists.
In short, you can build an ongoing relationship with your PCP and turn here first for your non-urgent medical issues. Note, however, that an urgent care facility can offer a lot of primary care too.
- Emergency Room
The Emergency Room (ER) has a staff of highly trained professionals, including often a physician trained and experienced in Emergency Medicine, who can react quickly to any life-threatening situation that rolls through the doors. This could include heart attacks, strokes, car accidents, bleeding during pregnancy, and so on. Emergency rooms carry the latest and best lifesaving equipment. This is reflected in their fees.
In short, if you or someone you know is having an emergency that threatens life, limbs, or organs, go to the ER. If you are considering calling 911, go to the ER.
- Urgent Care
Urgent Care facilities are a middle ground between your PCP and the local ER. They handle a range of non-life-threatening illnesses and injuries such as wounds that need stitches, sprains and even broken bones, as well as infections, fevers and things like flu and strep. Urgent Care centers also offer many routine services (see the next section). These clinics are highly convenient, with shorter wait times and greatly lower charges than an ER, combined with longer office hours than a PCP.
In short, if you need medical attention quickly and conveniently, but not for a life-threatening situation, visit your local urgent care.
The Advantages of Urgent Care
Urgent Care facilities have gained popularity because they fit the public’s need for services that aren’t life threatening but need to be addressed soon (hence the name ‘urgent’). They also offer a variety of convenient non-urgent services. These include:
- Drug and tuberculosis testing
- Strep, flu and mono testing
- X-rays for sprains and minor broken bones
- Stitching minor cuts
- Physical testing as required for various jobs like the Department of Transportation
Some clinics offer other conveniences like online bill pay and electronic check-in forms. These clinics have far shorter waiting and service times than the ER, typically under 30 minutes versus sometimes over 2 hours for the Emergency Room (and according to the CDC, ER wait times are increasing). Dr. Gregory Blomquist, Chief Medical Officer at Community Med Family Urgent Care, advises: “It always pays to get diagnosed and treatment as rapidly as possible.” And with the short wait times and walk-in welcome of urgent care facilities, this may be your best bet.
The lower charges of urgent cares can be as much as one-tenth of the cost of the ER. It can also pay off to go to Urgent Care instead of the ER for another important reason: insurance. These clinics typically take most major forms of insurance, including Medicare, and your insurance company is less likely to deny this claim than one from the ER, which always treats as an emergency and sometimes can include out-of-network attention.
The Limitations of Urgent Care
Urgent Care clinics typically offer general services, but they can’t handle specialized procedures like CAT scan, MRI or surgery. If you need to access these services you’ll have to go through a hospital.
Although they are open for evening and weekend hours, urgent cares do typically close at night. If you have chest pain and trouble breathing at 2 AM, don’t wait until your local urgent care clinic or PCP office opens – call 911 or get to the ER now.
Urgent Care clinics also do not fall under the Emergency Medical Treatment and Active Labor Act of 1986. The ER is required by Federal law to help anyone who comes in for care, regardless of whether they’re insured or can pay. This is one of the reasons why Emergency Rooms tend to be crowded with long wait times, since it’s one of the few options for people of limited means.
It Pays to Plan Ahead
The services, fees, and insurance options for urgent care vary from one clinic to the next. Consider taking a little time to map out what your local options are. It can save you trouble and money in the long run.