ER or urgent care or virtual Care? When to go where.
As welcome as it was for thousands of Washingtonians and millions of Americans, the advent of the individual healthcare market created an almost immediate shortage of care outlets. Emergency rooms caught the brunt of the overload with many patients showing up with conditions that could easily be managed by primary care providers.
Healthcare organizations quickly went to work on an updated model of care, one that could manage the influx of new card-carrying individual healthcare plan members.
One of the core features in this modernized model was the concept of urgent care. Largely an under-utilized option for decades, urgent care practices rose to prominence after 2010, popping up seemingly around every corner of town.
Meanwhile, the COVID-19 pandemic occurred. If the urgent care center hadn’t shown its place in the healthcare ecosystem before the pandemic, it sure did during, and after.
Access ramps up
Healthcare systems and health plan organizations both got into the act, opening their own urgent care centers and primary care practices (like our member-exclusive Kinwell clinics) to help fill the gap between a primary care practice and ER.
The pandemic also provided fuel to another budding tool that has since firmly rooted itself in the healthcare ecosystem: virtual care. For conditions that did not require in-person visits with the doctor, virtual care was (and is) a breakthrough tool for patients and providers.
But with more care outlets and options comes more confusion about where to go for what. When do you go to your primary care provider versus urgent care versus ER?
Here are our recommendations.
Primary care provider
For non-life-threatening emergencies, your first call should always be to your primary care provider (PCP). Your PCP has all your records and medical history, vital for faster diagnosis and treatment. Take advantage of your established relationship with a PCP anytime you can, especially for management of chronic illnesses.
Urgent care centers
Appointments with your PCP are sometimes not as timely as you’d like them to be. If your condition is not a life-threatening emergency but you don’t feel you can wait even until the next day, a trip to urgent care might be the answer for you. Think, allergies, cold or flu, fever, headaches, an ear infection, sprained ankle, back pain, or other occasional conditions you might otherwise see your PCP to treat.
Most urgent care centers keep hours that are longer and offer more flexibility than those of PCPs.
Virtual care
Virtual care isn’t a “level” of care in the vein of ER, urgent, or primary care. More so, virtual care is a convenient and optional tool typically used for connecting with your PCP on issues that don’t require an in-person visit. Say you’re a parent watching the kids at home and need to see a doctor just to get a prescription refilled. Perhaps you want to speak with your PCP about a condition flaring up while traveling. Maybe your doctor just wants to do a quick check in with you following a procedure or treatment. If your PCP has a virtual care option, use it to get access you need and a dose of convenience that makes sense for the moment.
Emergency room
First let’s be clear, for extreme conditions where obvious and immediate medical intervention is required for you, a family member, or someone you are with, call 911.
Otherwise, go to the ER for severe conditions that you think could be life threatening if left untreated. Examples of severe conditions include a persistently high fever, broken bones, open wounds, heavy bleeding, difficulty breathing, severe chest or other pain, and poisoning or drug overdose.
Ultimately, do what your body tells you to do. If you feel you need to go to the ER, go. Not sure? Go. Err on the side of caution.
And then there’s the cost
Primary care, urgent care, and virtual care will all be significantly less expensive than care from an ER. That said, don’t let cost drive your decision. All four services are covered under your LifeWise health plan. Just make sure it’s the right level of care for your condition.
Easing the burden
A study by Johns Hopkins found that more than half of emergency department visits were “non-emergent or primary care treatable.” Little wonder, then, why hospital administrators and other healthcare leaders are doing their level best to educate consumers on how and when to use the ER.
Easing the strain on overloaded emergency rooms is paramount. Helping people understand level-of-care options is one way to do it. Opening more clinics and care centers is another. Taking preventive steps about one’s own care is yet another. Be sure to stay up to date on vaccines, take advantage of medical screenings when recommended by your doctor or health plan, and make annual checkups part of your healthcare routine.