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ER, Urgent Care or PCP – Where should I go for health care?

ER, Urgent Care or PCP – Where should I go for health care?

Author: Dr. Bartley Bryt

Urgent care centers are a little like Starbucks: They seem to be popping up on every corner. Well, there’s a good reason for this, and it has to do with (you guessed it) money.

Urgent care centers are like a primary care physician, but in a storefront, and without any continuity in your care. And on all health plans I’ve heard of, they also command a higher copay. But urgent care centers are popular because we’re an impatient society that wants something when we want it, and urgent care centers deliver immediacyin care.

If your condition can wait, you’re better off seeing your doctor, who knows you and your history, and will cost you less. Below are some helpful guidelines – and see our infographic– about whether you should see your doctor, visit urgent care, or go to the ER.

Should I see my doctor, visit an urgent care center, or go to the emergency room?

Unless it is obvious that you should go to the emergency room (ER) or call 911, you should CALL YOUR DOCTOR! All doctors have an on-call service or a nurse triage line that can give you some direction. Your doctor or the nurse triage line can even call in a prescription to your pharmacy if medications are called for.

What if my doctor, her partner, or her practice is not available to speak with me?

If you have access to one, you can use a telemedicine service where a physician appointment is done – right on the telephone. Another alternative is to visit an urgent care center.

Before you find yourself sitting for hours in a hospital emergency room, or end up with medical fees that are not fully covered by your health plan, explore other options first.

When should I go to urgent care?

Urgent care is basically a primary care physician who you doesn’t know you, in a storefront. It’s preferable to go to your doctor who knows you and your medical history, for better coordinated care. Plus, you pay a lower copay to your doctor than you would pay at an urgent care center.

What if I don’t have a doctor?

You can find a doctor who’s in your network and make an appointment. If it’s after hours and you don’t have a doctor you can call, then go to urgent care if it can’t wait to find a doctor in the morning.

What exactly is emergency care?

Emergency care is necessary when a person has an unexpected onset of symptoms or a severe medical condition, accident, or illness that could place a person’s health in jeopardy if not treated with immediate medical attention. Severe, sudden symptoms or conditions that don’t quickly get better such as chest pain, extreme shortness of breath, and bad accidents causing severe pain or bleeding require emergency care.

A good rule of thumb is to ask yourself one question: Can it wait an hour or two? Situations that normally don’t require an emergency room and might not be covered by your plan if you go to ER include: persistent cough, headache, sore throat, rashes, and earaches.

Dr. Bartley Bryt is Chief Medical Officer at Brighton Health Plan Solutions (BHPS), an innovative health care enablement company with several industry-leading brands. BHPS’s new Create® health plan partners with local health systems of doctors and hospitals. These provider networks compete in the Create marketplace, delivering better health care at lower cost to employers in the New York tri-state area. Learn more about Create at createhealthplans.com.

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