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Should you visit primary care, urgent care or the emergency room?
When you’re sick or injured, it can be tricky to know which health care facility or service is best. Find out where you should go, depending on your symptoms, so you can get the care you need.
Between primary care doctors, urgent care clinics and the emergency room (ER), you have plenty of options to choose from when you need medical care. Unfortunately, it’s not always obvious which choice is best. And pandemic conditions have made it only trickier, with overwhelmed health care providers and additional protocols.
Here are some easy ways to figure out whether your concern is nonurgent, urgent or life-threatening.
When to call 911 or visit the emergency room
“The way I think about it is that ERs treat life-threatening conditions that can’t wait until tomorrow,” says Adrian Cotton, MD. He’s the chief of medical operations at Loma Linda University Health in California. “If you think it can wait, the emergency room is not the place to go.”
Look for other care options, such as an urgent care clinic, your primary care provider or a virtual care option. The Optum Store virtual care service makes it easy to schedule a same-day online appointment with a licensed doctor or nurse practitioner.
According to Dr. Cotton, the following symptoms may signal a medical emergency in adults. Call 911 or head to the ER if you have any of the following:
- Chest pain that feels concerning
- Shortness of breath or trouble breathing
- Severe headaches or a head injury
- Bleeding that won’t stop
- Sudden numbness or weakness in the face, arm or leg
- Unexplained seizures
- Loss of consciousness
- Bad allergic reactions that cause breathing problems or cause your lips to swell
- Sudden unexplained confusion or slurred speech
- Severe abdominal pain
- Fever that is not controlled by medications, fever that lasts for 2 to 3 days, or any fever of 105 degrees or higher
- Broken or fractured bones that are sticking through the skin or have resulted in a deformity, or if you suspect a serious break
These symptoms can be especially serious for older adults, pregnant women and people who have been diagnosed with a chronic condition such as diabetes, heart disease or lung disease.
Cost often influences where people go for care, and ER visits are often the most expensive care choice for you and your insurance carrier. But thanks to a new medical billing law called the No Surprises Act, which goes into effect on Jan. 1, 2022, all emergency room care is essentially considered in network.
This means you can visit any ER in the country without fear of getting billed for surprise charges. If there are any out-of-network charges, your health care provider has to notify you in advance and get your consent before providing care.
“Bottom line, if you have a concern or you are on the fence, it’s best to be safe and head to your local emergency department to be evaluated further, particularly if you have certain warning signs,” says Vivek Cherian, MD, a Chicago-based internal medicine doctor at Amita Health.
Freestanding emergency rooms offer the same services and care as traditional ERs without being connected to a hospital. But since they aren’t attached to a hospital, if you do need hospitalization, your care may be delayed.
When to go to urgent care
An urgent care center is a walk-in clinic. This is the place for less serious concerns that still need quick attention. Many clinics accept walk-ins outside of normal business hours, making them ideal for times when you can’t wait for a doctor appointment.
Expect varying levels of care. Some urgent care facilities provide care similar to that of an emergency room, including a wide range of diagnostic equipment (x-ray, computed tomography scan) and on-site laboratory services, according to the American College of Emergency Physicians. But many urgent care facilities are more limited. At the very least, you can get treatment for a variety of illnesses and injuries.
But no urgent care center has full emergency room capabilities, says Dr. Cotton. If you meet certain criteria, they will not treat you and will send you to an ER instead.
Visit urgent care if you notice any of the following symptoms:
- Minor abdominal pain, nausea or vomiting
- Burning or stinging sensation when you pee (urinary tract infection)
- Non-life-threatening allergic reaction
- Non-life-threatening breathing issues
- Skin problems such as a rash, infection or eczema
- Flu-like symptoms such as a fever, sore throat, sinus infection or cough
- Smaller wounds, such as cuts, that may need stitches
- Sprains or minor broken or fractured bones
- Headaches and migraine-like pain
Urgent care is also a good choice if you think you may have COVID-19. “The majority of urgent care locations now have the capability to screen and test people for COVID-19,” Dr. Cotton says. “It’s much better to go there than to clog up the emergency room trying to figure out if you have it.”
Urgent care centers may or may not have a licensed physician as a medical director, depending on state regulations. Most are staffed by primary care doctors, advanced practice registered nurses and physician assistants.
If you have insurance, check to see which urgent care centers near you are in your network.
When to see your primary care doctor
Primary care doctors can help with many of the same complaints that an urgent care center can, including respiratory infections, headaches, back pain and urinary infections. If your primary care doctor can fit you in for a same-day appointment (or even next-day, if you think you can wait), they may be able to get you started with care.
Keep in mind that primary care offices won’t offer the equipment or on-site testing you’d find at urgent care clinics and emergency room facilities. So if you need any lab work or x-rays to get a diagnosis, your doctor may need to refer you to a clinic. This will delay your treatment.
If you’re unsure whether you should visit urgent care, your primary care doctor may be able to guide you, Dr. Cherian says.
If you can’t reach your primary care provider, consider virtual care. “There are way more telehealth options today than there were two years ago, if you need to see somebody relatively quickly, which is really nice,” Dr. Cotton says.
Chatting with a health care provider through a phone or video call isn’t always the same as getting in-person care. But telehealth can be a quick, convenient way to get the answers you need.