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Know where to go: When to go to the ER, urgent care, or your doctor

Imagine it’s a Friday evening — and after a long week at work, the only thing that’s on your mind is food. But instead of your usual takeout, you decide to put on some jazz music, pour your favorite beverage, and cook a meal (from scratch, no less!). You start chopping up the vegetables and... 

 

Ouch. That didn’t feel good. You put your chopping knife down to assess what just happened.  

 

Double ouch. You cut your finger bad enough to make your queasy best friend leave the room (and lose their appetite). And you’re no doctor, but you have a hunch you’ll need stitches. The real question is, though: where should you go to get them?  

 

It’s a common question many have when they get a burn, the dreadful stomach bug, an infection, or a possible bone fracture. Even a sports physical! So if you’ve ever wondered where you should go to get the most effective care at the lowest possible cost, keep reading. (But you should probably get your finger checked out first.) 

 

When to go to an emergency room  

 
Emergency rooms are designed to treat critical patients or patients who need urgent care. Emergency rooms are on a first come, first serve basis, but also according to the severity of your condition.  

 

While an emergency room won’t turn you away for the treatment of a cold or flu, keep in mind that emergency room visits typically cost significantly more money and time. For instance, a visit to the emergency room can cost anywhere from $150 to $3,000, not including tests, lab fees, and other services. Plus, it clears the way for those in an actual emergency. 

 

You should dial 911 or head to the emergency room ASAP for:  

 

  • Severe injuries like fractures, severe burns, and severe trauma to the head or other areas of the body 

  • Chest pain or discomfort 

  • Unconsciousness  

  • Severe nausea or vomiting (which can lead to dehydration) 

  • Symptoms of a stroke (which are weakness on one side of the body, slurred speech, and blurry vision) 

  • Shortness of breath or difficulty breathing 

  • Severe or uncontrollable bleeding  

  • Any other serious or potentially life-threatening condition 

 

When to go to an urgent care or walk-in clinic 

 
Urgent cares are a convenient alternative to visiting your primary care doctor, if he or she is not available when you need them, if you don’t have a primary care doctor, or if you’re traveling. They’re also an effective alternative to urgent medical needs that aren’t severe enough to visit the emergency room. At urgent cares or walk-in clinics, you can see a medical provider (either a physician or nurse practitioner) without an appointment. Most are open after hours, on weekends, and most holidays.  

You should go to an urgent care or walk-in clinic if you think you’re experiencing: 

 

  • A minor illness such as a sore throat, cold, headache, or earache 

  • Skin infections and rashes  

  • Minor sprains, or fractures 

  • Minor eye injuries 

  • A mild to moderate asthma attack 

  • Dehydration or heat exhaustion 

  • Minor burns, cuts, and bruises  

  • Mild abdominal pain  

You can also go to an urgent care if you need a sports physical or vaccinations, but depending on your health insurance plan, it might be cheaper to stick with visiting your primary care doctor for these instances. Though urgent care visits are usually covered by insurance, there’s a chance your out-of-pocket costs (like your co-pay) could be higher.  

 

A few other things to keep in mind if you’re visiting an urgent care or walk-in clinic:  

 

  • Patients are seen on a first come, first serve basis, so wait times may vary. In some cases, you can check wait times online or even reserve your spot in line (or use a good old fashioned phone to call ahead). 

  • Check to see if your local urgent care is in-network. (Yes, networks extend here too!) 

  • You’ll need to bring a photo ID and health insurance information. Since it’s not a clinic you visit regularly (like your primary care doctor’s facility), they’ll want some verification.  

  • You’ll be responsible for any co-pays or payments at the time of your appointment instead of billing you later. 

 

When to go to your primary care doctor 

 

For non-emergency situations, your primary care doctor should be your first phone call. That’s because your primary care doctor knows your health history, the prescription medications you’re taking, and other important health information that he or she can take into consideration for treatment.  

 

You should schedule an appointment with your primary care doctor for:  

 

  • Preventive care  

  • Sports physicals 

  • Treatment of common illnesses (like cold and flu)   

  • Early detection of illnesses or conditions  

  • Management of chronic or long-lasting conditions   

If your primary care doctor isn’t available right away or you have a specialized need, he or she may refer you to a specialist for more effective care. For example, if you have recurring sore throats, your doctor may recommend you visit an otolaryngologist.  

Plus, the cost of visiting your doctor will be much less than if you head straight to the emergency room (unless you need to, of course!) if you have health insurance. You’ll usually just pay a co-pay for your visit and any tests, x-rays, or medications required.  

 

Sometimes determining where you should get care is a tough call, especially if you’re experiencing an illness or condition (or, you know, a deep cut on your finger) for the first time. So we hope this breakdown helped clear up the differences between a visit better suited for the emergency room, an urgent care, or your primary care doctor, especially given the rising costs of healthcare. And with that in mind, here’s another tip: if you have health insurance, give your plan benefits a read. You should be able to get estimates on what your co-pays or other out-of-pocket costs will be, so you can take your decision-making to the next level.  

 

Of course, if you’re in a true emergency, your decision should be obvious — but if squeezing in an appointment with your primary care doctor can save you significant cash, to us, it’s worth comparing! 

Tags: Health, Health Insurance, Care

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