Urgent Care or Emergency Department?

One of the most obvious changes in the medical landscape over the last 15 years has been the proliferation of urgent care clinics.  You can’t drive down almost any street in a major metropolitan area without passing at least a couple of urgent care centers.  These centers have become common because many people do not have health insurance or do not have a primary care physician.  When they get sick, they need somewhere to go.  Urgent care centers offer convenience and, in today’s world, convenience sells.

How Urgent Care Centers are Changing the Health Care Delivery Landscape

When you become sick or injure yourself and decide to seek medical care, you have to make a decision.  Assuming you are going to seek immediate treatment, you need to decide whether to go to an urgent care center or to a hospital emergency department.  There is a big difference between the two and the choice can be important, almost to the point of being life saving.

Hospital emergency departments are usually staffed by doctors who have extensive training in emergency medicine.  They have available to them the resources of the hospital, which include the ability to perform complex lab tests and radiology studies, such as CT and MRI.  If your condition is serious enough, they have the ability to arrange for you to be admitted to the hospital.

Urgent care centers are not usually staffed with residency trained emergency medicine physicians.  Over the course of my practice, in the cases I have brought, the doctors have often been family practice doctors.  The urgent care center may have an x-ray machine but it won’t be able to administer a CT or an MRI.  It is not likely to be able to do all of the lab tests a hospital emergency department can arrange.

If your condition is a serious one, you want to go to the emergency department.  If your condition does not appear to you to be serious but one you want evaluated and for which you want some treatment, the urgent care center will probably be just fine.  Chest pain, head for the ER.  Stroke-like symptoms, head for the ER.  Just feeling poorly with flu-like symptoms, urgent care is your destination.

Do not rely on the ability of the urgent care doctors or nurse practitioners or physician’s assistants to screen you and decide whether you need to go to the emergency department or not.  They will do their best and send you on to the ER, if they think your condition is too serious for them or if it is one outside their ability to treat, but they sometimes make mistakes.  Because they are not usually highly trained emergency medicine physicians, they may not recognize the seriousness of your condition.  Even if they do recognize it, it may take a while and the time lost before you finally get to the ER may be critically important.

You are the critical decision maker when you are in need of medical treatment.  If it is potentially serious enough, call 911 and let the paramedics decide where to take you.  Don’t take a chance on urgent care, if there is any chance that you are really hurt or have a serious medical condition.

And when you get wherever you are going, remember how important a good history is to the person who is trying to figure out what is wrong with you.  Tell them everything you think may be important.  Be sure also to bring with you a list of all of the medications you are taking.  Have someone with you to keep you company and to keep an eye on the medical personnel to make sure you get taken seriously and get the treatment you need.

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