More health care options mean more decisions. How do I know whether to seek care in a hospital emergency room or in a stand-alone emergency room? When is an urgent care center appropriate? And what about the walk-in retail clinic at the local pharmacy?
These are important questions when it comes to advocating for yourself or a family member, because knowing where to seek medical help could make a significant difference not just in the cost of treatment, but in caring for them. themselves.
Here are the basics of each:
hospital emergency room
The question to ask before going to the hospital emergency room is: “Is this condition life-threatening?” If the answer is yes, call 911 or have someone drive you to the emergency room. In general, chest pain, difficulty breathing, unconsciousness, heavy bleeding, or serious injury warrant a trip to the emergency room. If you need a CT scan or an MRI, go to the emergency room.
Hospital emergency rooms are open 24 hours a day, 7 days a week with experienced doctors, nurses and paramedics. When you enter, you will be screened – in other words, medical personnel will ask questions and take vital steps to determine the severity of your medical emergency. If, in their opinion, it is not life-threatening, you may have to wait a bit before being seen.
All the specialists, operating theaters and equipment are available to respond to any emergency. That said, everyone should have a friend or relative with them in the ER. An emergency doctor may only spend a few minutes with you, and without knowing your medical history, you may not know how seriously ill you are.
You need to clearly and succinctly state what the problem is to catch the attention of providers who are overwhelmed by the number of elective patients. I recently had a patient with a stroke who sat in the ER for an hour before I could get there and clearly state, “My patient has a stroke and she needs to be seen NOW.”
Most insurance plans have an ER copayment, which is waived if the patient is admitted. There may be multiple billings for diagnostic procedures and different physicians. If you are uninsured, find out about financial aid or discounts.
A stand-alone emergency room is not attached to a hospital and can be either a hospital or privately owned. It provides round-the-clock care for everything from broken bones to heart attacks, and the costs are similar to those of a hospital-based emergency department.
You might consider any of these facilities based on convenience. There may only be one hospital, but there may be several stand-alone ERs closer to home. Self-contained ERs are fully staffed and equipped, so if you go for a severe sore throat or earache, you’ll end up paying about the same price as going to the ER. hospital.
But they don’t offer surgery. If it is a heart attack requiring immediate angioplasty and stent insertion, you would be transferred to a hospital with an operating room, which would cost you valuable time.
Check your insurance network before going to a stand-alone emergency room to make sure you’ll be covered.
urgent care clinic
As the gap between patient access to primary care and emergency care has widened, emergency care (or sometimes referred to as immediate care) has expanded to fill it. And because a primary care provider is typically unavailable nights and weekends, these centers — unfairly derided as a “doc-in-a-box” — provide convenient, affordable care for illnesses and minor injuries.
An urgent care clinic is exactly what the doctor ordered if you experience:
• Allergic reaction
• Sore throat or ear infection
• Animal bite
• Flu symptoms
• Minor burns
• Broken bones
• Minor injuries
Being treated at an urgent care clinic can be tedious as they usually won’t have your medical history and you will need to answer many questions and possibly undergo tests. Again, make sure the clinic you choose is part of your insurance network.
Retail walk-in clinic
In the never-ending quest to reduce healthcare costs, the retail walk-in clinic is the latest innovation. Located in pharmacies, grocery stores and big box stores, such as Target (operated by CVS) and Walmart (operated by Optum Health), these clinics offer weekend and evening hours, walk-in availability and short waiting times. Prices are generally fixed and transparent.
The clinics treat a limited range of health issues, such as minor infections, respiratory illnesses and minor injuries. They are also becoming the go-to place for vaccines, including COVID vaccines. Care is usually provided by a nurse practitioner or physician assistant; pharmacists can dispense vaccines.
Illinois is one of the five states with the highest concentration of retail clinics. The typical user is young and does not have a regular doctor or insurance. Clinics generally accept Medicare, Medicaid, and private insurance, as well as cash payments.
So this is it. In a nutshell, choose your emergency healthcare provider based on the extent and severity of your condition.
• Teri Dreher is a Board Certified Patient Advocate. A critical care nurse for over 30 years, she is the founder of NShore Patient Advocates (www.NorthShoreRN.com). She offers a free telephone consultation to readers of the Daily Herald; call her at (847) 612-6684.