Know where to go: Choosing between doctor, urgent care and ER

John Owen, vice president and medical director of the Liberty Hospital Emergency Department, stands at one of the stations for nurses and doctors inside the hospital emergency room.

No one expects to get sick or need urgent health care. But when it happens, people have an immediate choice to make: call your doctor, visit an urgent care or go straight to a hospital emergency department. Which is the best option?

“Ideally, your choice should be based on the urgency of the situation,” said John Owen, MD, vice president and medical director of the Liberty Hospital Emergency Department. “Calling your primary care provider should be your first choice for nonemergency situations because your doctor will be most familiar with your health history, chronic illnesses and medications.”

While you may be limited to seeing your primary care provider during regular business hours, some clinics offer walk-in options with extended after-hours care. Be aware that at walk-in clinics you likely will see a certified nurse practitioner or physician’s assistant. Stand-alone, walk-in clinics at grocery stores and retail pharmacies often operate independently and will not have access to your health history. If you need imaging such as an X-ray, primary care and retail clinics often must send you elsewhere.

Urgent care is the correct choice when your injuries or illness are not life-threatening, but you need immediate attention and cannot wait to schedule an appointment. Urgent care centers typically offer extended hours and no appointment is necessary.

Common illnesses appropriate for urgent care include superficial cuts that require stitches, minor burns and allergic reactions, minor broken bones, abdominal pain, sprains, persistent vomiting and diarrhea and symptoms of flu such as cough, sore throat, wheezing and fever.

“Urgent care should be a supplement to your regular health care, but never a replacement,” Owen said.

Urgent care centers usually have the capability to perform X-rays and minor procedures like stitches and removing foreign objects. When comparing wait times, you’ll often spend less time in urgent care than at a hospital emergency department.

However, Owen advised, “if you’re in doubt about choosing urgent care or emergency services, always choose the safe side and head to the nearest hospital emergency department.”

The emergency department specializes in providing care for life-threatening symptoms or situations. Trauma or emergency illnesses include head injury, electric shock, sudden numbness or loss of feeling, trouble breathing, chest pain, loss of consciousness, broken bones, deep wounds, severe bleeding or severe burns. When you dial 911, you will be taken to a hospital emergency department.

“You definitely want to use emergency services and call 911 for time-critical diagnoses such as stroke, heart attack and trauma,” Owen explained. “For these situations, every second without emergency care can affect the outcome.”

Because hospital emergency departments rely on a triage system, which enables the sickest patients to receive attention and care first, you will likely wait longer the less urgent your illness. This is despite the emergency department’s goal to immediately place patients into a treatment room. This can be remedied by understanding the differences between primary care, urgent care and emergency care services and choosing the appropriate level of care for your needs.

No matter which care option you choose, it is a good idea to add the names, locations and phone numbers of your preferred emergency department, urgent care and primary care physician to your contacts and post a copy in a common space at home, such as on your refrigerator. That way, when a health care emergency arises, you will spend less time looking for information and more time getting the care you need.

Liberty Hospital is designated as a Level II Time Critical Diagnosis hospital by the state of Missouri for stroke, STEMI (heart) and trauma. Contact information for different departments can be found at libertyhospital.org.

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