Sunday, November 19, 2023

I am sick. Where should I go?

In the “old days,” say the 1950’s and 60’s, getting sick was much simpler. If you did not feel well, you called your doctor and either went to his (and 90%+ were male) office or he made a house call. Now, the set of choices is overwhelming – but where you decide to go can have a major impact on your health and your wallet. Your choices include:

The Emergency Department (ED). Pros: always open, prepared to handle just about anything acute that you may have. Cons: usually no idea who you are or your underlying health issues; very expensive – even if you have good insurance, there is usually a high co-pay; little continuity of care, and, unless you are critically ill, a long wait, often a very long wait.

Urgent care center. Pros: extended hours including weekends; can handle most minor emergencies; usually have X-ray and lab; less expensive than ED. Cons: Not 24/7, so be sure to check if they are open; no continuity of care; moderately expensive.

Pharmacy-based drop-in clinics, usually nurse-staffed. Pros: weekend hours; can handle most “minor” illnesses well; usually less expensive that the prior two. Cons: limited diseases that can be handled; little continuity; limited lab or X-ray available.

Your doctor’s office: Pros: they know you and can generally avoid over-testing; continuity of care automatic; least expensive. Cons: limited hours; may not be able to see you quickly.

So, what should you do?

As the ubiquitous phone message says, if you are having a medical emergency, hang up and dial 911. If you are experiencing chest pain, sudden shortness of breath, severe abdominal pain or are bleeding profusely, you belong in the ED. Calling 911 will get you there more safely than driving and will assure you are seen more promptly. Ambulance patients are almost always seen before those who drive themselves or are driven. Most insurance covers emergency ambulance transport (but not “convenience” rides).

If you need urgent attention but are not severely ill – think foreign object in your eye, a deep cut that will need suturing or a red swollen arm on a Saturday – the closest Urgent Care Center is probably your best bet.

For the myriad other “minor emergencies” that need prompt attention such as a bad sore throat, an earache, a possible urinary infection or a very itchy rash, try your doctor’s office first. If they are unable to see you, a convenience clinic at the local pharmacy will probably be able to help you at lowest cost and least waiting. These are the kinds of problems that do NOT belong in the ED.

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