Are you trying to decide whether to go to the emergency room or urgent care? There are some common myths and misconceptions about the differences in capabilities, costs, and access. Knowing the facts can help you make the best choice for your situation.
Myth 1: The Emergency Room Should be Used for Any Urgent Medical Issue
Many people assume the emergency room is the obvious choice anytime they have an urgent medical need outside of regular clinic hours. However, there are several myths wrapped up in that assumption.
The ER is specifically equipped to deal with life-threatening and critical health issues like heart attacks, stroke symptoms, major broken bones, head injuries, and severe cuts or burns. Urgent care handles less severe health issues you’d still like treated in a timely manner by a medical professional outside of regular doctor’s office hours, like:
- Sprains and strains
- Minor broken bones or fractures (ex: finger, toe)
- Small cuts that might require a few stitches
- Mild asthma attacks
- Skin rashes
- Flu symptoms
- Urinary tract infections
- Ear infections
Many people ask, “Does Medicare cover urgent care?”. While Medicare does cover urgent care for these types of health issues, you’ll usually face much lower out-of-pocket costs than the ER as well. The emergency room has the staffing and equipment ready 24/7 to save lives in critical situations when minutes matter most. Using it for non-life-threatening issues leads to longer wait times, frustrated (and more expensive) doctors and nurses, and higher medical bills for those seeking care.
Myth 2: Urgent Care Has Better Hours and Is Easier to Access
Since urgent care clinics seem to pop up on every corner nowadays, the hours and access may appear far more convenient than the emergency room…with shorter wait times to boot! This myth resonates for good reason. Many urgent care clinics are open seven days a week with some evening and weekend hours for those unavoidable health issues that spring up when the doctor’s office is closed.
However, hospital emergency rooms never close, so they essentially provide 24/7 access, 365 days per year. In addition, many hospital ERs allow you to sign-in online to get in the queue before you arrive. Once signed in, you can wait where you want until you receive a text that they’re ready to see you.
So truly, urgent care and the emergency room both provide good access relative to a traditional doctor’s office. Which one has the shorter wait time and is less predictable can depend on factors like the number of doctors/nurses on staff and current patient volume. During peak cold and flu season, they may have comparable waits.
Myth 3: Urgent Care Can Treat More Complex Health Issues
Some patients wonder whether the growing number of urgent care clinics can treat issues previously reserved for the emergency room. Can you get X-rays, lab tests, stitches, or IV fluids at urgent care nowadays? Such myths presume capabilities on par with an ER.
The fact is urgent cares are not equipped for very complex health issues. Few have an actual medical doctor on staff, nor X-ray or MRI imaging, surgery suites, or extensive testing capabilities. More advanced capabilities require hospital infrastructure the urgent care model does not provide. Extreme illness, injury, or trauma still necessitates assessment in the ER.
While urgent care can handle minor lacerations, the average ER doctor can expertly treat larger cuts requiring layered closing and reconstruction. They can detect subtle bone fractures an urgent care might miss. The ER handles complex work like diagnosing internal bleeding, providing emergency blood transfusions, surgical repair of dangerous organ damage, or life-saving interventions for heart attacks.
Rest assured the average urgent care knows its limitations and will send you by ambulance to the hospital if they realize your case exceeds their capabilities. But you’ll get top-notch care most quickly if complex symptoms start at the ER.
Myth 4: The ER is Much More Expensive Than Urgent Care
Emergency room costs are a common frustration – exacerbated by myths that less expensive options exist. The fact is, urgent care costs can vary widely and ER copays have been coming down in many health plans lately, so the out-of-pocket price difference may be negligible or non-existent depending on your health insurance.
That said, urgent care facilities do generally have lower operational costs than the overstaffed, cutting-edge ERs designed for regular crises. The urgent care can pass some savings along by offering simple services and common tests/treatments at fixed reasonable prices. Your final bill depends on what specifically gets examined and prescribed.
Unless facing a true area hospital monopoly, most health plans today negotiate reasonable in-network deals with emergency rooms to establish standard copays. Deductibles complicate things, but the upside is your share of medical bills is now generally predictable for either care option if your hospital participates with your health plan.
The smartest move is to check your insurance coverage details specifically for the urgent care clinics and hospital ERs nearby to understand your out-of-pocket responsibility beforehand, then deciding what option fits your need.
Which Option is Right for My Situation?
A quick checklist of do’s and don’ts when choosing urgent care vs ER can clear up when each makes sense:
When to Choose Urgent Care
DO go to urgent care for sprains, strains, minor cuts, rashes, or symptoms of common illnesses assuming the facility is properly equipped and rated.
DON’T use urgent care for complex symptoms or worsening health issues not resolving with initial treatment. Persistent vomiting, chest pain, difficulty breathing, mental confusion, or uncontrolled bleeding all signal “go to the ER” instead.
When to Use the Emergency Room
DO go straight to the emergency room if facing life-threatening injury or acute illness like heart attack, stroke, head trauma, suicidal thoughts, severe bleeding, or broken bones.
DON’T use the emergency room for minor health issues or a simple need for a prescription refill.
When uncertain if your symptoms require urgent care or an emergency room, call your doctor or a nurse hotline to describe the specifics. Often the best advice comes from a quick consult with medical experts.
