As a team of benefits strategists, we work hard every day to make sure we’re exceeding client expectations and providing the most innovative and value-generating plan designs and advisory services.
July 1, 2021
This week, one of our clients asked: “Our employees are unsure of when to use urgent care instead of the ER. Do you have any helpful tips to distinguish the two?”
As a practicing nurse who spends many weekends in the largest pediatric ER in our state, I would love to help answer this question.
The short answer is ERs are used every day for anything and everything. But that’s not a good thing. Let’s triage how you should truly approach an illness.
Before you’re sick:
- Establish care with a primary care provider
- Manage chronic conditions
- Refill medications ahead of time
- Know how to utilize your benefits: Do you have an EAP? Do you have a doctor available over the phone? Do you know where to go in case of an emergency?
If you are experiencing mild symptoms of illness such as a temperature below 100 degrees, aches and pains or a mild cough — rest, drink plenty of fluids, take over-the-counter medications like Tylenol and monitor your symptoms.
If your symptoms aren’t getting better over time or worsen and you feel you need to be seen by a doctor, calling your primary care physician would be beneficial.
An emergency room should be used for just that — an emergency. If you think about when you’d be inclined to call 9-1-1, it should be to that extent or urgency before going to an ER.
When to go to the ER
These should be for major illnesses or pains such as:
- Heart attack symptoms including chest pain, trouble breathing and clammy skin
- Stroke symptoms including trouble speaking or understanding speech, or sudden weakness or paralysis in the face, arms or legs
- Severe trauma including any head injury
- Severe allergic reactions
- Severe bleeding, or bleeding that doesn’t stop with pressure after about five minutes
- Any loss of consciousness
If you are in doubt, err on the safe side and head to the nearest hospital.
Consider an urgent care center for situations that are not life-threatening
Urgent care centers can handle a variety of situations that are not life-threatening. Some common situations you might find yourself in include:
- Animal bites
- Broken bones
- Cuts that require stitches
- Minor burns
- Sports injuries
These centers can take X-rays and perform minor procedures such as removing a foreign object from the eye or stitching a cut.
You will also spend less time in an urgent care center. It’s true an ER can handle all the same things an urgent care center can. But, you will spend significantly more time waiting and receiving treatment in an ER. The median wait time and treatment time is two hours.
In contrast, most urgent care centers have patients in and out the door in 60 minutes or less. This includes wait time and treatment time.
You will spend less money in an urgent care center.
Time isn’t the only thing you’ll save by choosing an urgent care center. The average cost of an ER visit is about $1,300 to $1,400. Many urgent care visits cost an average of $150.
If you have insurance, you’ll see a difference in your copay and other out-of-pocket expenses. Your copay at an urgent care center will likely be higher than seeing your doctor, but it’s likely to be a fraction of the copay for an ER visit.
Know what your plan covers before an emergency happens. It’s a good idea to program the name and location of your preferred urgent care center or hospital ER in your phone so you are prepared in case of an emergency. You may also want to post the same information on your refrigerator or other common area in your house.
That’s what employers are asking us today. If you have questions you want answered in real time, email us at firstname.lastname@example.org.