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When to Go to Urgent Care vs. Emergency Room

It may be hard to tell when you should visit urgent care and when you should head to the emergency room. Urgent care can address many issues that patients take directly to the emergency department.

Dr. Nick Colovos, Assistant Professor Emory School of Medicine Department of Emergency Medicine and Interim Chief Quality Officer for the Physician Group Practices, explains what requires an emergency room visit versus things urgent care can handle.
When to Go to Urgent Care vs. Emergency Room
Featuring:
Nick Colovos, MD, MBA
Nick Colovos, MD, MBA is an Assistant Professor Emory School of Medicine Department of Emergency Medicine Interim Chief Quality Officer for the Physician Group Practices.

Learn more about Nick Colovos, MD, MBA
Transcription:

Bill Klaproth (Host): You or a loved one are sick, but how do you know whether you should go to Urgent Care or the Emergency Room? Here to talk about that is Dr. Nick Colovos, Assistant Professor at Emory School of Medicine, Department of Emergency Medicine, Interim Chief Quality Officer for the Physician Group Practices at Emory Healthcare. Dr. Colovos thank you so much for your time. So, first off, what is the difference between Urgent Care and the Emergency Room?

Nick Colovos, MD, MBA, FACEP (Guest): The real difference between those two types of facilities is going to be in the level of care and treatment that each can provide to you. Urgent Cares have the ability to be able to see mostly nonthreatening type injuries, a broken bone, a sprained ankle, cold, flu type symptoms, minor cuts and burns. While the Emergency Department is going to be more directed towards things like life-threatening emergencies, injuries, severe illness, somebody having difficulty breathing, chest pain, stroke or those types of issues. So, there is a big dynamic between the two of those, but the Urgent Cares will have the ability to take care of quite a few of the things that are often seen in the Emergency Department.

Bill: So, is it a good rule of thumb if it’s an injury or illness where you can drive your loved one or family member that would be Urgent Care or because if it’s Emergency Room generally, the ambulance is going to come to your house? How do we – is there a rule of thumb to know? I know you just gave a very good explanation of the different types of injuries and medical things that they treat, but is there a different rule of thumb we should go by?

Dr. Colovos: I think the best thing to consider is if you believe that it’s a serious life-threatening issue; that going to the Emergency Department is going to be the way to direct oneself. However, if it’s a situation where it’s not life-threatening, you know we are not having severity of chest pain or evidence of a stroke or shortness of breath; then it would be more appropriate to probably go to the Urgent Care to be evaluated. And the Urgent Cares have the capabilities of administering medications, taking x-rays, performing a lot of procedures such as applying splints to fractures or sprains and so, they can offer us a great deal at a very convenient timing than the Emergency Department.

Bill: Okay, that helps. Think life-threatening or nonlife threatening. And do certain Urgent Care locations specialize in certain things, is that how that works?

Dr. Colovos: Not in particular. Most of the Urgent Care facilities that you will find throughout the Metro Atlanta area as well as across the United States are all pretty much delivering the same type of care. It’s where that episodic disease, illness and injury and they are taking care of a lot of those nonlife threatening events. They really focus on those types of things that can be managed in those types of settings, cold, flu, ear infections, sore throats, they have like I said, the ability to due x-rays on site and do a number of other things. There is some variance when you look at the retail clinics that we see out there where they don’t have the capabilities of doing some of those things and they are limited on both their ability to examine patients as well as doing some of the x-rays and other procedural type of things. so, the Urgent Cares really operate very closely to what you would do in an Emergency Department.

Bill: And you mentioned some services that an Urgent Care Center provides. Are there other ones as well, we should know about?

Dr. Colovos: Those are the principle ones. The other things that they offer is they do sports physicals. They can certainly do - many of them will do workman’s comp type injury and evaluations. And so, they have a relative vast array of things that they can do within their facilities. Most of them are all operating the same. It certainly is important to go online and find the local Urgent Care near you as many of them now offer the opportunity to actually be able to schedule your appointment online for same day as well as have a much shorter wait period for getting somebody in and out. On average from the time you enter one of those facilities to the time you are discharged is about 60 minutes in total.

Bill: And how about the services and offerings at the Emergency Department?

Dr. Colovos: Well the Emergency Department certainly has a larger spectrum of what they can offer. You have all of the advanced providers there, the emergency room physicians that have the capability to dealing with some of the real serious issues both trauma as well as chest pain, stroke and the like; but they also have the services of CAT scan machines and specialized MRI as well as other specialized studies. In addition, being located in most hospitals, they also have that ability to reach out to their colleagues on particular services. So, a much broader spectrum of specialized services can be available as well as life saving measures.

Bill: And Dr. Colovos you mentioned wait times. When going to Urgent Care or the ER, what should we know or bring to speed up the process?

Dr. Colovos: That’s a great question. The first thing is to understand that in the Emergency Department, it doesn’t really matter when you show up. We really determine how severe your illness, or the acuity of your illness is to determine your place in line. So, it’s very possible that you could be the first one to show up in the Emergency Department and you have a complaint let’s say of an earache; but somebody is coming in by ambulance with chest pain or one of the more severe type of illnesses; they are going to get bumped to the head of the line. So, it’s something important for the consumer and for folks to understand that the ER does not operate on a first come first serve; we really operate on those folks that are most serious are going to be seen first. When going to the Emergency Department I would certainly advise patients to first call their primary care physician, discuss what’s going on with that physician first so that they have an understanding. It may be possible that they can see you in the office for that particular ailment or issue and if they can’t then they direct you to the Emergency Department, they can often communicate with the Emergency Department to let us know that you are coming in so that we can be aware and potentially prepared for that. In addition, one of the things I tell folks that they need to be aware of is if you have the ability to bring your medical record, that’s particularly important especially for the older population that are traveling and visiting different areas. Having a copy of your medical records available with you can really expedite some of the care in the Emergency Department because it really allows us to see very quickly what your medical history is as well as compare it to what we are seeing on that particular day of the week.

Bill: I can see where that is a timesaver and if you are alone, you should never drive yourself to the ER, is that correct?

Dr. Colovos: Yeah, I think that if you feel that your condition is severe enough that you need to be seen immediately and you need to be seen in an Emergency Department; I would not recommend driving oneself to the Emergency Department. And the mainstay of that is really that you not only put yourself at jeopardy; but you are also putting a lot of other folks on the road at jeopardy should something tragically happen to you en route to the facility. Having the paramedics and the EMS personnel respond and transport you to the facility is probably the safest way. It also allows a trained professional to start evaluating you and potentially even start treatment which is really the mainstay of what we want to do with emergency care.

Bill: Absolutely and if you could wrap it up for us. What else should we know about going to Urgent Care or the Emergency Room?

Dr. Colovos: Well I think for me, Urgent Care’s standpoint, you are going to be seen probably a little bit faster. Most things can be handled in the Urgent Care arena that are low acuity and of low severity. From the ER perspective, from the Emergency Department as we mentioned already, contacting your PCP before going there, bring your medical records. The other thing for folks to understand is that Mondays are typically the busiest day for most Emergency Departments and that busy flow goes right into Tuesday. Mornings are usually a better time frame to show up the Emergency Department but unfortunately, like most disease, illness and injury; it’s episodic in nature and we don’t really have the opportunity to schedule those things.

Bill: That’s very interesting. So, any injuries that happen over the weekend is that why Mondays are busier?

Dr. Colovos: It seems to be that and for other reasons, it just seems that Monday is usually the busiest day of the week.

Bill: Very interesting. Well Dr. Colovos, thank you so much for your time. And for more information please visit www.emoryhealthcare.org, that’s www.emoryhealthcare.org. You’re listening to Advancing Your Health with Emory Healthcare. I’m Bill Klaproth. Thanks for listening.