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Primary care, urgent care, or the ER: which care when


Once upon a time, when a child woke up with a sore throat, a parent had few options. Call the pediatrician and hope to get an appointment sometime that morning, keep them home and wonder if they’re really sick with strep, or risk sending them to school. And weekend illnesses or injuries? It was the ER or nothing.

Urgent care centers have change all that. In 2017, the urgent care center (UCC) market reached $15 billion, with over 10,000 clinics nationwide. Patient volume is expected to average 300 patients per week per center by 2021, according to a report by Kalorama Information.  But what are the benefits of a visit to a UCC over heading to the ER, and when should one see their primary care physician instead?

Primary care physician/pediatrician

Your pediatrician knows your child and his medical history.  For example, if your child has an ear infection, his primary care physician will be able to note that it’s his third this year, and suggest next steps to tackle the problem — probably a referral to an otolaryngologist. For any health concern that isn’t life-or-death, it’s best to try to get in to see your regular healthcare provider first.

Benefits

-Knows your child
-Knows your child’s health history
-Continuity of care
-In-network
-Can call to discuss symptoms
-Can call or visit for follow-up

Urgent care centers

Urgent care centers are not intended to replace your child’s (or your, for that matter) primary care physician or pediatrician. Instead, they’re a convenient alternative when you can’t get in to see your regular doctor — whether it’s because their schedule is full, or your child’s illness or injury occurs after hours. Urgent care also can provide an affordable and timely alternative to a lengthy wait in a hospital ER.

Benefits

-Same-day visits, no appointments necessary
-Extended weekday hours, weekend hours
-Treat acute illnesses
-Treat minor injuries like cuts, scrapes, minor burns, and broken bones (wrist, hand, foot and ankle, with no protruding bones or need to reset)
-Most have access to labs (rapid strep tests, urinalysis) and x-rays onsite
-Lower co-pays and other costs than ERs

Hospital emergency rooms

Unlike urgent care facilities, hospital ERs are equipped and staffed for the most complex or critical needs. The wait times are typically a lot longer than urgent care centers, but depending upon why you’re being seen, they should have everything there to diagnose and treat you. The costs are higher than urgent care; the average national cost of an ER in 2016 visit was $2,259, according to CIGNA.

Benefits

-Open 24 hours a day, 365 days a year
-treat all severe or life-threatening illnesses or injuries

Urgent care or the ER?

Can’t get into see the pediatrician? Here are some guidelines on when to take your child to an urgent care center, and when to head straight to the ER.  Of course, even after hours, you should first call your pediatrician for guidance. And before heading to an urgent care facility, call to make sure they’re comfortable treating your child at her age for her symptoms.

You can typically use urgent care if:

  • Your suspect your child has the flu.
  • You think your child has an ear infection.
  • Your child has a sore throat
  • You suspect your child may have pink eye.
  • Your child has had a few episodes of vomiting or diarrhea (without blood in the stool) but has no belly pain or signs of dehydration.
  • Your child appears to have a sprained wrist or foot, with no visible swelling.

Plan on an ER visit if:

  • Your child is under 2 months old and has a temperature of 100.4 F. or higher
  • You suspect your child has a broken bone, particularly if there is visible swelling or unevenness and bumps in the injured area.
  • Your child hits his head and loses consciousness for a few seconds.
  • Your child has had a seizure.
  • Your child has signs of dehydration, such as very dry lips and mouth, no urination for more than 12 hours, lethargy and confusion.
  • Your child has heavy, fast breathing and is gasping for air.
  • Your child has gaping cuts on the face.
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