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December 19, 2017

ER, urgent care, or family doctor? Here’s how you know

Wellness Medical

Content sponsored by IBC - Native (195x33)

ER Medical Equipment for IBX CP Thom Carroll/PhillyVoice

When you get sick or hurt, the only thing on your mind is getting to a doctor as fast as possible. Some medical issues require immediate action to be taken, but for non-emergencies, taking a few moments to determine the most appropriate place to get care can make a significant difference.

A National Health Interview Survey found that almost 80 percent of adults who visited ERs over a 12-month period said they did so because of a lack of access to other health care providers. In fact, between 13.7 percent and 27.1 percent of all emergency room visits are non-urgent, according to a 2010 Health Affairs study.

So, how do you know when to use your primary care physician vs. an urgent care center or an emergency room? Keep on reading to learn more about the most appropriate site for services based on the type of care needed.

What is a primary care physician (PCP) or family doctor?

A PCP is a doctor you select to be your general source for addressing your regular health care needs. Your go-to doctor, they know your history and can typically coordinate your in-depth health care services with specialists if or when you need one.

Your PCP is the first one you should contact when you need care. PCPs often leave time in their schedule for “sick visits,” and can see you same day for minor illnesses or injuries. If the symptoms you share when making your appointment warrant immediate care, your PCP may suggest you instead visit an urgent care center or emergency room.

What is an urgent care center?

An urgent care center is a medical facility that employs board-certified doctors for the treatment of cuts, sprains, sinus infections, nausea, and other types of less serious medical conditions. You don’t need an appointment to visit an urgent care center and they often have night and weekend hours.

Always call your primary care physician first when you need medical care. If you need care at night or during the weekends when your primary care physician is unavailable, then you can visit an urgent care center for non-emergency health care needs. Just show your Independence Blue Cross member ID card at a participating urgent care center and your visit is covered at a cost less than it would at an emergency facility.

Urgent care is not emergency care – Know the difference. In case of an emergency, or if you are unsure if you can drive to the nearest emergency room, you should call 9-1-1.

A visit to an urgent care facility or your primary care physician is recommended if you experience:

• Allergic reaction
• Asthma attack (minor)
• Bronchitis
• Colds, cough, flu, fever
• Dehydration
• Dizziness
• Ear infection
• Insect bite
• Migraine
• Minor burns
• Minor cuts/lacerations
• Minor head injury
• Nausea
• Pink eye
• Rash
• Sore throat
• Sprain or strain
• Urinary tract infection

What is emergency care?

Seek treatment at a hospital emergency room for life-threatening medical situations. You should visit the closest emergency room or emergency facility if you experience one of the following symptoms:

• Chest pain
• Broken bone
• Fainting
• High fever
• Ingestion of obstructive object
• Major head injury
• Palpitations
• Pneumonia
• Seizures
• Severe abdominal pain
• Severe asthma attack
• Severe burns
• Severe headache
• Shock
• Shortness of breath
• Unconsciousness
• Uncontrollable bleeding

To summarize:

  1. If it is not a true emergency, try to contact your primary care physician. This is the most affordable cost-sharing option.  
  2. If it is not an emergency and your PCP is not available, try an in-network urgent care center. This option is still more affordable from a cost-sharing perspective and helps you to avoid the longer wait times in the emergency room.
  3. In case of an emergency, go to the nearest emergency room. If you are unsure if you can get there on your own, call 911.

Additional Resources:

• Where to go when I need care
• Find a primary care physician
• Find a participating urgent care clinic
• Find a participating retail health clinic

This content was originally published on IBX Insights.

About Paula Sunshine

As SVP and Chief Marketing Executive at Independence Blue Cross, Paula Sunshine is accountable for the Individual Under-65 market segment. In this capacity, she is directly responsible for developing and executing all direct-to-consumer marketing and sales capabilities. In addition, Ms. Sunshine is accountable for insuring the delivery of market-competitive products and pricing as well as operational readiness for the Consumer market.

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