ER vs. Urgent Care: Where Should I Go?If you have a painful but minor injury such as a sprain or fracture, it might be faster to go to an urgent care office instead of the emergency room. Dr. Tom Miller talks to emergency room surgeon…
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February 10, 2021
Family Health and Wellness Dr. Miller: It's the weekend and your primary care doctor is not available. What is best for you, emergency care or urgent care? We're going to talk about that next on Scope Radio. Hi, I'm here with Dr. Robert Stephen and he is an emergency room physician here at the University of Utah, also a member of the Department of Surgery. Robert, what do you think about that? Is there a difference between the care one gets at urgent care and emergency care rooms? Dr. Stephen: There's not a difference in the approach to the care per se. What's different is the capabilities of each one. The emergency room is by definition capable of dealing with all manner of emergencies, be they mild and merely painful to life-threatening, whereas an urgent care is much more structured to deal with what we call lower-acuity or more minor complaints which nonetheless need to be addressed, such as sore throats, lacerations, maybe sprains, simple fractures, things like that. Dr. Miller: So would you say if someone has a lower-urgency problem, as the examples you just mentioned, it might be better served at an urgent care center? When Should I go to Urgent Care ?Dr. Stephen: I don't know if they're better served, but they may be able to be seen and treated and evaluated appropriately and discharged more quickly than a large ER that is quite busy dealing with other critically ill patients. Dr. Miller: Now, urgent cares are not going to see very severe types of illness. Is that correct? Dr. Stephen: Generally, no, but of course, patients don't know sometimes how sick they are, and so urgent cares certainly do get patients being brought in by family members who tend to be quite ill, and if that's the case they evaluate them and then transfer them to a higher level of care, which would be an emergency room. Dr. Miller: Let's say you're at home, and you're watching TV and all of a sudden you have crushing chest pain. Should you go to an urgent care center or should you go to an emergency care center, or should you just call and ambulance and let them decide? When Should I go to the ER?Dr. Stephen: I think if you're having truly crushing chest pain you should probably call an ambulance and go to an emergency room. Chest pain is not a complaint to be trivialized by any stretch of the imagination, and probably the better part of valor is to go to an emergency room if you're having significant chest pain. Dr. Miller: Now very likely if you're in an auto accident and have significant trauma, they're going to take you to an emergency room, not an urgent care center. Dr. Stephen: Correct. Dr. Miller: But what other types of illness might you think you should call an ambulance for, and then they can decide where you need to go, or maybe ambulances just take people to the emergency room? Dr. Stephen: Ambulances generally take people to emergency rooms, but what you call an ambulance for is honestly based on the patient's perception of their illness. If you're having something that is severely painful, or if someone is, you notice, severely confused, if they appear to be ill, if they've obviously broken something in a fall, then you should call an ambulance to have them help assist you and determine how ill you are, and then they will take you to the appropriate level of care. Dr. Miller: Now urgent care centers, do they do the same sort of triage that emergency rooms do to decide how severe your problem is before they take you back? Dr. Stephen: They do an initial screening questionnaire to see if you're appropriate to be cared for there, and you're usually seen by the doctor or the treating physician or the treating physician extender, depending on who's manning it, and they will make the decision on whether you're appropriate to be treated there or sent to a higher level. Dr. Miller: Dr. Stephen, one final thing, I'd like to talk about the expense of either the urgent care center or the emergency department. Is one cheaper than the other? Is that a consideration? Expenses: ER vs. Urgent CareDr. Stephen: It is. Urgent cares generally tend to be cheaper than emergency departments, so that is something that some people may need to take into consideration although, again, an emergency department will see anyone at any time without regard to their ability to pay. Dr. Miller: And urgent care centers, they tend to be free-standing, that is, not associated with a hospital, many times? Dr. Stephen: Many times, yes. There are models where there are some associated with a hospital or they preferentially refer people to places, but generally free-standing. Dr. Miller: Now, it's interesting, we were talking before this show about our emergency room, and it sounds to me like you've developed an urgent care center within the emergency room here. Could you talk to us about that a little bit? Dr. Stephen: Yes, recently we established an urgent care that is actually inside the hospital itself, and is open from roughly, I think, 8:00 a.m. or 9:00 a.m. to the evening, sometime about 8:00 p.m., and again it's supposed to see more of the lower-acuity complaints, and people can request to be seen in the urgent care when they present to the emergency department.
If you have a painful but minor injury such as a sprain or fracture, it might be faster to go to an urgent care office instead of the emergency room. |
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What Happens When the ER Fills Up?Emergency room doctor Robert Stephen wants you to know that once you walk into the ER, you will not be turned away, no matter what. But there are times when the emergency room gets so full that…
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October 06, 2015
Family Health and Wellness Dr. Miller: If the hospital is full, will they still be able to see you in the emergency department? We're going to talk about that next on Scope Radio. Announcer: Access to our experts with in-depth information about the biggest health issues facing you today. The Specialists with Dr. Tom Miller is on The Scope. Dr. Miller: I'm here with Dr. Robert Stephen, and he's an emergency room physician here at the University of Utah. Robert, are there times when the emergency room gets so full you just can't see any more patients? Dr. Stephen: There are times when ERs do actually get what we call overcrowded, to the point where it can become problematic to treat anyone else who is critically ill. If at that point it is determined that we cannot safely take another critically ill patient because we are stretched so thin, we can temporarily go on something called divert. It usually lasts for somewhere around two hours, we do everything we can to get the situation stabilized and then open up again. I should note that divert does not mean that patients who walk in the front won't be seen, it means ambulance traffic. We will always see people who walk in the front room. Dr. Miller: I think we were talking a little earlier about the fact that Utah's blessed in the sense that we don't have too many times that we're on divert compared to some of the larger cities in the United States. Is that true? Dr. Stephen: It's true. I mean, we're quite fortunate in the city, we have a large number of hospitals, and we have a good wait time in that it's not overly burdensome. There are some places in the country where wait times can be quite onerous and quite long simply because they are chronically overrun. Dr. Miller: Now there can be times where the emergency room is open, and you're not seeing too many patients that overwhelm the capacity of the emergency department, but the hospital might be full. That is to say, there are no beds available. How do you take care of those patients who obviously can't leave the emergency department, and have a condition for which they need to be hospitalized? Dr. Stephen: We have several ways of approaching these patients. They become what we call borders. They are admitted to the hospital. The admitting service, be it medicine, surgery, or any of the other specialties, will come down and evaluate the patient, appropriate orders will be done, and they will be either maintained in a room in the emergency department, getting the appropriate care as if they are upstairs. Or we can actually, once our lower-acuity area closes, we can move them to those rooms, therefore open up more rooms in the ER to have people coming through the front door be seen. And we even have an observation unit that we can use to also, what we call, board these patients, until rooms open up upstairs. In the event that this happens the patient will still receive the same care as if they would if they were upstairs, they're just getting it in the emergency room or in these other two areas. Dr. Miller: So basically you have protocols that help decide, at whatever capacity you're currently running at, how to board those patients, how to care for those patients, and it sounds very dynamic, actually. Dr. Stephen: It is dynamic. We have to be able to adjust to the flow of the patients and what is going on at the rest of the hospital. And we will do our best to make sure that they get the appropriate care, no matter if they're downstairs or if they're on their way upstairs. Dr. Miller: That's good to know, we'll keep the public safe that way. Thank you very much. Announcer: TheScopeRadio.com, is University of Utah Health Sciences Radio. If you like what you heard, be sure to get our latest content by following us on Facebook. Just click on the Facebook icon at TheScopeRadio.com. |