When Should You Go To The ER?

You’re sick. You need medicine. And you have zero chance of seeing your doctor today.

Now what?

We’ve all been there: what starts as a tiny cough Monday morning has turned into a full-blown fever, headache, and sore throat by Tuesday afternoon. You know you need to see a doctor, but your primary care provider is booked through Thursday, and you need to be better in time for a meeting on Friday. Should you head to the ER? Urgent care? What about one of those newfangled “standalone ERs” popping up everywhere? In your flu-addled state, it’s hard enough to stay hydrated and vertical, much less run a cost-benefit analysis.

We’re here to help.

We know it can be hard to decide which option is best — and most cost-effective — for a given ailment. However, armed with knowledge, statistics, and, when necessary, ibuprofen, you can make the right decision, get to the right establishment, and receive the right level of care.


Urgent Care Centers

You’ve seen them. You’ve probably been to them. And you’re on the website of one right now. But you may not know exactly what an urgent care center is or does. Let us enlighten you!

According to the Urgent Care Association of America, an urgent care center is “healthcare provided on a walk-in, no-appointment basis for acute illness or injury that is not life- or limb-threatening, and is either beyond the scope or availability of the typical primary care practice or retail clinic.” According to Debt.org, they evolved in the 1990s to “serve the 73% of Americans who say they have no access to their primary care doctors at night or on weekends.”

What does this all mean, exactly? It means that you can fall ill or injure yourself and find care when your PCP is unavailable — with, importantly, the reasonable expectation that the final bill will likely be much smaller than that of an equivalent ER visit.

And what about “non-life-threatening”? The phrase is fairly vague, and you may be wondering what, exactly, should send you calmly proceeding to an urgent care center rather than scrambling to an ER. According to Cigna Medical Group, urgent cares are perfectly suited to treat the following types of illnesses and injuries:

  • Flu and cold
  • Coughs and sore throat
  • High fevers
  • Vomiting, diarrhea, stomach pain
  • Cuts and severe scrapes
  • Broken bones
  • Minor injuries and burns
  • Sports injuries
  • Ear infections
  • Animal or insect bites
  • Seasonal allergies
  • Bronchitis
  • Breathing discomfort, such as moderate asthma
  • Urinary tract infections
  • X-rays and lab tests
  • Abdominal pain
  • Minor back pain
  • (and more!)

There are other benefits of going to an urgent care:

  • Open late and on weekends and holidays
  • Staffed by doctors and nurses
  • Offer nearly all the services available at a traditional doctor’s office
  • Have x-ray machines and lab testing on site
  • Nearly all procedures covered by insurance
  • Average cost is much lower — around $125-150 per patient per visit 

Bottom Line: Urgent care centers are equipped to handle all non-life-threatening injuries and illnesses. A visit costs, on average, $125-150, and many take insurance.


Retail Clinics

Retail clinics refer to medical establishments based in supermarkets, retailers, and big-box stores that treat a limited range of common ailments and offer some preventative care such as vaccinations. They have spread like wildfire — jumping from  60 in 2006 to 1,090 in 2008 — but are somewhat controversial:according to Consumer Reports, the American Medical Association “called for state and local agencies to investigate potential conflicts of interest posed by joint ventures between clinics and in-store pharmacies” in 2007 and the American Academy of Pediatrics “advises against taking children and teens to them.”

Bottom Line: If you have a quick, basic issue and can’t get to your PCP or an urgent care, try a retail clinic (do not take your sick child or teen). A visit costs, on average, $55-75.


Stand-alone ERs

Stand-alone ERs offer an important service: they can treat nearly any medical emergency. But they have many people worried. According to the Denver Post, critics are concerned that patients may “mistake these new ERs for urgent care clinics” and “run up huge bills, increasing their own payments — particularly with high-deductible plans that are more common today — and everyone else’s insurance costs.”

Keep in mind: stand-alone ERs are still ERs, and while they can play a key role, they should be reserved for emergencies only. Chest pains? Head to an ER (stand-alone or otherwise). In fact, head to an ER for any of the following:

  • Allergic reactions to food and animal or bug bites
  • Chest pain
  • Constant vomiting
  • Continuous bleeding
  • Severe shortness of breath
  • Deep wounds
  • Weakness or pain in a leg or arm
  • Head injuries
  • Unconsciousness

Otherwise? Your PCP or an urgent care will do.

Bottom Line: Stand-alone ERs are intended for life- or limb-threatening injuries and illnesses only. They are more expensive than urgent care and retail clinics, running $400-$2000, and sometimes much higher.


At the End of the Day

Still can’t decide? We suggest doing the following test from Debt.org (emphasis ours):

The real question that should be answered when deciding between urgent care centers and emergency rooms is:  Why am I going?

If the answer is: “Because I have life-threatening injuries or symptoms,” then the choice is simple: Go to an emergency room. Otherwise, an urgent care center should do.

Debt.org also provides a handy chart of average costs by condition. Take a look and then decide for yourself!


Condition Emergency Room Cost Urgent Care Cost
Allergies $345 $97
Acute Bronchitis $595 $127
Earache $400 $110
Sore Throat $525 $94
Pink Eye $370 $102
Sinusitis $617 $112
Strep Throat $531 $111
Upper Respiratory Infection $486 $111
Urinary Tract Infection $665 $112

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