Dr. Who?

Determining Where to Go When

When it comes to medical attention, when should you see your primary care physician, and when should you consider heading to an urgent care facility or emergency room?

Some patients like the convenience of an urgent care center when their regular doctor is unavailable, but that may not be the best option in certain situations.

Common Illness and follow ups “for common chronic illnesses or routine follow ups, you can wait to see your primary care physician, but the choice gets fuzzy when it comes to going to the urgent care versus the ER,” says Dr. Eric Jones with Bon Secours’ Tri-Cities Medical Associates in Portsmouth, Va. Jones has experience as a primary care doctor as well as working in urgent care and ER settings.

Urgent cares typically fill with patients looking for treatment for seasonal conditions, like flu or cold symptoms during the winter. During the summer months, urgent care physicians see patients with sunburn, lacerations, or those involved with aquatic accidents, as well as patients who are from out-of-town. Workplace accidents are also commonplace at an urgent care.

Major issues

“Urgent cares aren’t set up to handle major issues, like chest pains, coronary events or strokes, and you could lose significant time if you don’t go directly to the ER,” Jones says. “If you have something like a twisted ankle or a broken toe or finger, generally you are okay to go to an urgent care because you can be seen quicker. In that kind of a scenario, the urgent care works well.”

When time counts

Patients cite time, cost and convenience as reasons to visit urgent care. They are generally cheaper and, depending on the time of day, patients can usually be seen within 45 minutes.

“An urgent care also tends to have hours beyond what a regular doctor does, usually after 5 p.m. or on the weekends, so if a doctor can’t get you in as quickly as you would like, then urgent care is an option,” says Jones.

Acute Problems

Dr. Jennifer Wolff Dean, who works at Sentara Urgent Care in Williamsburg, Va., says: “We are there to support the primary care doctor. We help fill that gap. We handle acute problems, anything that arises suddenly like falls or wounds or upper respiratory issues. If someone is having a heart attack or a stroke, they should go straight to the ER. That is not something for urgent care.”

Dean suggests that women with pregnancy complications or someone with severe abdominal pains should go to the ER. Emergency rooms are better equipped to handle serious conditions.

Concerning the little ones

When it comes to pediatric care, a child’s condition should be the determining factor.

Children with bumps or bruises, breaks or sprains, flu-like symptoms, pink eye, strep throat, or ear or sinus infections can be treated at an urgent care. Parents are advised to visit a facility that treats children, as well as one offering on-site labs and X-rays.

“If a parent has developmental concerns about speech or behavior, that is best discussed with a primary care physician,” says Dean.

For more dire situations, go directly to the ER.

“If a child has an extremely high fever, or if there is a change in the child’s personality, if they become lethargic or confused, if there is a head injury, or if they are turning blue and have difficulty breathing, they are better served at the ER,” says Jones.

Brandy Centolanza: Brandy Centolanza is a freelance writer who has contributed regularly to The Health Journal since 2005. She covers health, travel, parenting, education and community issues for several publications in Hampton Roads and Richmond. Brandy lives in James City County with her husband, two children and two cats.