PCP, Urgent Care or ER?

Where to go when you need quick medical help

By Deborah Jeanne Sergeant

Urgent careUrgent care centers have helped decrease the load on emergency rooms. According to a 2018 study published by JAMA International Medicine, ER visits dropped by 36% between 2008 and 2015 and during the same time period, visits to urgent care facilities and telemedicine increased by 140%.

Shifting to urgent care and telemedicine can help reserve ER personnel and resources for the direst cases. Knowing the difference between what is treatable at the primary care physician (PCP), urgent care or ER can continue to improve those numbers.

“More and more people are realizing that urgent care centers fill an important care gap between primary care providers and the emergency room,” said Jenilee Foster, physician assistant and regional lead provider at WellNow Urgent Care, which operates in several locations in Central New York and other locations. “Many patients are comfortable calling their PCP as a first step if they feel well enough to wait for an appointment. However, if someone is experiencing a non-life-threatening illness or injury and doesn’t have a PCP, or their PCP is not available and they need to be seen right away, urgent care is a good option.”

Urgent care facilities typically use the same equipment as PCPs, plus have access to X-ray and other tools related to acute issues. But for issues like chest pain, suspected stroke or heart attack or a complicated fracture or burn, the ER is the right place to go.

When it gets tough is when a patient cannot wait for a PCP visit but cannot decide if their issue is serious enough to go to the ER. If the illness or injury is not life, limb or function threatening enough for the emergency room, yet the availability of the primary care physician cannot accommodate them, the urgent care is a good option to avoid waiting several days.

“Then a visit to urgent care would make sense,” Foster said.

Urgent care is not meant to replace regular care from a PCP for chronic conditions. Ongoing treatment by a primary care physician would suit these patients better as they would see the same provider instead of whoever happens to be at the urgent care.

“When you need non-emergency care and your primary care physician is not available, urgent care physicians, physician assistants, nurse practitioners, nurses and others can care for you,” said Jamie Leszczynski, senior director of communications for Oswego Health. “An urgent care does not take the place of your primary care physician, but it can work in cooperation with your physician. Urgent care can be more costly than your physician’s office but less expensive than a visit to the emergency department.”

She suggested symptoms that can help make the decision of where to seek care:

When to visit an urgent care center:

• Cuts or wounds that may require stitches

• Sprains, strains or deep bruises

• Mild to moderate asthma attacks

• Ear infections

• Upper respiratory infections

• Coughs and congestion

• Sore throats

• Insect bites

• Rashes

When to visit an emergency room:

• Severe bleeding

• Chest pain or pressure

• Trauma or injury to the head

• Severe abdominal pain

• Difficulty breathing

• Broken bones

• Sudden dizziness

• Pregnancy-related complications

Any condition perceived as life threatening should be evaluated at the emergency department.