When you should go to Urgent Care vs. hospital emergency room

A nagging cough that won’t go away. A cut that will need stitches. A sports injury that could require a cast or eventual surgery.

It used to be that conditions like these would be worth a trip to the local hospital emergency room.

Now they are among the long list of ailments better suited for Urgent Care or similar facilities, said Dr. Creston Tate, medical director of WellSpan Urgent Care.

“One of the easiest ways to determine if your case is for an Urgent Care instead of an emergency department is asking the question, 'Is this going to require extensive testing?'" Tate said Wednesday. "If it is a straight-forward injury, an upper respiratory issue, dermatology, that is all appropriate for treatment at an Urgent Care."

Urgent Care vs. hospital emergency department was a hot topic of discussion on social media in the wake of a recent report that an untreated patient died in the WellSpan York Hospital emergency department on Aug. 16.

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Many commenters speculated that emergency rooms are filled because people go there with ailments that could be treated at Urgent Cares or family physicians.

About 20 percent of the patients seen in the WellSpan York Hospital emergency department each year could be treated at an Urgent Care, based on a level of acuity at triage being a 4 or 5, Tate said. This is comparable to national averages.

Websites and phone numbers

Tate understands it can be difficult for patients to make a treatment decision, so WellSpan and UPMC are trying to make it easier.

“Patients can go to WellSpan’s Urgent Care page, where there are lists to help them figure out where they should go based on their condition,” Tate said. “And if they are still unsure after looking at the website, there is a phone number (888-520-5060) that people can call to help them.

“We aren’t the only site with Urgent Care information. Patients can simply check out the lists and figure out where to go from there.”

Check out UPMC Pinnacle's Urgent Care page here.

Tate has been involved in Urgent Care-type medicine in the York and Lancaster areas and believes there is a learning curve as they continue to grow. He said there are more than a dozen offices in the area that offer extended hours and seven-day service over regular physicians’ offices.

“Urgent Cares are great sites to visit if you don’t have much time and aren’t acute,” he said. “It’s for a young, healthy population … young families with kids and colds.”

But for patients who are used to going to emergency rooms on weeknights and weekends, making that switch to an Urgent Care isn’t automatic. That’s where the learning curve comes in, Tate said.

Like smartphones and self-parking cars, people will have to follow a different path when they are sick. It’s not self-diagnosing, but making better decisions about the best place to get treatment.

Insurance part of the plan

Some commenters on social media also said insurance pointed them toward emergency rooms instead of Urgent Care. They said it is more expensive to go the non-emergency route, if their insurance was accepted at all.

“It might be a bit more expensive,” Tate said. “The copay at the emergency room might be a bit cheaper than at Urgent Care, but except for a few of the smaller types, we take most of the major insurance plans.”

The bottom line is that people need to take advantage of the resources they have, and Tate said, medically speaking, that includes making the decision to use Urgent Care instead of the emergency room.

“If someone makes the decision and comes to Urgent Care, but needs the emergency department, we’ll take care of it,” he said. “We’ll get them stabilized and transported to the ER.”

When to go to Urgent Care 

• Bladder infection
• Cough
• Bronchitis
• Pneumonia
• Sinus infection
• Ear pain
• Influenza (flu)
• Migraine headaches
• Minor lacerations
• Minor puncture wounds
• Pink eye
• Sore throat, tonsillitis and laryngitis
• Hives
• Insect bites
• Minor cuts and burns
• Rashes and minor skin reactions
• Seasonal allergies
• Sunburn
• Constipation
• Diarrhea
• Gout
• Arthritis
• Back pain
• Sports-related head injuries
• Sprains and strains
• Tendonitis
• Stitches

When to go to Urgent Orthopedics

• Arthritis
• Back pain
• Broken bones
• Musculoskeletal emergencies
• Sports injuries
• Sports-related head injuries
• Sprains and strains
• Sudden back and neck pain
• Sudden joint pain
• Tendonitis
• Sports physicals

When to go to the ER

• Chest pain
• Compound fracture
• Difficulty breathing
• Heart attack
• Ingestion of poison
• Major head injuries
• Major trauma
• Seizures
• Severe abdominal pain
• Severe burns
• Shock
• Snake bites
• Stroke
• Uncontrollable bleeding