Primary care, urgent care, telemedicine, or the ER?

Not that many years ago, when you were sick or injured, you had two choices—make an appointment to see your doctor or go to the emergency room. But there are more ways to seek care now and it can sometimes be confusing knowing which provider is the most appropriate one. Of course, if you’re facing a serious or life-threatening illness or injury, you should seek care at an emergency room or call 911.

Understanding what type of care each of these healthcare providers offers is the first step in choosing where to receive care. The best place to start may be to call your primary care physician, describe the problem you’re facing, and ask where she or he suggests your seek care, though that often isn’t possible after office hours or on the weekend. Some insurers and physician practices also offer telemedicine services. If you can’t reach your primary care doctor, this can be another resource to help you decide where and when to seek care.

Understanding the difference between your options

The differences between primary care offices, urgent care clinics, telemedicine services, and the ER include what type of providers deliver your care, whether you need an appointment, and the cost of the care you receive. Here’s an overview:

• Primary care physician’s office: The care you receive here may be delivered by an MD, DO (doctor of osteopathy), physician’s assistant, or nurse practitioner, depending on how your care provider’s office is staffed. In most cases, you’ll need an appointment to be seen, though some primary care practices have walk-in hours or offer same-day sick care appointments. One of the benefits of receiving care from your primary care physician is that he or she is familiar with your personal and family health history and has access to your medical records. Primary care physicians can also refer you to a specialist if need be. The cost of care received in your primary care physician’s office will be significantly lower than care received in an emergency room. In addition, it’s likely that you chose your primary care physician because she or he is in your health insurance network, so you’ll pay the lower, in-network cost for care.
• Urgent care clinic: Depending on the regulations of the state where you’re seeking care, the caregiver at an urgent care clinic may be a physician, nurse practitioner, or physician’s assistant. Keep in mind that there’s a difference between an urgent care clinic and a retail clinic like the ones you can find in pharmacies and big box stores. Many retail clinics are staffed only by nurse practitioners and physician’s assistants. You don’t need an appointment at an urgent care clinic and many have extended hours that include nights and weekends. You may choose to receive care here if your primary care physician isn’t available or you’re out of town when you get sick or injured. Check to see if the clinic is in your insurance network to keep costs lower. And if you need X-rays or bloodwork, ask if the providers of these services are part of your insurer’s network as well.
• Telemedicine: In some cases, you don’t even need to leave your home to get care. A growing number of insurers, physician practices, and organizations now offer a range of telemedicine services. Through these services, patients connect with physicians for a virtual appointment either via a smartphone app or computer. These consults can be a good choice for the same types of health issues you would seek care for at an urgent care clinic. The most significant advantage of telemedicine is the convenience of receiving care at home on your schedule, but this type of care can also be less expensive. If after your telemedicine consult your condition doesn’t improve in a timely matter, you should follow up with your primary care physician. In addition to care for illnesses and minor injuries, some telemedicine providers also offer consultations with specialists and second opinion services.
• Emergency room: No appointment is needed in the ER, but the wait times can be long, especially if your health problem is less serious than that of other patients. You may receive care from a team that includes an emergency medicine physician, resident physician, nurse practitioners, physician assistants, and nurses. Many people seek care in the ER simply because their primary care doctor’s office wasn’t open. One study conducted by the National Center for Health Statistics, found that 48% of people went to the emergency room for that reason. That decision can significantly increase what you pay for care. Not only is care that’s delivered in the ER more expensive on average, even if the hospital is part of your insurance network, some of the providers who treat you may not be, resulting in large, surprise bills.