Your Health: Urgent care vs. emergency room care

 Having begun my career in a busy county trauma emergency room (ER) and now working in urgent care, I wanted to use this experience as an opportunity to explain how you can decide when to go to the ER and not to urgent care.
Emergency rooms see more than 300,000 patients daily in the U.S. To help diminish this large number of patients — many of whom do not have serious problems — urgent-care centers began seeing patients in the late 1970s.
There are now more than 9,000 urgent-care centers functioning across the country and the number is growing.
Because of lower overhead, urgent-care centers charge much less for non-emergency care than do emergency rooms where overhead to provide needed comprehensive care is much more expensive.
In general, ERs can utilize all that the hospital has to offer, which includes the ability to admit a patient, especially to the intensive care unit (ICU) for more serious problems. Also, a hospital-based ER is able to utilize state-of-the-art X-ray and imaging studies, as well as a full laboratory — which in most cases can obtain immediate test results.
ERs usually have a full complement of specialists on call to take care of a variety of medical, surgical, or pediatric problems.
In general, almost any condition which can be described as “severe” should be treated at an emergency room.
Coming to urgent care, even though it may be closer to you than the ER, with such a severe problem often leads to being sent by paramedics to the emergency room. This is not only very expensive, but can waste valuable time to begin much needed treatment. Once you arrive at urgent care, it is the on-duty doctor who determines whether your particular problem can be treated there, or if you need to be sent for more comprehensive care at the ER.
The following are some of the more common reasons to go to an ER rather than urgent care:
If you have severe:
– Chest pain.
– Abdominal pain.
– Headache.
– Backache.
– Vomiting and/or diarrhea.
– Difficulty breathing and/or shortness of breath.
– Burns.
– Trauma.
Or go to the ER if you have:
– An allergic reaction with trouble breathing, feeling faint, or severe hives.
– Fainting, sudden dizziness, or weakness.
– Sudden changes in vision.
– Confusion, change of mental state, or difficulty speaking.
– Suicidal thoughts.
– Uncontrollable bleeding. (Remember to always apply pressure to the wound until you receive treatment.)
– An injury to an arm or leg that causes a deformity, that is to say an arm or leg that is bent instead of being straight.
– Poisoning or drug overdose.
– Loss of consciousness.
– Miscarriage or a sick newborn baby.
– Illegal drug-related problems.
Call 911 if you consider an injury or illness to be very serious or potentially life-threatening.
– Terry Hollenbeck, M.D., is an urgent-care physician at Palo Alto Medical Foundation Santa Cruz in Scotts Valley. Readers can view his previous columns on his website, valleydoctor.wordpress.com, or email him at

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. Information in this column is not intended to replace advice from your own health care professional. For any medical concern, consult your own doctor.