ER or Urgent Care? Where to Go When Illness Strikes

Let’s face it, everyone has an embarrassing medical moment or two--and I remember mine. I was sitting in one of my college courses when I began to experience hearing loss in my left ear. Not having any medical training at the time, I immediately thought of worst-case scenarios: a brain tumor, infection or a ruptured ear drum.  Panicked, I begged my father to take me to the local emergency room where I was diagnosed with a cerumen impaction.  Translation: I had so much wax in my ear it closed up the ear canal and blocked any air (and thus sound) from getting through.  One large wad of unsightly wax later and my hearing was fully restored.  I vowed never to visit the ER again for something so minor.

As a family medicine physician working for Indiana University Health, I see a lot of patients in follow up of emergency room visits. And I often answer questions about where people should go when their doctor’s office is not open. Unfortunately, many individuals go to the wrong place (as I once did).

A good rule of thumb: If you are having a problem you would normally see your regular physician for, such as a cold, flu-like symptoms, nausea, vomiting, diarrhea, minor injuries, insect bites, prescription refills, or immunizations, head to an urgent care center. They are well equipped to handle these issues.  The emergency room should be reserved for things such as chest pain, serious injuries and accidents, loss of consciousness, stroke symptoms, trouble breathing, serious abdominal pain, or uncontrolled bleeding.  These are situations that will require urgent imaging or lab work, the results of which may result in a hospital admission.  If you are pregnant and experiencing symptoms of labor, you should start with your local emergency room, as urgent care facilities cannot facilitate childbirth. 

If you are still not sure, most physician offices have an after-hours line that can be reached by calling the normal office number.  This will connect you with a triage specialist who can give you further direction on where to go.  You could also call their closest urgent care center, and receive general advice on whether a specific problem can be addressed there.

It is important to know where to go for your symptoms.  Going to the correct place can save you time, cost, and improve your outcome.  If you have a chronic illness such as heart disease or diabetes, discuss with your doctor the symptoms that could trigger an emergency room visit.

-- By Dr. Lena Franklin 

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