Choosing the Right Emergency Service (Hint: It Might Not Be the ER)

With the birth of Urgent Care facilities across our nation, more choices are available for health care than ever before. Just as the military triages patients based on the severity of their injuries, everyone is now able to ‘triage’ their healthcare needs at the moment, and there are a variety of facilities available to accommodate the level of care required. The ability of a patient to choose the correct level of care has a number of benefits, including cost, time and treatment options. These levels are as follows:

Primary Care Physician (PCP)


Your personal physician is the foundation of your healthcare. The advantage of having a consistent practitioner who knows you well, understands your health issues, and manages your care is priceless. Establishing that relationship and scheduling regular check-ups creates a baseline of your health status.

PCPs can care for routine health needs such as the management of chronic illnesses, treatment of minor illnesses, and pain management and prescription use. The average practitioner can see over 60 patients a day, and some have practices that cover more than 1000 patients!

The vast majority of your health care needs should be handled at this level if possible. Most insurances have a co-pay set up for physician visits, making it the most economically priced option for healthcare. A visit with your PCP is also the most time sensitive, as it is appointment driven.

With so many hours available during the day, there may be some difficulty in accessing an appointment. Virtual doctor visits with a physician can be very convenient if you need this level of care quickly.

Urgent Care/After Hours Facilities



These facilities provide basic illness and injury related care with or without an appointment. They are staffed with an array of physicians or mid-level providers, such as physician assistants or nurse practitioners. They handle such issues as coughs and colds, headaches, fevers, rashes, and stomach illnesses. Most of these facilities have access to laboratory and radiology services, so limited diagnostic testing can be done.

The cost is a bit higher than physician offices due to the convenience, but is far less expensive than emergency care. Since many of these facilities accept appointments and walk-ins, these visits often take a larger investment in time (average wait time 1 hour).

Emergency Care


Emergency Departments provide the highest level of care for critically injured or ill patients. They have a full array of diagnostic capabilities at their fingertips, and the staff is highly trained to care for patients that are not stable. They are especially adept at treating health problems that are ‘time critical’ in nature. Time Critical diagnoses are those in which immediate treatment will lessen serious complications. These conditions include heart attack, stroke, and trauma.

Due to all the high level functionality of emergency departments, they are the most expensive method of obtaining healthcare. Emergency Departments function on a triage system where the sickest or most critically injured patients get seen first; in other words, patients are not seen in the order of their arrival and there are no appointments. This means Emergency Centers have the longest wait times to be seen (average wait time of 4 hours).

So Which One Do I Choose?

Selecting the correct level of care is imperative to the patient, the pocketbook, and the paradigm of healthcare. For the system to flow efficiently, the vast majority (> 70%) of all healthcare needs should be seen by the private physicians.

If illnesses or injuries are minor but occur after hours or patients cannot get an appointment with their PCP, then the Urgent Care/After Hour Facilities are perfect. However, any patient demonstrating symptoms such as chest pain, numbness in the face, arm, or leg (stroke symptoms), head injuries, pregnancy complications, or uncontrolled bleeding should bypass those facilities and seek emergency care immediately.

The rationale for ensuring that the right patient gets to the right facility is easy. If patients require emergency level care, but show up at their physician’s office instead, they have created a delay in treating a potentially time critical health issue, and outcomes may be diminished. Conversely, if patients with minor illnesses and injuries always seek their care at Emergency Departments, they bog down the system, and create backflow and increased stress for the staff to juggle critical and non-critical patients at the same time.


To demonstrate, recent data shows that of the 136 million ER visits per year, over 70% of them are for non-emergency problems. While all of us may use any one of these options at any given time, selecting the right option for the right illness or injury is everyone’s responsibility.

It is fantastic that we have these resources available to us, creating, in essence, a triangle of healthcare. But like any other resource, it must be balanced and used to its fullest potential. Taxing any one portion of the triangle would weaken the entire system. So assess your symptoms, access the appropriate level of care, and achieve the best health possible.

Learn more about emergency services at ProMedica and download the “Know Where to Go” guide.


Diane SimonDiane Simon, RN, CEN, is the Trauma Coordinator/Registrar for ProMedica Defiance Regional Hospital.