Urgent Care, freestanding ER, hospital ER got you confused? Need to know which one to pick? I am hoping to at least help my friends and family understand the differences in these entities--and help them decide which one to choose if they need attention! If you have time to wait for your primary care doctor, that is always the best. Cough, cold, sore throat, urinary infection, management of chronic diseases (blood pressure, gout, diabetes) can all be managed by them. Pluses: doctor knows you, knows your medications, knows your history, copay is LOWEST for most, cash pay price generally less than $50. Minuses: cannot handle all injuries, cannot give IV fluids or meds if needed, may take one day to one week to get an appointment! May wait in the lobby for 1-2 hours past your appointment time. Urgent Cares can handle low-grade injuries and infections, and can see you more quickly for your cough/cold/sore throat/urine infection than your doctor. Pluses: Most can see you quickly, on a drop-in basis with little wait. Copay is more than PCP but less than ER, most have cash pay price around $80. Minuses: luck of the draw on doctors (or NPs) experience and bedside manner, still have some limitations on setting fractures, starting IVs, giving IV meds, obtaining x-rays or CT scans, generally open 8 am-8 pm or 8 am-5 pm. FREESTANDING ERs--most people mistake these for Urgent Cares--were created to alieviate strain on overwhelmed hospital-based ERs for patients with insurance or who can afford the high cash pay price. These generally have NO WAIT but carry the highest copay your insurance will make you pay, some as high as $500! Cash pay prices for freestanding ER start at $150 and range up to $350 just for the medical screening. Medicare and Medicaid do not recognize freestandings as covered providers, so these payor sources are not accepted and these patients are asked to pay the cash price for service. Freestanding ERs are happy to see you for coughs, colds, and sore throats, but most people dont want to pay the higher copay when they can go to Redi-Clinic and pay $25-50. Freestanding ERs are equipped to handle any emergency that a hospital-based ER can handle--and they can see you within minutes of arrival. If, God forbid, you were having a stroke or heart attack, or other life-threatening illness, the same ER treatments would be initiated, and most freestandings (such as Paragon) have a button that allows for direct admission to the nearest hospital. Patients can be transferred from a freestanding to a cath lab within 10-15 minutes of arrival. Full range of IV medications and laboratory testing, fully appointed radiology department with CT scan, 24/7 ultrasound--all with reports back in less than 30 minutes. Pluses: concierge ER experience with a lot of face time with your provider and nurse, all questions answered, food and beverages provided, nicely appointed ER rooms with large TVs, guests accomodated, pain adequately controlled in a timely fashion, can handle any emergency situation, open 24 hours/day unlike Urgent Care. Minuses: very expensive; cost to your insurance company will be over $1000 just for stepping foot in the door, no consultants available (ophthalmology, cardiology, ENT, ortho, etc), may require transfer to hospital if illness requires. Hospital-based traditional ER: This would be the best choice if you were to require admission to the hospital, or are suffering from an illness that is much more serious. You will find yourself lost in a whirlwind of ER activity and probably wont see much of your doctor and nurse, but you will have a full range of services and consultants available to you should you have a serious illness. Pluses: Able to accomodate every illness, with consultants available in every specialty (the larger hospitals of course), knowledgable and experienced physicians, admission to the hospital if required. Minuses: Extremely busy, overcrowded, not much face time with providers. If you have any questions about these, I am happy to answer them! I hate to see people get trapped in a freestanding ER situation when they think that they are going to be paying an urgent care copay! I also find that people are not familiar with the services offered at freestandings.
Posted on: Wed, 13 Aug 2014 19:51:32 +0000
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