A patient needs to know the difference between routine, urgent and emergency care.
Routine care is the norm with scheduled visits that a patient needs to maintain his or her health status. Sick visits such as sore throats, bronchitis, etc. that can be provided in the primary care office in a timely fashion can also be considered routine. However, if your primary care provider is unavailable in the office, that same visit can be an urgent care visit.
Urgent care is a sudden illness or injury that is not life threatening. Other examples of urgent care include eye infections, cuts, skin infections, sinus infections, sprains and minor fractures. An emergency is a medical or mental health condition that in the absence of immediate medical attention could result in serious medical consequences or place one’s health in serious jeopardy. Examples of a medical emergency include severe chest pain and/or shortness of breath.
If you believe that you have a life-threatening situation, you should immediately go to the emergency room or call 911. With a true emergency, you do not need approval from your insurance company or your primary care physician.
If you have an urgent care problem, you should always contact your primary care provider and explain your problem. If your primary care provider is not available or is unable to accommodate your urgent issue, an urgent care center is usually the next-best option. Urgent care centers usually have much shorter waiting times versus emergency rooms, which can often take six hours or longer for urgent issues. Your problem can be placed behind a major trauma or a cardiac issue that has to be treated first.
The co-pays for an urgent care visit are less costly than an emergency room visit, where your minor issue may divert needed staff from more serious problems. Urgent care centers usually are open on weekends and have extended weekday hours. When in doubt, call your primary care physician. He or she knows more medical conditions and your personal health history and can better assess whether you need to go to the emergency room, go to an urgent care center or make a primary care appointment. The costs involved can be found in your health insurance benefits description materials, along with a more detailed description of what constitutes emergency services for the purpose of coverage.
After an emergency visit or, in many cases, after an urgent care visit, you should follow up with your primary care provider to make sure your problem is resolved. ••
Joseph Pongonis, D.O., practices family medicine with EPIC Physicians, 8019 Frankford Ave. in Holmesburg, 215-332-1300.