It’s 7pm. Your daughter’s sore throat has worsened. Your doctor’s office is closed.
Where do you go? The hospital emergency room, urgent care, or a drugstore clinic?
It’s a dilemma, agrees Dr. Jasmeet S. Bhogal.
“That’s the million-dollar question,” he says.
Bhogal is an urgent care-trained physician and medical director of Lancaster General Health Retail and Urgent Care. In his words, urgent care is typically for “for acute illnesses or injuries that are not life-threatening,” while retail clinics provide some—but not all—of the same services. “I completely understand there is confusion between retail care and urgent care and the emergency room. It’s up to the patient to decide.”
But how to make that decision?
What’s the difference between facilities?
Most urgent care facilities are staffed by physicians and physician’s assistants, and they’re usually equipped for x-rays, lab tests, EKGs, and dispensing prescriptions. Clinics in drugstores or other retail settings are usually staffed by certified registered nurse practitioners and lack x-ray capabilities.
“Urgent care is primarily defined by non-appointment service and extended hours,” says Dr. R.P. Sowers, founder and chairman of the Virginia-based Patient First, which has offices in the Susquehanna region.
Urgent care and retail clinics offer daytime, evening, and weekend hours. Some are open 365 days a year.
“More and more people are wanting what they want, when they want it and where they want it,” says Patty McGuire, Wellspan Medical Group administrator, York. Wellspan operates ReadyCare urgent care and retail CareExpress clinics.
What do they treat?
Chances are, if your family doctor can treat it, so can urgent care. Sore throat, flu, and cough. Minor sprains and puncture wounds. Urinary tract infections. Nausea. Vomiting. Allergic reactions. Tests for strep throat or pregnancy.
Retail clinics tread much of the same ground, although “the severity of the symptoms has a role to play,” says Bhogal. Sometimes, Lancaster General Health Urgent Care will get a call from the retail clinic, LG Health Express, about a patient with more severe symptoms, “and we tell them to send the patient to the emergency room right away.”
Urgent care differs from family practice and retail care in its capabilities for stitching up lacerations and treating broken bones.
Which do I choose?
Urgent and retail care are first-come, first-served. If you show up with a life-threatening condition, they’ll do an assessment and send you where you should have gone in the first place—the ER.
“If you think you’re having a stroke, or you feel chest pains, or you’re having the worst headache of your life, don’t think you’ll be seen quicker because you come to ReadyCare,” says McGuire. “We’ll call an ambulance for you.”
For less pressing cases, you might try your family doctor first, says Bhogal. When the family doctor can’t see you right away, “that’s the time you come to urgent care.”
Does urgent care treat chronic conditions?
Urgent care staff can treat symptoms of chronic conditions and share the records with primary care physicians. A retail site, such as a CVS MinuteClinic, can screen and monitor for diabetes, high blood pressure and high cholesterol. The Pennsylvania Medical Society warns against use of store-based clinics to manage chronic conditions “based on concerns for patient safety, continuity of care and confidentiality.”
Urgent care operators differ on long-term treatment.
Children with chronic conditions should see pediatricians, says Sowers, but many adults choose Patient First as their primary physicians.
However, if a health system’s urgent care facility treats or discovers a chronic condition such as high blood pressure, the next step is probably follow-up with a family doctor.
“We’re strong believers in the patient-centered medical home,” says McGuire. “We are an extension of the family doctors.”
Who has oversight?
The Pennsylvania Department of Health does not certify urgent or retail care. As a smart consumer, look for accreditation by the American Academy of Urgent Care Medicine, the Urgent Care Association of America, or the Joint Commission, says Bhogal.
How do I pay for care?
Most urgent and retail care facilities accept most insurance policies, but double-check whether they accept Medicaid.
Many patients pay from their own pockets, providers say.
“Typically, the charges are in line with running a family practice,” says Sowers. “Emergency room costs are so much higher. It makes sense. We have a large number of patients who self-pay.”
