By Dr. Sonny Saggar, MD
There is a great deal of confusion among the general public regarding the access to healthcare.
Where should I go? Whom should I see? How much will it cost? How long should I wait before someone can see me? How long before I can get an appointment? Will they take my insurance? Can they handle putting in stitches if I have a cut? What if I’ve broken a bone? Is the ER the best place for everything? Or would my primary care physician be better? How do I know I’m going to a good place? What should I do if my physician takes forever to call me back? Who won’t mind a silly question? I feel like such a fraud going to the ER for something as minor as this!
You have 3 simple choices: your primary care physician (PCP), the emergency room (ER) or your local urgent care center. Let’s look at the pros and cons of each:
Whom will I see? Usually a PCP is an internist or family physician. Sometimes it can be a ‘mid-level’ such as a Nurse Practitioner (NP). At an urgent care, it is almost always a medical doctor. The ER will also have physicians but quite often physicians assistants (PAs) and NPs too. It’s often a good idea to see whether a certain location has received national accreditation, much like you’d want for a good university. An example is the American Academy of Urgent Care Medicine.
How much will it cost? Typically, if you have a copay due on your insurance plan, the cost will be ER (often around $100 to $250) > Urgent Care (around $20 to $50) > PCP (around $25). Not that it will affect you immediately, but the same cost structure is reflected in the bill submitted to your insurance company. Although we might love to hate our insurers ‘because I pay such high premiums’, it’s a good idea to save them money too, because otherwise, ‘the spiraling cost of healthcare’ will eventually come back to you, in the form of higher premiums in subsequent years.
How long will I have to wait? Well you can go to the ER immediately, but unless you have a life-threatening symptom, such as chest pain, stroke or trouble breathing, you may have to wait several hours to be seen by a physician. If you want to see your PCP, they may not be able to fit you in for several weeks. Often they are kind enough to ‘squeeze you in’ to their already busy schedule, which unfortunately often translates to another hour or two in the waiting room. At an urgent care, you will often be seen by a physician within 20 minutes of arrival, and discharged home within a reasonable time. Remember, you’re looking for quality time-efficient care, rather than just a “quick fix” facility.
Will they take my insurance? ERs and Urgent Cares will typically accept ALL insurance plans. Many PCPs will not take certain health plans, which could be private or Medicare, leaving those folks being forced to visit an ER or Urgent Care. If you have no insurance, you may get a massive bill from the ER (which could run into thousands of dollars). Most Urgent Cares will have a ‘cash discount’ for a set rate, such as $150 flat, regardless of how many tests they need to do.
Can they handle cuts or broken bones? Every ER and Urgent Care will have an x-ray machine and the ability to suture the majority of lacerations. Occasionally however, the case may need the involvement of a plastic surgeon or orthopedist on the same day. PCPs generally do not repair lacerations or set/splint fractures.
Is the ER the best for everything? Not at all. It is best if you’re having a life-threatening problem, such as a heart attack, a possible stroke or you can’t breathe. In these cases, hospitalization is often necessary, as well as higher resolution studies such as a CT scan. An urgent care can handle every other non-life-threatening problem and, if it is determined that you should have gone to the hospital after all, the Urgent Care will transfer you immediately by ambulance, quite often bypassing the ER completely.
If you’d like to have questions answered during your visit, generally speaking, the ER doctors are usually very pressed for time and aren’t available for discussion other than essential care items. PCPs will often have the most time to talk, unless they have a very busy waiting room. Urgent care physicians tend to spend more time with the patient and are usually happy to spend the extra time to answer and address all questions.
Going to an Urgent Care with a ‘non-emergency’ immediately helps alleviate ER overcrowding. It will often save you having to take a day off work to go and see your PCP for a 15-minute visit and hence maintains productivity in the workforce. All things considered, urgent cares are good for the community and good for the economy. One might even argue that they result in greater national wealth as well as health, because they save time and reduce the spiraling cost of healthcare. Let’s face it, Urgent Cares are just environmentally friendly.
To learn more about Downtown Urgent Care, visit downtownurgentcare-stl.com or call 314-436-9300 ext. 1. Dr Sonny Saggar is the founder of, and one of 5 emergency physicians working at, Downtown Urgent Care, located at 916 Olive Street in Downtown Saint Louis. Dr Saggar is an emergency physician, on the active medical staff at 7 major emergency departments all around Saint Louis. Dr. Saggar is an environmentally friendly vegetarian whose passion is to promote preventative health measures, as well as caring for the critically ill.