Take Me to the Emergency Department? Urgent Care? Free-Standing ED? Hybrid UC?

The average consumer has a lot of confusion on what venue of emergency medical care is available or appropriate for their immediate needs.

An emergency department (ED), also known as accident & emergency (A&E), emergency room (ER), or casualty department is a medical treatment facility specializing in acute care of patients who present without prior appointment, either by their own means or by ambulance.  These are 24 hour venues with full services that are usually attached to a hospital and function under the EMTALA law.  In 1986, Congress enacted the Emergency Medical treatment & Labor Act to ensure public access to emergency services regardless of ability to pay. 

Free-Standing Emergency Department functions as full facility that is not attached to a hospital.  They are also subject to the EMTALA law.  Patients who need hospitalization are transferred to a hospital.

Urgent care is a walk-in clinic focused on the delivery of ambulatory care in a dedicated medical facility outside of a traditional emergency room.  Urgent care centers primarily treat injuries or illnesses requiring immediate care, but not serious enough to require a ER visit or hospitalization.
Urgent care centers are distinguished from similar ambulatory healthcare centers such as emergency departments and convenient care clinics by their scope of conditions and treatment available on-site.  While urgent care centers are not typically open 24-hours a day, 70% open by 8:00am and 95% close after 7:00pm.  They do not fall under the EMTALA law.

Hybrid Urgent Cares are designed to evaluate all levels of patients.  They usually perform ultrasound, cat scan, or x-ray and complex lab tests on-site.  Most are open from 8am to 10pm.  Patients who need hospitalization are transferred.  There is no emergency department facility fee, so the process are lower.  They too are not subject to EMTALA law.


When an individual is ill, where should they go and get the most "bang for the buck"?  This is not an easy decision under stress.  The best method is working with your primary care physician and figuring out, in advance, what level of care and convenience you desire or need.  Insurance companies play a huge role in this as they drive patients toward less expensive platforms of care.

Do your homework!

1. Pick a hospital system you trust where your primary care physicians operate.
2. Ask your neighbors/relatives.  They might not recognize quality care, but are aware of attitude, efficiency and caring.
3. Analyze the capacities of local and hybrid urgent cares -

Good questions are...

• Level of testing
• Transfer policies
• Procedures performed
• Insurance issues
• How do they relate to your primary care physician

What to do when you are ill?

If you have time "Google your symptoms" and try to figure how complex a problem is.

1. High risk illnesses: need a higher level of care.  This list is not inclusive. - chest pain, severe abdominal pain, severe shortness of breath, severe bleeding, syncope (passing out), possible stroke, pregnancy related vaginal bleeding, potential labor, sever infections, acute exacerbations of a chronic illness that leads to hospitalization routinely, pediatric patients under 3 months of age elderly patients with multiple complex illnesses and medications, sever trauma, head injuries, severe fractures that need surgery, and severe lacerations.
2. Moderate illnesses can probably go to a quality urgent care.  A quick phone call to you primary doctor's office can direct you to the "right place".  The primary care provider can to handle most of these problems, if they can see you immediately.

Bottom line- when in doubt GO TO THE EMERGENCY DEPARTMENT!  If there is time to sort things out, make an informed decision (medical and financial).  A little pre-planning can go a long way.