Navigating Healthcare

Navigating our healthcare system can be challenging, especially when you are not feeling well.  One of the biggest questions that patients face is deciding whether their symptoms warrant a trip to a doctor’s office, urgent care clinic, or the emergency room.

For most health problems, your primary care doctor—usually a family doctor, internist, or pediatrician—is often in the best person to provide the first line of advice for health concerns.  These primary care physicians are equipped to handle most chronic health problems and minor complaints. Examples of conditions that can be managed by your primary care physician include muscle strains/sprains, joint and back pain, coughs and cold symptoms, minor burns and injuries, headaches, and stomach and intestinal problems (as long as the patient can drink fluids normally).

Many primary care physicians are able to perform procedures like joint injections and drainage of abscesses, dress wounds, and provide referrals to the right specialist if needed.  Most primary care offices can order blood tests, and many can perform immediate rapid tests for pregnancy, urine infections, strep throat, and influenza. Some even offer x-rays on-site.  

An advantage to seeing a primary care physician is that your regular doctor usually knows you and your medical problems best and is able to provide follow-up for your medical conditions.  If you’re having a hard time finding a primary care physician, you can ask your friends or family for recommendations, check with your insurance company to see who is in network, or search for your area on this physician mapper.  

Urgent care clinics include walk-in clinics which may be associated with a retail pharmacy or hospital system. They are most often staffed with nurse practitioners and physician assistants which means that you are unlikely to see a physician. Examples of complaints that can be managed by an urgent care clinic include straightforward conditions like colds, influenza, minor sprains/strains, minor skin cuts, and minor burns (not to hands/feet/genitals/face). Urgent care facilities often have access to an x-ray machine and can diagnosis and splint (but not cast) a fracture.  They may also have access to some of the more common blood tests. An advantage of urgent care is that they are often open on weekends and after hours when your primary care physician may not be available.

The emergency department (ED) should be reserved for true emergencies. Examples of

complaints that should be seen in the ED include chest pain, shortness of breath, stroke symptoms such as difficulty speaking or weakness on one side of the body, fractures where there is bone outside of the skin, fainting, severe headache, and inability to keep down liquids. EDs are always open but can be the most expensive option when it is not a true emergency. When you go to the ED, you may see a physician, nurse practitioner or physician assistant.  It’s important to be aware that not all EDs have physicians working on-site. When you or your loved one in sick, you should ask the credentials of the clinicians who are taking care of you and know that it is okay to ask to be seen by a physician.

Rebekah Bernard MD is a Family Physician and the president of Physicians for Patient Protection.

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