Urgent Care or Emergency Department

Is it the Emergency Department or Urgent Care: What level of care is right for summertime injuries and illnesses
By Michael McHugh, MD

After a long and snowy winter, we’re heading into the high season of summer with great weather and lots of fun times ahead. While it’s a relief to finally be outside, chances are pretty good that someone you know will have a summer illness or an accident related to increased outdoor activity. In fact, visits to hospital Emergency Departments increase during the summer, making it the most injury-prone season of the year.

According to the Centers for Disease Control and Prevention, about 27 percent of all Emergency Department visits take place in the summer. Some of them are true emergencies. Others can be treated successfully with a lower level of medical intervention. Yet until just recently, all of them headed to their local - and often over-crowded - Emergency Department where the most serious cases were seen right away and the less sick or injured patients waited a longer time for care – and paid a hefty co-pay.

That’s why so many Urgent Care centers are springing up across the country. In less than a decade, nearly 7,500 of these centers are now located here and in most communities across the country. Patients are receiving care more quickly, and their co-pay is usually the same as an office visit. (It’s important to note that Express Care services often available in hospital Emergency Departments may have a significant co-pay.)

So where should you go – to the Emergency Department or Urgent Care? We find that most people can assess their conditions fairly accurately. Nationally, just three percent of patients showing up at Urgent Care centers must be diverted to an Emergency Department. Those who have any life-threatening emergency, such as symptoms of a heart attack, stroke, a head injury, trouble breathing or severe bleeding should always call 911 or go to the closest hospital Emergency Department. 

The following are illnesses or injuries that we typically see during the summer, and the best level of care for treatment: 

Urgent Care:

Tick bite, rash, minor asthma attack, sore throat, allergic reaction to a bee sting or bug bite that does not include difficulty breathing, muscle and joint sprains and strains, simple laceration, low-grade fever, minor burns, flu-like symptoms, eye and ear complaints. 

Emergency Department:

In addition to the life-threatening symptoms listed above, patients should always go to the closest ED for allergic reactions to bee or bug bites that include difficulty breathing, or severe asthma attacks, persistent vomiting, high fever, bone fractures and severe pain anywhere on the body. 

During the summer, emergency physicians also see an increase in high velocity accidents including falls from a bike, a horse, from all-terrain vehicles, as well as car, truck and boat crashes. As a general rule, if the accident involved a high energy mechanism, it’s always best to go to an emergency department. 

Hospital Emergency Departments will see more trauma during the summer, including falls from ladders as people take advantage of the nice weather to paint their homes; lawn mower and tractor accidents, and, unfortunately, a seasonal uptick in gunshot and stabbing victims.  The increased availability of Urgent Care centers means that emergency physicians can now focus on true medical emergencies. 

And they are meeting a significant need in all communities, no matter what the season. The evening, weekend and holiday hours have made the difference for people everywhere who often went without medical attention because they could not take time off from work or other obligations to see a physician in a more traditional setting. While Urgent Care was originally designed to ease the burden in emergency departments, one of their most compelling benefits has been expanding access to essential healthcare for many people. 

Michael McHugh, MD, is board certified in Emergency Medicine and is Chairman of the Department of Emergency Services at Berkshire Medical Center.