Washington Family, "Urgent Care vs. ER: How to Decide Where to Take Your Child"

Published October 30, 2017

By Dr. Subir Jossan & Dr. Steven Neufeld

Just knowing where to go could save you $1,000 in medical costs.

Americans make more than 130 million visits to the emergency room each year. And up to 20 percent of those visits are for minor conditions – such as a sprain or bronchitis – that could be treated in an urgent care clinic or a physician’s office. Caring for these patients outside of the emergency room could save as much as $4 billion a year.

More importantly, knowing which level of care is appropriate could save you hours of time and a significant amount of money. For patients in Northern Virginia, the average emergency room visit costs $1,124, according to Virginia Health Information, and lasts over four hours. In comparison, patients pay $150 on average for an urgent care visit and typically wait just 15 minutes for prompt medical attention.  

But when you suffer sharp pains in your back, or your child is injured on the sports field, it can be hard to judge which level of care would be best. Here are a few tips for deciding where to go with an injury:

Evaluate The Energy Level

High-energy injuries are those that involve speed or height, such as a car accident or fall from a ladder. This level of trauma can be very serious and warrants a trip to the ER. Patients may have head or internal injuries in addition to the visible orthopaedic injuries, and so it’s best to be evaluated in a facility with access to CT scans, imaging devices and trauma surgeons.

However, low-energy injuries such as sprains, strains and even fractures can be treated in the urgent care setting or the next day by your orthopaedic provider. Most fractures, even in children, don’t need to be treated in the ER unless there is a deformity in the affected limb, or an associated wound on the skin. Splinting, ice and elevation should be performed to decrease pain and swelling after the injury and prior to visiting a physician. Over the counter pain medicines, such as Tylenol and NSAIDs, are recommended.

Know Which Sports Injuries Can Wait

Head injuries should always be treated as an emergency, regardless of how they are sustained, due to the patient’s risk for a concussion. Concussions are very serious, but can typically be examined and ruled out by an athletic trainer or physician if the injury occurs during an organized sport. If you do experience a concussion, or receive a head injury without a trainer or physician present, you should seek emergency care.

Most other sports injuries can be treated in the urgent care setting or by an orthopaedic provider the next day, even if you can’t finish the game. If it’s more serious than a sprain, strain or fracture – such as an ACL tear – the ER and urgent care clinic would likely refer you to an orthopaedic surgeon to treat the injury. You can save time and money by going straight to an orthopaedic provider and calling your primary care doctor for a referral.

Plan For Medical Treatment

Many patients assume that a bone is not broken, or an injury isn’t serious, if they can still move the affected area. But ligaments, tendons and muscles hold bones together, allowing them to still move even if they are broken. In some cases, this can cause it to shift or displace, necessitating further correction. Similarly, some patients have a high threshold for pain and can tolerate walking on or using a broken bone – which is likely to further aggravate the injury. If you suspect an injury, visit urgent care or your orthopaedic surgeon for proper care and don’t try to tough it out.

Not all injuries are an emergency. And if you can tell the difference, you can save significant time and money while still receiving high-quality care.

Dr. Subir Jossan and Dr. Steven Neufeld both practice throughout Northern Virginia with The Centers for Advanced Orthopaedics, the largest private orthopaedic provider in the country. Dr. Jossan also serves as Treasurer.

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