Seconds after your 10-year-old makes a spectacular play on the soccer field, she collides with another player and falls down hard. She’s writhing in pain and may have just broken her arm. So where do you take her?
In the past, you’d head straight to the local hospital emergency room (ER). But these days, the waiting time and cost of treatment in the ER can be prohibitive. Besides, an ER’s real priority is to treat life-threatening conditions and injuries. While a broken arm can absolutely be treated there, you have other options.
Here’s a look at the differences between hospital ERs, private urgent-care clinics and the in-store clinics that have popped up at various drugstore or department store chains.
• Care Offered: The emergency room is equipped to handle any urgent-care need, from broken bones and fractures to allergic reactions, serious flu symptoms and high fevers. But it is intended for the treatment of potentially life-threatening emergencies: serious issues such as crushing chest pain, massive injuries, symptoms of appendicitis or stroke, breathing difficulties, loss of consciousness, large body burns or severe, uncontrolled bleeding.
• Hours / Wait Times: ERs are always open – 24 hours a day, seven days a week. Because so many people still visit ERs for broader urgent-care needs, the wait time for treatment can sometimes last a couple of hours or more as patients with higher-priority needs are seen first.
• Cost: A study published in the Annals of Internal Medicine put the average cost of treatment in the ER at $570 – much higher than visits to a doctor’s office, urgent-care or in-store clinic. This may be due to the need to support the fixed costs of the hospital itself. Regardless, ERs are required by federal law to treat any patient, regardless of ability to pay.
• Care Offered: Urgent-care clinics offer treatment for mild to moderate injuries, including sprains, strains, broken bones, bee stings and smaller or less severe burns. Health care providers here can also treat allergies and allergic reactions, colds, viruses, infection and the flu, and can administer vaccines, as well. Services usually vary per clinic; some may offer laboratory testing or X-rays; others might offer extras like high-school sports physicals. These clinics are usually staffed with physicians trained in primary and emergency care, as well as other care providers, such as nurses, medical assistants and specialists like lab or radiology technicians. Some clinics offer patients who don’t have their own primary care doctors the option of seeing the clinic’s on-staff doctors regularly over a long-term basis.
• Hours / Wait Times: While usually not open 24 hours a day, urgent-care clinic operating hours vary, with some offering extended hours into the evening on weekdays and daytime hours on weekends. The wait time here is much less because the number of patients and the time required for treatment is less than what you might encounter in the ER on any given day. Some clinic websites will even list their current wait times to be seen by a doctor or medical assistant.
• Cost: The Annals of Internal Medicine study put the average cost of a visit to an urgent care clinic at $156, less than the average physician’s office visit cost of $166. These clinics accept most health insurance plans. Patients are responsible for any co-payments, co-insurance or deductibles required by their insurance carriers.
• Care Offered: Clinics located in drugstores, grocery stores or even retail department store chains offer a limited number of services but have become increasingly popular due to convenience. They’re usually staffed by nurse practitioners who can write prescriptions if necessary. Among the services offered: treatment for minor illnesses like colds, viruses, infection, hay fever or pollen allergies; influenza vaccination; and some screening for conditions like diabetes or hypertension. These clinics may also do college and camp physical exams and other wellness or preventative care. More recently, some clinics are offering nebulizer treatments for breathing problems, such as an asthma attack.
• Hours / Wait Times: Retail clinics are open during set hours within the operating hours of the particular store where they’re located. They’re generally not 24-hour clinics even in, say, a 24-hour CVS pharmacy, but they do offer evening and weekend hours. Many people use them if their regular physicians’ offices are closed. You can make an appointment at some of these clinics or simply take your chances as a walk-in. Wait times vary but generally aren’t long.
• Cost: A visit to a retail clinic is the least expensive option for medical care, averaging $110 in the Annals of Internal Medicine study. That may be the draw for people who don’t have health insurance or prefer to pay for this kind of care out-of-pocket. The prices for specific care are usually posted online or in the clinic itself. Patients who want their insurance companies to cover the care are generally only responsible for any co-payments, co-insurance or deductible required by their insurance carriers. (These clinics recommend that you check with your insurer before visiting to make sure you have coverage.)
Talk with your physician if you have any questions about using the ER or a private clinic, particularly when it comes to treatment for your child. Keep in mind that some of these clinics will not treat a child under 18 months of age.
Deirdre Wilson is former senior editor of the Boston Parents Paper.
Local Massachusetts Hospitals
• Beth Israel Deaconess Hospital,148 Chestnut St., Needham; www.bidneedham.org.
• Brigham and Women’s Hospital, 75 Francis St., Boston; www.brighamandwomens.org.
• Children’s Hospital, 300 Longwood Ave., Boston; www.childrenshospital.org.
• Emerson Hospital, 133 ORNAC, Concord; www.emersonhospital.org.
• Lowell General Hospital, 295 Varnum Ave., Lowell; www.lowellgeneral.org.
• Tufts Medical Center, 800 Washington St., Boston; www.tuftsmedicalcenter.org.
• Winchester Hospital, 41 Highland Ave., Winchester; www.winchesterhospital.org.
Urgent Care Facilities in Massachusetts
• AFC Doctors Express, various locations; www.doctorsexpress.com.
• CareWell Urgent Care, various locations; www.carewellurgentcare.com.
• Dedham Medical Urgent Care Center, 1177 Providence Highway, Norwood; www.dedhammedical.com/urgentcare.