When should you go to urgent care vs er

When immediate injuries or illnesses strike outside your primary care doctor's usual hours, you have two options, depending on your symptoms and their severity: You can either go to the emergency room (ER) or head to the nearest urgent care clinic. 

As the name suggests, ERs are intended for emergencies, like severe bone fractures, persistent chest pain, or uncontrollable bleeding.

Urgent care clinics, on the other hand, offer a middle ground between the ER and waiting until your primary care doctor's office opens. You'll want to visit the urgent care for issues that aren't necessarily emergencies but still require prompt care. Examples include high fevers, mild to moderate difficulty breathing, or cuts that may need stitches. 

Below, ER doctors share insight on how to determine when you should go to the ER, and when to opt for an urgent care visit instead. 

When to go to the ER

You'll want to head to the ER right away for any condition or injury that poses a threat to your life, organs, or senses, including:

1. Excessive or uncontrollable bleeding

2. Severe head injuries

3. Psychosis

4. Fainting or sudden, persistent dizziness

5. Intense, localized abdominal pain

6. Sudden numbness or weakness in the body, loss of coordination, or other signs of a stroke

7. Sudden vision changes

8. Sudden confusion or disorientation

9. Coughing or vomiting up blood

10. Trouble breathing

11. A fever of 103°F or higher, along with other symptoms like irritability, vomiting, stomach or head pain, and light sensitivity

12. Any fever in infants under 2 months of age

13. Severe burns

14. Severe allergic reactions

15. Asthma attacks

16. Vomiting or diarrhea that doesn't stop

17. Inhaled smoke or poisonous fumes

18. Open wound fractures  

19. During pregnancy: heavy vaginal bleeding that's similar to a period or worse, severe and persistent abdominal pain or cramping, fever or chills, or sudden vision changes coupled with severe headaches

Dr. Jennifer L. White, Director of Clinical Operations of the Emergency Department at Thomas Jefferson University Hospital, advises trusting your gut when it comes to the above symptoms and conditions. 

For example, if you have bronchitis — a condition that can typically be treated at an urgent care clinic — and are experiencing wheezing or shortness of breath, you should visit the ER as soon as possible.

"I have treated many young patients who think they are having a panic attack and instead are experiencing supraventricular tachycardia, an abnormal heartbeat that may require emergency care. What looks like a bug bite may be a flesh-eating bacteria. Back pain from lifting a toddler out of the car could warrant spine surgery. The bottom line is to get guidance when in doubt, which is why the ER is open 24/7," White says. 

If you're unsure whether you should go to the ER, call your personal doctor for more guidance. 

When to go to urgent care

You'll generally want to visit an urgent care clinic for symptoms that require somewhat immediate attention but aren't life-threatening. 

Note: It's always best to receive continued care from your regular doctor, so it's always worth a quick phone call to check if they can fit you in for an appointment before you head to urgent care.

According to Dr. Jay Woody, chief medical officer of Intuitive Health and co-founder of Legacy ER & Urgent Care, medical conditions that may require a physician's care but not a trip to the ER include:

1. Food poisoning — unless you experience blood in your vomit or stool, or severe dehydration symptoms

2. Sinus infections 

3. Strep throat

4. Rashes, unless they spread rapidly or are accompanied by a high fever, blisters, or bruises 

5. Cold and flu symptoms, like severe sore throat or cough

6. Mild to moderate headaches

7. A fever higher than 100.4°F (38°C)

8. Minor sprains and fractures in toes or fingers

9. Minor burns and cuts, unless there's excessive bleeding, or you have signs of infection like oozing pus or yellow crust around the wound

10. Minor ear, nose, and throat issues, including pink eye and nosebleeds

11. Urinary tract infections, unless you have signs of a kidney infection like a fever, chills, or upper back and side pain

12. Bronchitis, unless you have difficulty breathing 

13. Moderate back and joint pain 

14. Earaches and eye infections

If a physician at an urgent care clinic determines your symptoms or condition require more intensive measures, they may transfer you directly to the nearest emergency room for treatment, according to Dr. Jared Sharza, a resident emergency medicine physician at McLaren Macomb Medical Center.

Here are some other things to consider when choosing between the ER and urgent care.

Prepare for a long wait when visiting the ER

Urgent care clinics are designed to treat a higher volume of patients than emergency rooms, so prepare to wait longer in the ER, White says. On average, ER wait time is 55.8 minutes in the US. 

However, wait time can depend on how fully staffed the department is and how many beds are available. Your individual risk factors and results from your vital sign assessment can also come into play. If your injury is severe enough to threaten your life, you'll receive treatment much sooner.  

White says the longest ER waits tend to be on:

• Mondays, Tuesdays, and Wednesdays
• After 7 p.m. when urgent care clinics close

On the other hand, you may receive treatment more quickly:

• Before noon on a weekday
• After midnight on a Saturday or Sunday

"ERs use a triage system to decide who can wait and assess if there are tests, imaging or treatment that can begin before they're seen," White says.

White recommends bringing comfortable clothes, a book, and a phone charger with you — along with your photo ID and insurance info.

An ER visit can be expensive

Going to the ER can be far more costly than visiting an urgent care clinic, according to Woody.

With insurance, the average cost of an emergency room visit is $1,014, whereas the cost of an urgent care clinic visit can range from around $22 to $261 — about 85% less.

So, unless you're dealing with a potentially serious issue or condition, you may want to skip the ER and visit an urgent care clinic instead. 

ERs have access to more resources for specialized care

According to Sharza, most emergency rooms are connected to hospitals, so they typically have access to more resources — like advanced imaging technologies and specialist physicians.

Specialists like allergists, dermatologists, urologists, gastroenterologists, and infectious disease doctors have advanced training for treating complex, nuanced medical problems. 

Moreover, only some urgent care centers may offer X-rays, MRIs, CAT scans, and in-house labs, while all hospitals offer these services. 

Also, emergency rooms have easy access to on-call surgeons, whereas urgent care centers would need to transfer you to a hospital for surgery.

Note: While you can call 911 or head to your nearest ER if you have thoughts of suicide, the care provided in the ER may not be ideal during a mental health crisis. Instead, consider calling the Suicide & Crisis Lifeline at 988 for free, confidential support.

Insider's takeaway

Visit your nearest emergency room for any condition that may impair or endanger your life. Urgent care clinics are a great solution when you need medical attention for an issue that's not life-threatening but can't wait until you can visit your usual doctor. 

Still unsure about which option is a better fit? You can always call your doctor's office or a local emergency room for advice based on your current symptoms. 

Experts agree, however, that it's always better to be safe than sorry. So, if you're at all concerned about the severity of your symptoms or the risk they pose to your health, head to your nearest emergency room to get evaluated.