Can you get the care you need outside of the ED?

There are millions of visits to hospital emergency departments (ED) in New York state each year that don’t result in a hospital stay, according to New York State Department of Health data. And while some health conditions require emergency care, many are better suited for care in a different setting, such as a physician’s office, telemedicine, or urgent care center. As health care resources become increasingly strained from the pandemic, it’s important to understand these differences.

“Too often, patients show up at the emergency department for minor medical conditions, such as sore throats and earaches, which could have been treated as effectively, with shorter wait times and lower out-of-pocket costs, in a primary care setting,” says Elizabeth Nicholas, MD, emergency medicine physician and medical director at Excellus BlueCross BlueShield. “When a patient’s own doctor isn’t available, such as in the evening or on weekends, an urgent care center or telemedicine visit may be appropriate alternatives.”

Emergency departments have the expertise and technology to evaluate and treat medical and surgical emergencies. Individuals experiencing severe injury or illness should call 911 or go to the nearest ED. Some examples include chest pain, stroke symptoms, difficulty breathing, traumatic injuries, seizure or loss of consciousness, severe abdominal pain, and burns.

Individuals with minor medical conditions can overcrowd emergency departments and divert vital health care resources from true emergencies. “If possible when ill or injured, patients should contact their primary care physician first for guidance on the best steps for care,” says Dr. Nicholas.

 Urgent care centers are an option for patients when their doctor isn’t available.  They offer treatment for non-life-threatening medical issues such as lacerations requiring stiches, fever, flu, sore throat, cough, minor infections, rashes, short-term medication refills, and back pain.

Orthopedic-specific urgent care clinics can often give complete and efficient care on the same day for injuries such as broken bones, strains and sprains.

 For patients with non-life-threatening illness, check with your primary care doctor or specialist first, to see if they are available either by telemedicine or an in-person office visit.  If your doctor is not available, you’re out of town or not able to get into their office for any reason, telemedicine using a source such as MDLIVE, may be an option for you to talk to a provider by phone or online. Telemedicine providers can assess the condition, provide care, and send prescriptions to the patient’s nearest preferred pharmacy. This type of care works best for conditions such as colds, flu, pink eye, sinus infections, rashes, insect bites, minor skin conditions and some behavioral health conditions.

“I encourage patients to be proactive and speak with their primary care doctor about options for after-hours care, telemedicine visits, and recommendations for urgent care centers,” advises Dr. Nicholas. “If your insurance carrier offers telemedicine services, register for them before you become ill. By planning for the unexpected, patients can get the right care in the right setting, and free up hospital EDs for true medical emergencies.”

Excellus BlueCross BlueShield members, for example, can find out more about their telehealth and telemedicine options by visiting ExcellusBCBS.com/telemedicine.