Emergency room vs. urgent care based on a recent experience

Last updated on May 2, 2017

Our whole family got sick not too long ago with a viral stomach infection. It was a disaster as you can imagine, especially since both our three-year-old toddler and our 10-months-old baby were sick too. Getting treatment was much more complicated and time-consuming than we would have expected. It took a total of five trips to urgent care facilities, the emergency room (ER) and the pediatrician. In this article, I compare emergency room vs. urgent care, based on our recent experience.

Patient zero

The fun started with my wife waking up at 2 am because she felt nauseous. Shortly after, she began vomiting, which continued until she went to an urgent care center in the morning. Fortunately, a friend could drive her while I stayed with the kids. The urgent care center closest to our house was closed, so Kathy went to another one about 20 minutes away. At that point, we thought it could be a reaction to lactose (milk sugar) because we had pizza the night before but hadn’t had any other dairy in months. Digesting lactose requires an enzyme called lactase. Babies produce lactase to digest mother’s milk, but production usually goes down when the kids grow older. Once you have reached adulthood, you may not produce sufficient lactase and thus become lactose-intolerant.

It’s a myth that the body stops producing lactase when you stop eating food that contains lactose (such as dairy), but the doctor at the urgent care center thought that might be the case and indicated the cheese on the pizza, rather than a virus had caused my wife’s symptoms. The doctor prescribed medication for nausea and stomach cramps that helped Kathy’s symptoms to improve quickly.

The virus is spreading

Around noon, I also felt the onset of nausea and decided to take the medication Kathy had received proactively. At 4 pm I had to stop working and get some rest, and at that point, we knew that it was a virus and not anything we had eaten. Not long after, the virus went into full effect, I had the chills, and I was sick in my stomach. Fortunately, I didn’t feel like vomiting (yet). While I was lying in bed with a heating pad, feeling sorry for myself, Isabella starting complaining about a stomach ache. At 6 pm she threw up, and her condition went downhill from that point on. Only our preemie Lucas was holding up well.

The first visit to the urgent care center

Equipped with two buckets, Isabella and I got into the car and drove to the nearby Piedmont Urgent Care by WellStreet. Isabella cried the whole drive out of pain, and before we got there, she had to make good use of the bucket that she was holding. Upon arrival, we had to fill out ten pages of forms, mostly consisting of redundant information. I wasn’t sure if I felt more sick or pissed at that point but started filling out the forms while holding and attending to a crying child.

Not all Piedmont Urgent Care centers are created equal

Halfway through the forms, the lady at the check-in counter called me and said that our insurance (BlueCross BlueShield of Florida) was not accepted. Interestingly enough, the other Piedmont Urgent Care center that Kathy went to in the morning had no issues with our insurance. But after having wasted 10 minutes to drive there and 15 minutes of filling out forms, we left. Isabella was still crying like there was no tomorrow and I felt like I would have to vomit anytime soon.

Back in the car, I called Kathy to tell her that we would be driving to the same urgent care center she went to in the morning. But she asked me if we could pick Lucas and her up because he started vomiting as well. Being a baby and a preemie we didn’t want to risk for him to get dehydrated, so we decided to go to the ER of North Fulton Hospital. We figured we would get quicker help there than at an urgent care center that had only one doctor on staff.

Primary care vs. Urgent care vs. Emergency room

You have to be patient at the ER

I knew that unless you get admitted to the ER by an ambulance, you will have to wait. But I was hoping that a vomiting infant and a crying toddler would give us a bump in priority. I felt like trash and didn’t know how to sit. My face, arms, and hands were tingling, and I was counting the seconds until we would get admitted. After 45 minutes I was sick of counting (pun intended), and when they told us it shouldn’t be much longer than 20 minutes, we packed our buckets filled with vomit and left.

Back to the urgent care center

We decided to go back to the urgent care center that Kathy went to in the morning. They understood that the three of us weren’t feeling well and admitted us immediately. While the nurse started taking our vitals, Kathy filled out the necessary forms. Isabella and I got prescriptions for the same medication Kathy got earlier that day, but the doctor claimed that Lucas’s weight was too little for him to get any anti-nausea medication. That turned out to be an incorrect assessment, as the next day, our pediatrician prescribed him the same drug.

Walgreens: Go home and eat while we prepare your prescription

After we had left the urgent care center, we drove to our local Walgreens to pick up our medication. The lady at the drive-through must not have seen how crappy we all looked when she suggested to go home and eat while she prepared our prescription. When I gave her the evil eye she responded: “Well, don’t try to pick up your order before it’s ready.” Fortunately, I was too sick to tell her what I thought about that statement as it wouldn’t have been pretty or appropriate.

A slow recovery

The good news was that we had enough of Kathy’s medication at home to get us through the night. So we all had a decent night without further incidents. It took us all a while to fully recover, and a few days later we boarded a plane to Costa Rica. Lucas took the longest to recover fully, and we had to go to the hospital with him twice in Costa Rica.

The virus we had turned out to be so potent, that it quickly spread among Kathy’s family. They knew the risk but couldn’t resist holding the baby. Fortunately, most affected family members were fine again within 48 hours.

Emergency room vs. Urgent care

The lesson we have learned from this experience is, to better prepare for the eventuality of the whole family getting sick. We will also stick to urgent care facilities that we have used before. That way, we are already in the system and can skip filling out endless forms. We will stay away from any emergency room unless there is a real emergency and an ambulance admits us. From a cost perspective,  urgent care centers are usually also the less-expensive option anyway.

Michael Kummer

Atlanta | Austrian | Blogger | Father of a preemie | Paleo fan | Traveler | Amateur photographer | CrossFit
2 Responses to "Emergency room vs. urgent care based on a recent experience"
  1. If you don’t have one already, you might want to look for a family physician with admitting privileges at your local hospital. Two years ago, I thought I had constipation, but it turned out to be an infected and blocked prostate, enlarged bladder and shut-down kidneys. Not good.

    My physician got me in for an after-hours CAT scan, and I was next to the last person they handled that evening before shutting down. Any delay in the ER, had I been forced to go there, would have meant that scan would have delayed until sometime the next day.

    The CAT results got me admitted to a hospital room, a uriologist assigned, and the blessed relief of a catheter. I voided a liter in mere minutes and five liters overnight. My blood chemistry was so out-of-kilter, any delay might have been bad news.

    A regular physician with admitting privileges can bypass that ER evaluation. If he or she says you, your wife, or one of the kids needs immediate hospitalization, it’ll happen. And he can refer you to the appropriate specialist too. And if you’re a regular, most physicians will find a way to fit you in.

    While I was waiting for my room, I was sent to the ER, but staff assured me I wasn’t having to go through it. I could see why they said that. It was so crowded, I doubt I could have been seen in less that two or three hours.

    ERs and Urgent Care centers have their place, but you’ll often be much better off if you’ve got a regular physician who knows you and whose judgment means he can bypass all the checkpoints that delay getting care.
    ——
    I know how your family felt. A stomach virus can be dreadful and little kids can get dehydrated very quickly by vomiting. When I worked at Seattle Children’s Hospital, I had a resident order ‘sips’ of various fluids rather than go immediately to an IV. I thought, “This is not going to work.” Why, I asked myself, delay that IV?

    I tried every fluid we had on the unit and the boy tossed them all up. Finally, I found that two-year-old boy so thirsty, he was trying to lick up his vomit. I went ballistic, and shoved aside the usual hospital pecking order. I told the nurse bluntly, “Wake the resident,” it was in middle of the night, “and get an order for an IV.” Only a few minutes after we started that IV, the boy was comfortable and soon fell sound asleep.

    Keep in mind that the downside of large, teaching hospitals is that nights are often covered by residents with limited experience, So if you find yourself in a situation where you suspect the care isn’t quite what it should be, don’t hesitate to push. Push politely, but push.

    –Michael W. Perry, author of My Nights with Leukemia

  2. Awful experience. For pediatric problems, if it is beyond the level of care rendered by our pediatricians, we go to one of CHOA’s urgent care centers. They have lower co-pays that the ER and you will probably be seen faster. On their web page they even have the wait time for all their locations. Here is the link:

    https://www.choa.org/locations

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