Choosing care: emergency department, urgent care, or primary care?

[4 min read]

In this article: 

• Whether it's cold or flu symptoms or a sudden illness or injury, it can be hard to know where to go to seek the right treatment. 
• Advice on your symptoms to help you decide if virtual care, urgent care or the emergency department is the right place to get care when you need it. 
• Choosing the right care setting for your illness or injury can help ensure that you get appropriate, timely treatment.  

When you or someone you love are ill, how do you decide whether to seek treatment at an emergency department, urgent care clinic or from your primary care practitioner? Why does it even matter? According to a 2021 study published in Health Services Research, up to 50 percent of emergency department visits are for conditions that could be treated elsewhere.  

“In our health care system, we often try to go to the highest level of care first. It may be how we’re wired — the ER has always been there for us,” says Arooj Simmonds, M.D., divisional chief medical officer at Providence Swedish. “The reality is that your primary care physician can take care of so much.” 

There are many benefits to seeking the appropriate level of care for your needs. Emergency departments typically have longer wait times and higher costs. Another notable statistic from the study mentioned earlier found that the average emergency department visit is four times as expensive as the average urgent care visit. 

Dr. Simmonds notes that using the appropriate level of care helps balance the overall system and ensure the timeliest and most effective level of care. Since COVID-19, many hospital departments, including emergency departments, struggle to maintain enough staff at all shifts. This can add to those longer wait times, especially during surges in illness through the region, or in the summer, when people are exploring the great Pacific Northwest and come home with injuries.  

So how do you choose where to get care and when a trip to the emergency department is the right call? In all cases, a call to your primary care office can lead you to the next right step. Dr. Simmonds’s children have all hit their heads and broken bones, like children tend to do in their active lives. The triage nurse at her pediatrician’s office provided guidance for each situation over the phone, whether to wait, come into the clinic, visit urgent care or go to an emergency department. Let us help you find a starting place. 

What are your symptoms? Where should you go?  

Primary care  
If you have care established with a primary care physician, you know it can take weeks to schedule a normal appointment. However, most clinics hold a few same-day or next-day appointments for their patients’ urgent issues. These concerns may include:  

• Nausea, vomiting and diarrhea.
• Urinary tract infections.
• Minor burns.
• Asthma, sore throat and cold/flu or COVID symptoms. 

Telehealth  
Having established care with a primary care physician (and a good outcome of the COVID-19 pandemic) means telehealth appointments are typically available for many concerns. The secure video connection can reduce travel and wait times, increase your access to your doctor, and reduce the time needed to diagnose and treat some medical conditions. A surprising variety of conditions can be handled virtually, including:

• Common upper respiratory issues (cold/flu and COVID symptoms, allergies, etc.).
• Skin and nail infections.
• Gastrointestinal issues.
• Eye problems.
• Minor pains, strains, burns and insect bites.

Urgent care 
If your primary care physician isn’t available or it’s after clinic hours, or you are very uncomfortable and want to be seen before appointments are available, an urgent care clinic may be the best step for faster care. Urgent care clinics do not require appointments and are open in the evenings and on weekends, beyond what a primary care facility’s hours may be.  

Urgent care facilities may be freestanding or connected to a hospital or medical care complex. They can treat many acute injuries like sprains, and may offer lab tests, immunizations, and treat skin wounds. Other reasons to visit urgent care may include: 

• Nausea, vomiting or belly pain.
• Urinary tract infections.
• Suspected sprains or broken bones. 
• Earaches or sore throats.
• Rashes.
• Small skin wounds.

Emergency department 
“Emergency departments are where to go when seconds count,” says Dr. Simmonds. Emergency departments are designed to care for immediate needs, with advanced imaging for strokes, appendicitis, chest pain, and other true emergencies.  

If you’re experiencing a life-threatening emergency, call 911 or head straight to the emergency department. These include, but are not limited to:

• Chest pain or difficulty breathing.
• Seizures.
• Paralysis.
• Blurred vision, vision loss or slurred speech.
• Head or eye injury.
• Serious motor vehicle accident.
• Drug overdose.
• Bleeding during pregnancy. Ingesting a poisonous substance.
• Severe burns.
• An open wound that won’t stop bleeding.

While these guidelines can help you choose the best facility for care, timing matters. In the middle of the night, especially on a weekend, an emergency department may be your only choice.  

Dr. Simmonds says it’s also important to “remember that illness looks different in kids versus adults.” Fever in a teenager or adult may not always be cause for great concern, but it is in an infant. 

Knowing what your care options are near home before you need them is a good strategy that Dr. Simmonds recommends. You can save yourself stress, time and money by researching your options now. 
 

“If you are seeking care at the moment when you or your child are sick, it’s hard to stop and assess the best place to go,” Dr. Simmonds says.  

Learn more and find a physician or advanced care practitioner (ACP) 

Whether you require an in-person visit or want to consult a doctor virtually, you have options. Contact Swedish Primary Care to schedule an appointment with a primary care provider. You can also connect virtually with your clinician to review your symptoms, provide instruction and follow up as needed. And with Swedish ExpressCare Virtual you can receive treatment in minutes for common conditions such as colds, flu, urinary tract infections, and more. You can use our provider directory to find a specialist or primary care physician near you. 

If you have questions about vaccinations or your child’s wellness health, Swedish Pediatrics can help. If your kids aren’t up to date on immunizations, particularly the measles vaccine, call their pediatrician today to schedule a visit.

Information for patients and visitors

Additional resources

The best time to find a primary care practitioner is when you don’t need one

Keep your kids safe and healthy this summer

There's a new treatment for urinary tract infections. What should you know?

Achieve your fitness goals with these tips from an Ultimate Frisbee pro

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.

Providence Swedish experts in the media

Follow us on Facebook, Instagram and X.