this post was submitted on 28 Sep 2024
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How are you supposed to decide where to get care for emergent conditions? Where is the dividing line between "just book a clinic visit", "head into urgent care when you get a chance", and "go inmediately to the ER"?

So this is a question I've always struggled with and it makes me feel very dumb especially because I literally am a EMR. This feels like something I should know. But at the same time I have also called to book a clinic visit before and had the scheduler tell me to go to the ER immediately only for it to wind up being nothing.

Certain things are obvious of course. Like if I need stitches or there is other major trauma then I know to go to the ER. If it is something like a concerning infection then I know urgent care can sort me out. For a skin rash that's probably a clinic visit. If urgent care is closed and it can't wait then default to the ER. But there are also the issues where I genuinely don't know on what side of the line they should fall. This is especially an issue for things that have been going on for a while which I know could be severe but almost certainly aren't.

For example (not asking for medical advice) I've been having repeated extended periods of heart palpitations for the past 2 weeks. At first I just chalked it up to screwing up my anxiety med schedule while I was on vacation because my med situation does cause heart palpitations if I screw it up. So I didn't think much of it at first but now I've been back on my meds properly for 2 weeks with no change. So, that's cardiac symptoms which in a patient would make me tell them to immediately go to the ER just to be safe. But at the same time it's been going on for 2 weeks and it's probably just some vitamin deficiency or something so it probably wouldn't kill me to wait a week for a clinic appointment (no walk in clinic here). Do I split the difference and go to urgent care? It's like schrodingers medical issue, it's both the worlds most benign thing and a symptom of immediate death until someone looks into it, so how do I know who should open that schrodingers box?

It seems like there has to be some easy dividing line on how to know which one to go to that I just don't know.

Edit: In USA, because that probably matters here.

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[–] SwearingRobin@lemmy.world 14 points 1 month ago (3 children)

Since you're in the US I imagine my method won't apply to you, but just in case, or for other people reading: in my country there is a phone number you can call in situations like this. They have doctors, nurses and specialists on call, initially you talk with a nurse that asks triage questions once you've explained your problem they give you advice for home treatment, if relevant, or send you to the correct urgency level care, including already sending the information on the triage questions to wherever you are going.

[–] BananaPeal@sh.itjust.works 5 points 1 month ago

I'm in the US and I can do this. I call my primary care, they connect me with a nurse, and I tell them what's going on. They will then inform me if I should go to UC, ER, or wait for an appointment. The primary care office even has a walk in clinic as an option. This is why it's good to have a primary care physician, even if insurance doesn't require it.

[–] BigPotato@lemmy.world 2 points 1 month ago (1 children)

Called once to ask, they said go to urgent care.

Then billed me for a telehealth visit and also the Urgent Care billed me too.

[–] SwearingRobin@lemmy.world 3 points 1 month ago

USA, Land of the free ~~to pay~~ 🤷 in my country it's all completely free. Once I had a bad cold they even called me back the next day to check in if I was doing better.

[–] HeyThisIsntTheYMCA@lemmy.world 1 points 1 month ago (1 children)

Oh i love the nurse advice line. My experience with that line is that their advice is "if it takes more than a bandaid to fix it, you need to go to the emergency department" and they've never heard of urgent care.

[–] SwearingRobin@lemmy.world 2 points 1 month ago

I'm pretty happy with the one in my country. I once mixed up some medication times and they escalated to a doctor that then put me on hold to consult a pharmacist just to be sure. I would have spent 7 hours in ER just for a doctor to tell me that I was fine, and instead I just waited a bit on the phone.