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.

  • @Rolando
    9•3 months ago

    This is why healthcare in the US sucks.

    • A wealthy person will have a 24-hour hotline to connect with a nurse or doctor (immediately or through return call) with access to their medical history who will help them figure out what to do.
    • A moderately well-off person will have a web/phone interface where they can send a message and someone will return their message in a day or two.
    • Everyone else has to make a gamble: do I spent money to try to figure this out? Do I risk spending money and then it turns out to be nothing? But what if it’s something and it’s more expensive later on? What will my insurance pay for? How do I find someone that’s reliable, but also inexpensive? All of this causes stress which makes things worse.

    In your case, think of anyone who knows your medical history and who you can ask questions of. The doctor who prescribed your anxiety medications - can you call/message them and ask them? The pharmacist who dispenses the meds - can you go/call and ask a question about your medications? Some pharmacies also have nurse / clinic stations, too. If you have any kind of medical insurance, check out their web page - a lot of them have set up tele-medicine offerings recently. If your job has an HR department, this is actually one case they can be helpful; an HR person in my company helped me figure out what health resources I had access to, based on my plan. Finally, if you haven’t been getting annual checkups, you should start thinking of doing so (especially as you get older), and ask them how you can contact them to ask questions like this.

    Good luck fam, I hope it turns out OK for you.

    • @FoshezeOPEnglish
      4•3 months ago

      Yeah, my area used to have a really good public nurse line where you could just call in, tell them what was going on, and based on your medical history on file they could roughly triage you and tell you where to go. But I imagine keeping it running was cutting into the hospital exec yacht fund so they cut that service.

      I could always message my primary care doc but normally I just catch one of the nurses and they just tell me to make an appointment. Considering my primary care doc is always booked solid 6 months out I almost never bother going that route unless it is for an anual exam or something. My meds are just through a chain pharmacy so the pharmacist won’t know much about my particular situation. Someone else had mentioned insurance offering telemedicine too so I will definitely be looking into that one. I also happen to be on the medical response team at work so I am intimately aware of what our offerings are for healthcare options (practically nothing). Also I am 100% on the regular checkup train. I will ask my doc if there is something to fill the place of the old nurse line at my next checkup.

    • BoozillaEnglish
      4•3 months ago

      There’s a hospital very close to my house. Less than 2 minutes away.

      Twice we’ve driven there (the person driving did not have the issue in question). Both times it turned out ok, but everyone at the hospital felt the need to lecture us that we “really should have called for an ambulance”.

      I said wow, you guys really want that $2,000 taxi fare for nothing.

      There are definitely times when you should call for an ambulance. But it enrages me when you know it’s only about the fucking money, but they give you the concerned sanctimony attitude.