Urgent Care vs. the Emergency Room: How to Choose

When you need immediate medical attention for a sudden illness or injury, should you head to a hospital emergency room or to an urgent care clinic? It depends, says retired anesthesiologist David Sherer, MD.

When the ER Is Best

Hospital emergency rooms are better-staffed with board-certified physicians in multiple specialties…and better-equipped with access to operating rooms, CT and MRI scanners and other medical equipment than urgent care centers. That makes a nearby ER the go-to place for anyone experiencing symptoms of a potentially life-threatening condition, such as…

• Shortness of breath. Sudden, severe breathing difficulties can be caused by an asthma attack, allergic reaction, pneumonia, pulmonary embolism and other potentially dangerous conditions.
• Pain or a sensation of tightness in the chest, potentially radiating to the jaw or left arm, along with dizziness, may indicate a heart attack or other cardio event.
• Sudden loss of speech or vision, difficulty speaking or understanding speech, tingling and/or numbness on one side of the body, loss of ability to move a limb and/or a very severe headache are symptoms of stroke.
• Severe abdominal pain, especially when accompanied by fever, nausea and vomiting. These can be symptomatic of appendicitis, intestinal blockage, sepsis and other potentially serious conditions.
• Major traumatic injury, including any that cause uncontrolled bleeding from a cut or a broken bone that protrudes through the skin.
• Suspected poisoning or drug overdose.

When Urgent Care Is Best

Urgent care centers are a better bet for minor health problems, including sprains and strains…cuts smaller than a few inches that might need stitches but that aren’t bleeding profusely…persistent sore throat…pain suggestive of an ear infection…redness or swelling consistent with a skin infection…and pelvic pain, painful urination or other symptoms of urinary tract infection.

Urgent care centers also may be more conveniently located than local hospitals and less likely to have long wait times than crowded emergency rooms. Patients visiting urgent care clinics are typically seen within a few minutes, but only 41.8% of emergency room visits result in patients being seen within 15 minutes, according to the National Center for Health Statistics. No wonder then that the number of urgent care visits rose by around 40% between 2019 and 2023, according to a report from the health-care analytics firm Trilliant Health.

Waits at both urgent cares and emergency rooms are likely to get longer as the US population ages and because of the chronic shortage of doctors and nurses.

Keep in mind: While hospital emergency rooms generally are open day and night throughout the year, many urgent care centers have limited hours. Check first to make sure the urgent care center you intend to visit is open.

Note: In urban areas, you’ll likely have a choice between a nearby hospital emergency room and an urgent care center. But rural areas may lack urgent care clinics, so a hospital ER may be your only option. Also: If there’s any doubt about the severity of the illness or injury, it’s better to call 911 to request an ambulance than to drive yourself or someone else to the hospital.

What About Insurance?

Health insurance plans generally cover emergency room care for true emergencies, but not all plans cover treatment in urgent care centers. Before an urgent medical problem arises, check with your insurer about the specifics of your coverage. Federal law dictates that an emergency room must provide treatment for a potential emergency, but your health insurer may later deny coverage for the visit if it determines your situation was not an emergency. That said, these decisions may be appealed with some success.

If you lack health insurance and must pay out of pocket, you’ll spend less at an urgent care clinic than a hospital emergency room. ER visits typically run $1,500 to $3,000, according to Bettercare.com. Urgent care visits typically cost $150 to $250.