ER vs. Urgent Care vs. your doctor’s office: when to go?

January 18, 2012

When to schedule with the doctor:

a patient’s guide to scheduling

I get many phone calls each week from patients and parents asking,

Should I schedule an appointment?

The truth is, if you are worried enough to call and ask, then you or your child most likely needs to be seen by a physician.

Most complaints and concerns can be triaged by your doctor, at their office. You can consider your doctor’s office an urgent care clinic, during their open office hours. We are lucky enough at NFM to have both a Naturopathic Physician resident and a Nurse Practitioner on hand who will almost always be able to see you within a few hours of you calling the office.

If you feel like you need to be seen sooner than what NFM has available, then this is the appropriate time to go to the Urgent Care. If you think you are having a heart attack or a stroke, having an anaphylactic reaction, cannot breath, or are having some other life-threatening emergency such as a seizure, you need to dial 9-1-1 or go immediately to the nearest emergency room.

Otherwise, reserve Urgent Care for when your doctor’s office is closed, and save the ER for a true emergency (anaphylaxis, respiratory distress, suspected heart attack or stroke etc.)

The following list is the TOP 20 MOST COMMON PEDIATRIC COMPLAINTS derived from San Diego Children’s Hospital, with general averages a child is expected to be ill with the listed complaint per year. You can click the link of each complain to be redirected to San Diego Children’s Hospital “Your Child’s Health guideline page to read more about each condition in detail and to receive more guidance about scheduling an appointment with your child’s physician.

1.  Colds:  5-10 times per year

2.  Coughs:  4-5 times per year

3.  Croup:  1-2 times per year

4.  Sore Throat:  4-5 times per year. Mostly  with colds, occasionally with Strep

5.  Eyes with Pus or Drainage:  1-2 times per year

6.  Earache:  1-2 times per year

7.  Diarrhea:  3-4 times per year

8.  Vomiting:  1-2 times per year

9.  Wheezing:  50% of infants experience wheezing during a viral respiratory infection (called bronchiolitis).

10.  Fever:  5-10 times per year with the above symptoms/infections. 1-2 times per year without any other symptoms

11.  Skin Injuries:  Including bruises, cuts or scrapes, skin injury, and burns

12.  Head Injuries

13.  Arm or Leg Injuries

14Stomachache

15.  Headache

16.  Constipation

17.  Crying, Unexplained

18.  Immunization Reactions

19.  Hives

20.  Rashes, Unexplained

Below is a long, yet incomplete list, of more conditions and concerns that warrant an appointment with your doctor:

  • Allergic reaction concerns
  • Animal bites
  • Blood in urine or stool/ or on toilet paper
  • Broken bone suspected
  • Child refusing to eat or drink and appears ill
  • Color changes: skin, nail or lip color appears white, yellow, or blue
  • Crying baby < 3 months
  • Diarrhea that is persistent
  • Diaper rash and your child appears very sick, or it is not getting better after 3 days of treatment
  • Eyes with discharge or redness
  • Fever over 100.4
  • Fever that is not responsive to Tylenol
  • Head bonks
  • Headaches- new onset, “Worst headache of your life,” or persistent headaches
  • Joint swelling and/or joint pain
  • Loss of Consciousness
  • Muscle weakness or paralysis
  • New symptoms
  • Pallor: child appears pale
  • Penile discharge
  • Seizures
  • Sickness after recent travel
  • Supplement and home treatment advice
  • Swollen scrotum
  • Umbilical cord concerns
  • Urinary pain or frequency
  • Vaginal or uterine bleeding in menopausal women
  • Vaginal discharge
  • Worsening symptoms

And as Dr. Amy Hawkins pointed out: “When a doctor’s eyes see you, and a doctor’s hands touch you, you receive phenomenally better care than what you would otherwise receive by a doctor just listening to you over the phone.”

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