If you sprain your ankle do you really need to be seen in the emergency room? Not only will you pay with high out of pocket costs, you also will very likely have to wait for hours to be seen and treated. Urgent care centers, which are almost everywhere, are very capable of managing minor complaints such as minor injuries and colds.
If insured, expect to pay a lower deductible or maybe even nothing if you go to an urgent care center instead of the ER. Shorter waits are almost guaranteed. And the good news is that if it turns out you have something more serious, the urgent care providers will contact the ER and arrange for transport there.
It is simply not possible to see every complaint in the ER. There are not enough primary care providers, so naturally people come to the ER not only for acute problems but also for chronic issues such as high blood pressure, chronic pain and elevated cholesterol. The problem is that ED docs not trained to manage chronic issues. They are overwhelmed with very sick patients and therefore cannot see you until sicker patients are first taken care of.
Because ER care requires 24/7 nurses, techs, respiratory therapists, lab techs and xray techs just to name a few, everything costs a bundle. A simple blood count done as an outpatient or at urgent care, might for example cost $30 but that same test drawn in the ER could cost several hundred dollars.
Medicare is wise to the huge costs incurred in the ER. Expect to see more and more incentives to stay out of the ER. And what Medicare does, other insurance companies follow.
This is not to say that you need to be on death’s bed to go to your ER.If you are concerned, by all means come to the ER.
By law, any ER must at least triage all patients to determine whether immediate care is needed. At the present time because of legal issues, the overwhelming number of ERS will see you. However, more and more ERs are experimenting with triage programs, in which patients, who after triage are determined not to require high level of care,are being sent to urgent care, primary care and even told to make appointments themselves.