“Do I really need to go to the ER?” The last time I asked myself that question was at the end of a long day at the Euphora Health clinic.
Without warning, I began to feel pain in the side of my lower back and in the pelvis on the same side of the body.
Being a physician at my own clinic, I suspected that it was a urinary tract issue and took out a urine collection cup with the intention of checking for red blood cells under the microscope. I thought at first that I could easily handle the situation. Yet soon the pain was so severe that I was worried about passing out in the bathroom with a locked door behind me, and with everyone else already home for the day I thought I better lay down somewhere safer. It was the worst pain I’ve ever felt in my life.
As I was lying on the floor of my office in a pool of sweat, I decided the pain was too much to bear and that I should go to the ER. My wife came by to drive me there. I was however in such agony that I could not even stand up to go to the car. My wife called EMS even though I was extremely embarrassed at being a doctor carried out of his own clinic into an ambulance.
Even before reaching the ER, the pain started abating. There was very little the ER doctor had to do beyond patting me on the shoulder and saying, “Yup, sounds like a pretty classical presentation for a kidney stone.”
Many of you may have had a similar experience. When faced with pain or other terrifying symptoms, it’s instinctive, even for someone with medical training, to seek relief in the form of a trip to the emergency room. Unfortunately, this spur-of-the-moment decision driven by fear or anxiety can cost you a minimum of $1,500 to $2,000.
Building a relationship with your primary care provider can help you determine whether you really need to go to the ER and can spare you the expense of an unnecessary visit. A primary care doctor can also provide preventive care and manage chronic conditions so that a medical emergency becomes much less likely.
Understanding Emergency Department Overuse
The discussion around emergency room overuse has traditionally focused on the “medically homeless” – individuals who, for whatever reason, do not have a primary care physician.
As insurance deductibles and copays have increased, fewer and fewer people can afford coverage. Even among the insured, there is a tendency to cut down on primary care visits to avoid unpredictable out-of-pocket expenses.
A 2020 study published in Annals of Internal Medicine, cited by NPR, found that adults with health insurance are visiting their primary care doctor less frequently than they did in 2000.
Nearly half of the study respondents had gone at least a year since their last visit. The study noted the shifting patterns in health insurance that accompanied the decline in primary care visits. In 2008, only 10% of primary care visits were subject to a deductible. By 2016, that figure was 25%.
A downstream effect of patients not being able to see a primary care physician consistently or at all is that they delay getting care for simmering medical issues until they boil over into true healthcare emergencies.
Of course, at the point when someone is facing a life or limb threatenting emergency, it’s too late for them to ask, “Do I really need to go to the ER?” They definitely do! The first way that access to quality, affordable primary care reduces emergency department overuse is therefore by treating or managing health concerns before they ever become life-threatening.
Additionally, primary care physicians reduce unnecessary ER visits by identifying and treating medical issues that are urgent, but not emergent.
Urgent, Not Emergent, Medical Issues
Some medical issues cause pain and people often seek emergency help to relieve it. For females, UTIs, kidney stones, skin infections, and yeast infections frequently lead to a trip to the ER. For males, the most common concerns are cardiac symptoms (such as heart palpitations or reflux), kidney stones, and skin infections.
I can affirm from my own experience with kidney stones that extreme, unexplained pain can cause panic. It’s easy to understand why someone who is in pain would not be willing to wait several days for the next available appointment with their primary care provider – that is, if they have a primary care provider at all.
Access to Quality, Affordable Primary Care is a Solution
There is no question that access to a primary care provider decreases death rates from diseases such as cancer and heart disease.
Unfortunately, high insurance deductibles and copays are driving people away from regular primary care visits and in many cases, causing them to become medically homeless with no primary care provider at all.
Euphora Health is proud to offer an alternative to insurance-based practices. The Direct Primary Care (DPC) model allows us to offer high-quality, affordable healthcare.
We take the time to listen to each patient and refer them to low-cost labs and procedures so that concerns are diagnosed and addressed before they can boil over.
Our patients can contact us by phone, email, teleconference, or secure portal 24/7, including after-hours in case of an urgent matter. We can immediately reduce anxiety by allaying fears and prescribing medicine to manage pain. If necessary, we can schedule a more complete in-person consultation for a later time.
Call us today to learn more about how we can reduce the likelihood that you experience a true life or limb threatening emergency, provide timely care when you experience an urgent medical issue, and help you answer the question of, “Do I really need to go to the ER?” when you’re not sure where your situation falls on that spectrum.
