When to Use the Emergency Room During Flu Season

October 31, 2014
Your throat is sore, your temperature is high and you have no appetite for even Ben & Jerry’s ice cream. Influenza is a miserable condition, and during the throes of an infec­tion, it’s common to wonder if you will live to see another day.
However, before you set out for the nearest hospital emergency department (ED), think twice about whether that’s the best place to obtain care. In this era of high health care costs, professionals are urging patients with non-emergency illnesses to seek help at an urgent care center or their physician’s office.

In the ED, every patient is treated as a true emergency, which means a higher level of care, including tests and exams. Providing this level of service around the clock is costly for all hospitals. Urgent care can often be a better option for patients in non-emergency situations.

“Inappropriate use of the ED is not good for the community as a whole,” says Ben­jamin Yasharel, MD, medical director of Affiliates in Medical Specialties in West Hills. “If you’re occupying an emergency room for something that is not an emergency, then you may be delaying the care of someone who has a life-threatening condition.”

Using an emergency room for non-emer­gency conditions also is an expensive choice. According to estimates, inappropriate use of the ED is one the biggest contributors to wasteful health care spending.

“Inappropriate use of the emergency department is an issue for everyone because the cost of health care continues to rise,” says Elizabeth Sander, MD, medical director of Axminster Medical Group, Inc., in Hawthorne. 

It makes much more sense to seek non-emergency care at a doctor’s office or urgent care center, she says. One study found that a respiratory infection, such as bronchi­tis, treated at an ED will cost at least double than if treated at a doctor’s office.

“The care at an ED is more expensive be­cause the overhead is greater than an urgent care or doctor’s office,” Dr. Sander says. Even though some hospital EDs have “fast track” features designed to expedite the care of patients with less serious ailments, “those services are still billed at the ED rate,” Dr. Sander adds. “The reason they have a fast track is more for consumer convenience. It’s not a cost-cutting measure.”

People may assume they’ll get more thor­ough care, such as X-rays or blood tests, if they seek care at an ED. But Dr. Yasharel cau­tions: “Most consumers overestimate the care they need. An urgent care doctor can quickly assess whether you need emergency care.”

Sometimes, however, it’s hard to know when to use an ED. Unless it’s a life-threatening issue, call your primary care physician’s office before going to the ED. You may be referred to an after-hours doctor or nurse who can advise you on what to do.

Another option is to go to an urgent care center. Many urgent care centers have ex­tended evening and weekend hours for your convenience. Know where the nearest urgent care center is and whether it’s affiliated with your physician and hospital network.

“Urgent care centers are all over the place now, and Providence has many of them,” Dr. Yasharel explains. “One advantage Providence has is a system-wide electronic medical record. If you see any of our urgent care doctors or go to any Providence hospital, your studies will be available, online, to your primary care doctor and any Providence doctor you see. This ensures that your doctor has all the most up-to-date, correct information about your health and any special health care needs you may have, which helps provide better, more coordinated care.”

While every individual is different, in general you don’t need to go to an ED for influenza-type symptoms unless there is altered consciousness, such as passing out or confusion, or the risk of dehydration, Dr. Yasharel says. A fever, sore throat, headache, nausea and vomiting are symptoms that, typically, can be evaluated at an urgent care center or doctor’s office.
However, those younger than age 1, older than age 85 and people with chronic immune problems (such as individuals with HIV, active cancer or who have had organ transplants) should seek emergency care for flu-like symptoms, Dr. Sander says.