Know your options: ERs, Urgent Care, Virtual Care and clinics

When your doctor isn't available, what is the best option to get the care you need?

INDIANAPOLIS (WTHR) — When Karamjit Kaur started feeling ill and her doctor wasn't available, she faced a decision. Where do you go?

"I knew I was getting sick," ​Kaur said. "I'll go to urgent care. I'm not going to go to emergency. So, I chose urgent care."

Urgent or immediate care facilities are good for common illnesses like colds and flu, stomach aches, allergic reactions, sinus infections and minor burns. In Greenwood, MedCheck is an example of urgent care.

"We're a perfect alternative when you can't get in to see your primary care doctor for an acute care need. But, you're acute care need isn't as serious as what would warrant an emergency room visit," said Dr. Yasemin Altuglu. He serves at the senior medical director of Medcheck/Urgent Cares.

"We're great for strains, sprains, small bone injuries or fractures. We do have x-ray capability at all of our locations," Dr. Altuglu said.

Community Health Network encourages patients to start with the "Connect to Care" website.

"It's going to have each of those scopes of service listed and you can identify your illness or injury and it will help you determine where you should be receiving your care," Dr. Altuglu said.

When you need an ER

An emergency room is recommended if a patient's symptoms are significant chest pain, severe abdominal pain, shortness of breath, seizures or a significant traumatic injury.

"If you feel you're sick enough to go to a hospital, you should seek care in a hospital," said Dr. Randy Todd, medical director of Franciscan Health's Emergency Departments in Indianapolis and Mooresville.

The emergency department in Indianapolis averages about 66,000 patient visits a year while the Franciscan Health emergency department in Mooresville averages 28,500.

St. Francis Hospital on the south side of Indianapolis has seen a one-two punch of flu cases in 2019.

"We had a wave in January. Kind of got better for awhile and we thought maybe we'd get through it, but it probably hit harder in March than it did earlier in the winter this year," said Dr. Todd.

He recommends young patients with a fever of 103 or 104 to seek medical care in an emergency department.

"If you have severe headache, if you're having numbness or tingling or weakness that suggests maybe a stroke, if you're having chest pain or shortness of breath that might suggest a heart or lung problem, if you're having abdominal pain, if you have an injury that's significant or has a deformity, those are great reasons to be seen in an emergency department as opposed to an urgent care center," said Dr. Todd. "Any uncontrolled bleeding in areas that are difficult to control, if you're throwing up blood, if you're having blood in your stool, those are difficult to be seen in an urgent care setting. If you have a laceration that's associated with a bone fracture, that should be seen in an emergency department. But, a lot of simple lacerations can be managed in an urgent care setting."

Dr. Todd says his emergency department is busiest on Mondays and Tuesdays, typically between 11 a.m. and noon and then again at 2 a.m. Saturday and Sunday are the slowest time for the ER, according to Dr. Todd.

Traditional ER, neighborhood ER or micro hospital ER

Dr. Todd recommends that patients know the difference between a hospital emergency department and a free standing building or micro hospital emergency department.

“If you need emergency care close to where you are, this is the place for you.”

"A lot of these free-standing emergency departments are not much more than a nurse and a doctor and a CAT scanner," said Dr. Todd. "They don't usually have ultrasound, they usually don't have MRI. They don't have cardiologists and pulmonologists, and all the specialists that we rely on when someone is sick enough to stay in the hospital."

If you don't need medical care in a large hospital and more care than a micro hospital, St. Vincent has an option called a neighborhood hospital.

"If you need emergency care close to where you are, this is the place for you," said Dr. Rich Fogel who serves as the chief clinical officer with St. Vincent Health. "We can do all the things that major hospital emergency rooms can do. It's a smaller hospital with a full-service emergency room."

"We have full capabilities of CAT scan, x-ray, ultrasound and the ability to transfer if we need any specialty care," said Dr. Nikole Funk who works in the emergency department at the Plainfield neighborhood hospital. "We have seen patients - anything from heart attacks, strokes, bleeding in the brain, trauma."

St. Vincent leaders say the wait time at the neighborhood hospital is less than ten minutes.

"Think about the times you've gone to an emergency room and you've sat in the emergency room waiting room. Was it a door-to-doc time, door to doctor of 10-minutes or less?" said Dr. Fogel.

Another point Dr. Fogel made is that 89 percent of patients who come through the neighborhood hospital ER give it a 5-star rating.

Virtual Care

If your symptoms are a cough, congestion, fever, allergies, stomach or urinary problems, Community Health has an option called Virtual Care.

This gives patients the opportunity to talk with a doctor 24 hours a day, seven days a week using your phone or computer.

Walk in clinics

You can also get medical care at select Walgreens.

"Community Clinic at Walgreens is great for upper respiratory infections, minor illnesses, coughs, colds, congestion, ear pain, throat pain," Dr. Altuglu said. "They do provide some vaccination services."

If a patient's medical care doesn't rise to the level of an emergency, the suggestion is to book appointments online. MedCheck offers a service called "save a spot."

"It will send you text updates to let you know when it's time to come in so you avoid sitting in our waiting room," Dr. Altuglu said.

Do your research

No matter where you go, research the cost of medical care ahead of time.

Some providers post standard charges online. Community Health Network, for instance has a Central Pricing Office that can help patients prepare for the financial reality of medical care.

Where you go will determine how much you pay.

"Immediate care you're looking at $40 to $150. Whereas, if you went to the emergency room, you're going to spend at least a thousand dollars," said Dr. Lynn Schuetz, who is a family practice physician at St. Vincent.

Ultimately, where you go is up to you.