It has become quite common for patients to use emergency departments for their primary healthcare needs. There are different reasons for this – primary care providers aren’t readily available, the patients don’t have insurance, etc.

 As an ED nurse, I’ve taken the brunt of a patient’s anger when:

• The ED visit took longer than expected.
• They had to answer questions about their health history.
• They didn’t feel as if they were high enough on the patient priority list.
• They didn’t receive the medications they wanted.

 That list could go on for days.

Here is what I realized – patients can avoid unhappiness if they seek care at the appropriate level.

Emergency departments treat patients who are experiencing an emergency.

What is an emergency, exactly? Google’s dictionary provides the following definitions: “a serious, unexpected, and often dangerous situation requiring immediate action” / “a person with a medical condition requiring immediate treatment.”

Patients who need immediate treatment are those who are experiencing health conditions that threaten the loss of life or limb. A common complaint bringing people to the ED is “chest pain”. (If you think you are having a heart attack, please seek help at your closest emergency department.)

On the other hand, unchanging knee pain that has been ongoing for the past five years is probably safe to have evaluated in your primary care office.  

Primary care offices establish relationships with patients the ED simply cannot replicate.

Primary care providers dedicate time for each scheduled patient. You have their undivided attention for that fifteen-minute time slot. ED providers deliver care to multiple patients, while their priorities are ever-changing.

Primary care offices are usually calm and relaxed; it’s a controlled environment. The ED is always full of activity. (We like to think of it as “organized chaos.”)

ED staff are trained to stabilize and transport (or discharge if the patient can go home.) It doesn’t leave much room for building relationships with patients the way primary care offices do.

The ED staff will never know every detail of your health history.

Your primary care provider may be in the same network as your local emergency department, but that doesn’t mean the ED providers know your entire medical, surgical, or social history.

While electronic medical records have made it easier to communicate chronic health conditions, current home medications, past procedures, and recent treatment information between primary care offices and emergency departments, the ED staff cannot possibly comb through every detail in your chart.

The ED won’t follow-up to ensure preventative health screenings are completed.

Blood draws, colonoscopies, and mammograms…oh my!

Your primary care provider keeps track of necessary screening tests based on your age, weight, current health needs, etc. They direct your care based on preventative health measures because their goal is to keep you in a good state of health. They’ll remind you when exams and tests are due, and if you need help scheduling those appointments, they can take care of that for you as well.

The ED staff focuses on the problem you present with, known as your “chief complaint.” If you go to the emergency department for knee pain after an injury, you’ll likely get an x-ray, maybe something for pain, and instructions to follow-up with your primary care provider or an orthopedic provider (depending on what they find, of course.)

You may have a history of high blood pressure and high cholesterol, and may even be due for some lab tests, but those things will not likely be addressed in your ED visit for your knee pain.

ED providers will not refill prescriptions for routine medications.

While the ED providers know your life is busy, they won’t refill prescriptions for your routine medications. If you happen to run out, a call to your primary care office is the way to go. (You can also request a refill through your pharmacy, and in many cases, they will contact your primary care office if authorization is needed.)

Primary care offices, urgent care facilities, and emergency departments each have different purposes, processes, and resources. Understanding the different levels of care and choosing appropriately can significantly improve your satisfaction when you’re looking to have your health needs met.