Know the Difference: Hospital ER, Freestanding ER and Walk-In Clinic

8/31/2018

When a medical emergency arises, knowing where to go for treatment is half the battle. But making that split-second decision can be tough, especially if you don’t understand the difference between a hospital-based Emergency Room, a freestanding Emergency Room, and a walk-in clinic. Sometimes it is not an easy decision, but knowing where to seek treatment could make a significant difference in the cost of treatment, and in the care that is delivered.

Hospital-based Emergency Room

Most people are familiar with the traditional hospital-based Emergency Room (ER), which offers 24-hour medical care from top-level physicians, year-round. They offer the skilled staff and technology to provide quality care in most situations. However, patients who head to a traditional ER may find themselves waiting long hours if their visit is not life-threatening. ERs are not designed for routine illnesses, and patients are not always seen on a first-come, first-served basis. Therefore, ERs use a triage system to ensure that the most critical patients get immediate care. This allows patients with life-threatening injuries or illnesses, such as heart attacks, serious accidents, or victims of violent crimes to be treated first. People with less-serious injuries may have to wait before being treated. Furthermore, the law requires hospital ERs to meet the standard of care, meaning several tests will be performed in order to rule out certain conditions. Therefore, it’s important to know that patients, or their insurance provider, may receive multiple bills from the hospital, and most times from the ER Physician, and/or pathologist and radiologist, if diagnostic exams were needed. Many times patients who are insured will only pay a co-pay, and those without insurance, often receive a discount. So knowing which conditions truly require a visit to a hospital ER is important. The question to ask oneself: “Is the condition life-threatening?”

Freestanding Emergency Room

In 2015, a new concept was introduced in Laredo—freestanding Emergency Room (ER). Free-standing emergency rooms are facilities that provide round-the-clock care for everything from the common cold to heart attacks. However, the charge for the visit is usually the same as an emergency room visit – regardless of the nature of the ailment. Patients receive bills for professional fees, a facility fee and ancillary fees (if radiology or lab services are needed). Facility fees are needed because, like traditional hospital emergency departments, freestanding emergency departments have emergency physicians, nurses, techs and staff, and advanced laboratory and imaging capabilities available. As a result, a patient with a mildly acute condition, such as a cold or sore throat, who visits a freestanding ER, will end up paying approximately the same amount as a traditional ER. Freestanding ERs can be owned by a hospital or they may be privately owned, but all have one key difference – they are not attached to a hospital, so if a higher level of care is required, such as immediate surgery or cardiac procedure, patients will be transferred to the nearest hospital, potentially losing valuable time and delaying treatment. More than likely, patients will also receive two bills if their diagnosis requires a subsequent trip to the hospital. Additionally, some independent freestanding emergency rooms do not accept Medicaid or Medicare patients.

Walk-In/Urgent Care Clinic

While hospital-based ERs and freestanding ERs must be equipped and medically staffed at higher levels, walk-in clinics/urgent care clinics are not required to maintain these at their facilities. Walk-in clinics/urgent care clinics are outpatient clinics that treat most illnesses and injuries, but do not handle life-threatening conditions like chest pain, stroke, breathing difficulties, or severe bleeding. Because of these limitations, if the emergency is beyond the scope of their care, patients will be referred to a local ER. Most clinics also do not offer 24 hour/365 day service and are usually staffed by mid-level providers, such as nurse practitioners. Typically, these types of facilities offer care 10-12 hours a day, seven days a week, with costs considerably less than an ER—usually only requiring a co-pay.

Visit a walk-in clinic/urgent care clinic if you have the following symptoms or problems:

• Allergic reactions
• Sore throat
• Sprains
• Animal bites
• Flu symptoms
• Minor burns
• Broken bones
• Minor injuries

It is important to note that everyone should establish a relationship with a primary care physician. Having a ‘Medical Home’ ensures team-based healthcare delivery led by a provider. The goal is to maximize health outcomes and prevent escalation of conditions due to the lack of preventive care.

Without a Medical Home, many patients end up in life-threatening situations in an emergency room, sometimes with fatal outcomes. Other benefits include comprehensive and integrated care, a history of medical records and treatments, and most often affordability of quality care.

For more information on any of these services, please contact Laredo Medical Center at (956) 796-3223.

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