​Avoiding the E-Room

Okay, great. It's happened again. You're sniffling, wheezing, congested, and your head feels like the morning after a Keith Richards party. The office cough has gotten around and you've caught it. Congratulations! It's time for another visit to the dreaded emergency room, with all of the wait time and out of pocket costs that entails.

Or is it?

Don't Go To The E-Room

Going to the emergency room is probably not your best option. The perception that both costs and wait times are rising isn't fake, it's quite real. According to a CDC report released two years ago, the typical wait time at the e-room is just over 58 minutes long. An NIH study took a look at the costs of ER visits, and found that out-of-pocket costs are rising between 3 and 6% a year, and that the typical bill for that visit “is 40% more than the average American pays in rent each month".

Why is this the case?

Quite simply, we have a critical shortage of health care providers such as nurses. The supply simply isn't keeping up with demand. The American College of Emergency Physicians fact sheet has stated that from 2006 to 2009 the number of ER visits increased by 17 million. In the fifteen years prior to this rise, the number of emergency departments in the U.S. had dropped by more than 20%. In the face of such a radical shift it's no wonder that wait times and costs are up.

My advice? Avoid the e-room if what you have isn't life threatening. The National Institute of Health has a list describing when you should go to the ER, and when you shouldn't. Basically, if you aren't dying, don't incur the cost, and don't add to the crowd already waiting to get in.

So What's The Alternative?

There are alternatives to a visit to the emergency room. Unless it's a serious trauma or other critical scenario, these should be carefully considered to determine your best course. (If you are dying, careful consideration is not something you have time for. Dial 911!) Keep in mind I am offering general advice when you examine these options. Individual things specific to your situation can completely change the equation.

Option one is to tough it out. Don't seek any medical treatment at all. Now, this is not the recommended course of action in many circumstances, but carefully think about it. If you are the eighth person in the office to catch the same thing, and six are already back to work without any long term effects, don't seek medical help. If you have paid sick days, take a couple of them. If you don't, determine if a day or two of lost pay will cost less than that ER visit. Pump up on the vitamin C, grab a bottle of Nyquil, and sleep it off. If you go when you don't need to you'll simply add to the wait time, and likely be prescribed with antibiotics you don't need (with long term consequences).

Option two is to go to an urgent care clinic. These “Doc in the box" facilities are set up specifically to take care of these kinds of needs. If your cold is something likely to go the distance and turn into bronchitis or pneumonia, just sitting on it isn't a good idea. Unlike a cold that will go away if you wait it out, chronic illnesses like the big B or the big P only get more expensive with time. If you think you're headed that way, nip it in the bud while it is still cheap.

Option three is to seek professional advice over the phone. Maybe you aren't sure if you should wait it out or get that yellow stuff you are coughing up checked out. If you are unsure pick up the phone and make a phone call. If you have a primary care provider, the on call nurse there can look at your records and offer history based advice about whether you should come in and see a doctor or can simply take two aspirin and call back in the morning. In fact, some nurses are qualified to be general practitioners in their own right. If they think you should be on medication to prevent a chronic condition from developing they can write you a prescription without your ever having to see (and wait for, and pay for) a doctor.

Lastly, option four is to simply schedule an appointment with your regular family doctor. This does mean waiting until there is an opening in the schedule, but it is cheaper than either the emergency room or an urgent care facility. If you are taking this option it's typically going to be because you do feel you can sit it out, but want to be on the safe side and get a checkup.

You Don't Need the E-Room

With these alternatives it's clear that you don't need to visit the ER for the office crud you picked up. Shortages of ER staff and increases in people visiting are leading to higher wait times and larger bills.You can avoid these problems and save the emergency room for actual emergencies by simply investigating the alternatives.