You’re hurt or ill: Do you go to an emergency room or to urgent care?
By Daniel Wolowicz

danielw@theacorn.com

While playing a weekend game of driveway hoops, you roll your ankle and a sharp pain rockets up your leg. In a few moments, your throbbing ankle has begun to swell and you figure it’s badly sprained, possibly broken.

After a call to your family doctor, he suggests you go to an emergency room. Upon arriving, you’re told the wait may take up to five hours.

Now you can add depression on top of your discomfort as you spend the rest of your Saturday waiting to see someone about your now black-and-blue ankle.

With the continual closures of emergency rooms across the United States and the increase in ER visits by people seeking regular care, waiting time in emergency rooms continues to rise.

According to a report released earlier this year by the Center for Disease Control, visits to emergency rooms increased by 26 percent between 1993 and 2003. More than 113 million people made trips to the ER in 2003.

In addition, more than 12 percent of the nation’s hospitals closed their emergency room doors during those 10 years.

Ventura County saw the closures of both Santa Paula Memorial Hospital and the Westlake Village Medical Center. Los Angeles County hospitals were hit especially hard, closing 10 of 23 emergency rooms over the past decade.

There are only seven acutecare hospitals in Ventura County with emergency rooms.

Fortunately, there is an alternative. For most non-life-threatening injuries, an urgent care center can offer basically the same treatment as an emergency room, generally in half the time.

The Urgent Care Association of America represents nearly 15,000 urgent care centers nationwide. There are eight urgent care clinics in Ventura County.

“We can do 85 to 90 percent of the same things that an emergency room can do,” said Dr. Razmig Krumian, a doctor at the Westlake Village Urgent Care Center, which serves this area from its L.A. County location. “A true emergency, in my opinion, is something that can be life-threatening. If it’s life-threatening, it does not belong here, it belongs in an emergency room.”

Emergency Rooms

Call 911 if you have chest pain or difficulty breathing. The two symptoms may be signs of heart problems, a severe allergic reaction, asthma or pneumonia. Patients should also call 911 immediately if there are signs of a stroke. Symptoms may include numbness in any extremity.

It’s recommended that patients call an ambulance because immediate medical care while en route to the hospital may be necessary. An ambulance can only take patients to an emergency room, not an urgent care center.

Serious injuries such as a bad burn, an amputation, severe head trauma, a complicated fracture or electrical shock should be treated in an emergency room.

ER attention is also required if someone shows an altered mental state, has a seizure or is unconscious. An ER visit is also recommended if poison is ingested.

Legally, emergency rooms cannot deny anyone care and emergency room staff cannot ask for type of payment before medical services are performed.

Most major hospitals staff emergency rooms with doctors who are board-certified in ER medicine. All emergency room doctors at Los Robles and Simi Valley hospitals are certified in ER medicine.

Los Robles recently renewed its emergency department accreditation for pediatrics. According to Los Robles officials, it’s the only hospital in Ventura County with that accreditation.

Los Robles has about 15 physicians in its emergency room rotation, while Simi Valley has seven. Both hospitals staff 35 ER nurses.

Los Robles sees about 37,000 patients a year in its emergency room, and Simi Valley reports nearly 25,000 ER visits annually, according to hospital officials.

Diane Freeman, director of the Los Robles ER, said wait times can be anywhere from 20 minutes to several hours. All emergency rooms treat patients based on severity of injury, helping the most critically injured first.

Emergency rooms are open 24 hours a day, seven days a week.

Urgent Care

By law, urgent care facilities must have oxygen, a defibrillator, an x-ray and laboratory capabilities. The centers can handle a myriad of non-life-threatening problems such as a cough, fever, vomiting, sore throat, diarrhea, earache, insect/snake bites and minor cuts requiring stitches.

In addition, urgent care centers treat anything from minor burns and simple fractures to removing moles and cleaning infected ingrown toenails.

Most urgent care centers will also provide drug screening, give travel immunizations and perform school and work physicals.

Although urgent care centers, which are typically privately owned, aren’t legally required to treat everyone, Krumian said, doctors are ethically required to provide help. Krumian said he’s never heard of anyone being turned away from his urgent care center.

Westlake Village Urgent Care Center is a privately owned facility with five physicians on staff. Krumian said the doctors are primarily general practitioners, but the center also has a hand specialist and a plastic surgeon on call for certain injuries.

Urgent care centers also treat patients on an as-needed basis. Wait times, however, for urgent care centers are typically shorter. Westlake Village Urgent Care Center provides services to nearly 15,000 patients a year, clinic officials said.

Their facilities are open 7 a.m. to 7 p.m. seven days a week.

Whether you visit an emergency room or an urgent care center, it’s suggested you bring a list of all medications you are currently taking, as well as a list of any medications you’re allergic to.