The DO’s and DON’T’s when Taking Your Child to the Urgent Care

Urgent cares have become wildly popular.  Just in my immediate town, there are at least 5 urgent cares only 0.5-1 mile apart.  My practice is in a multi-specialty medical building where there is an urgent care on the bottom floor.  Even CVS pharmacies are starting to provide urgent care “Minute Clinics.”

While these may be convenient at times, repeat after me: Convenience care doesn’t always equal good care.  It’s important to understand that not all urgent care centers are not created equal, and not all health care providers will be as well versed in pediatrics as your pediatrician. I recommend calling ahead to ask a few important questions.

Firstly, does the clinic see children and at how young of an age?  Many urgent cares are not comfortable seeing children and have limits at only seeing children 2 years old and above.  It will save you time and hassle by calling ahead to know this.

Secondly, please do NOT consider urgent cares as the equivalence of Emergency Rooms (ER).  They are not.  Emergency rooms are equipped to handle almost every single emergency.  Urgent cares are not.  Depending on what the medical issue(s) are, your child may need further care, ie IV placement, imaging, labs, etc.  Some urgent cares do not have these capabilities or provide these services for children. If you call ahead, you can save time by going straight to the ER or driving the extra distance to a peds-equipped urgent care.

Please consider that if you do not have time to call because the problem is severe or seems to be worsening, then this alone might just be an indication for an emergency room (ER) visit. 

While urgent cares are a very valuable service, there are certain tips I like to pass along to parents in my practice when it comes to utilizing urgent cares, ie when is an urgent care appropriate for a problem and when it’s not.

DON’T use an urgent care to address chronic problems.

If your child’s had a cough for the last month and you keep forgetting to call the pediatrician, so instead you want to go to urgent care on Saturday, please don’t.  This is something your pediatrician wants to know.  It could be anything from a habit cough to asthma to a foreign body.  As the cough isn’t worsening, this would be a better use of your pediatrician.  Of course, if your child has difficult or labored breathing, seek medical help, but I wouldn’t use the urgent care to solve chronic problems like stomach pain off and on for multiple weeks or a rash that’s been going on for a week.

DO know the difference between urgent and life-threatening issues.

Urgent is very different from life-threatening and when minutes matter, it is best to go to an emergency room. So what diagnoses warrant the ER versus an urgent care?  So many!  We don’t expect you as a parent to know-that’s what a board-certified pediatrician is for!  If you call your pediatrician after hours and get a barrage of odd and specific questions in response to the history you give us, trust that we are asking you detailed questions to know what level of urgency the situation is.  If your gut feeling goes against what the pediatrician advises, that’s ok!  Let them know why!  Parental intuition is important

Please note this is is a very very short list and not at all extensive of all the possible diagnoses that qualify for an ER evaluation, but just an example of a few:

  • Fever in a newborn less than 3 months old
  • Concern for poisoning
  • Seizures, convulsions, or loss of conciousness
  • Uncontrollable bleeding
  • Suicidal or homicidal feelings

DON’T use urgent cares as means of a second opinion.

Please don’t.  Urgent cares see a snap shot in time of your child’s health.  Your pediatrician should (ideally) be the same person every time who knows your child’s medical history.  They make decisions not just based off their clinical judgement at the moment in the office but also based off your prior medical history.  Just because urgent care gives you a different diagnosis than your pediatrician does not mean your pediatrician’s diagnosis was wrong.  It can mean that your child’s exam changed to support the new diagnosis which is completely NORMAL turn of events.

An example of this would be an inflamed ear canal which doesn’t quite look like an ear infection.  The pediatrician likes to do his or her due diligence and not prescribe an antibiotic unnecessarily.  He or she gives you strict guidelines on what to look for if symptoms worsen.  If they do worsen and you take your child to urgent care where they are diagnosed with an ear infection, then your pediatrician wasn’t wrong!  Many things can cause an inflamed ear canal that don’t all warrant antibiotics.

*Regarding where you obtain your second opinion, please consider always asking for the credentials of the person who is providing your care or advice.  There are differences in the level of training required to practice pediatrics between pediatricians and mid-level providers.

DO always follow up with your primary care.

It’s just a good practice as a patient.  When notes are sent to your PCP from an urgent care center, they will likely get scanned directly into your chart.  Your doctor will likely not even have a chance to update himself until the next time you book an appointment. The best thing to do is call the office and keep your doctor in the loop by letting his or her nursing staff know or leaving a message for the physician.  The office should be able to further guide you on if a follow up appointment with your doctor is warranted.

While urgent cares have really changed the accessibility of medicine, they by no means replace your primary care doctor.  As a pediatrician, I prefer my families keep me in the loop about chronic coughs or ongoing abdominal pain.   These are things I can address as the medical home and gatekeeper of your child’s health.  Urgent care may be a quick fix, but don’t let it be the last or only encounter for that problem.

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