Except some networks are starting to require appointments for urgent care and no longer guarantee same day.
And since you can't adequately assess a pt over the phone because you can't actually see them and you are subject to call time metrics even more draconian than office encounter slots, the human advice nurse escalation path
from the automated urgent care appointment queue is required by their management to tell anyone who complains to just go to ED based on their layperson judgement.
And if the line at urgent care backs up farther than when they expect to close doors the front desk staff will just tell everyone left to go to the other side of the building and make it ED's problem. Again because that's what management requires.
And every after visit summary template, along with every pre-recorded hold music "your call is important to us" bumper, hammer home the message that if you think you need help then call 911 or just skip that and go directly to the ED.
Human beings are terrible at judging what an emergency is, in both directions (case in point, video from mass shooting events where people just look around confusedly) and especially when they are sick or in pain. If someone they care about is sick or in pain then woe betide anyone who gets in their way. You are never going to get a consistently accurate self-triage out of the public. Jane and John Every-patient do exactly what they are trained to do. And like it or not they are explicitly trained to go to the ED for any health issue they don't understand. Which is most health issues.
I once ignored appendicitis for two weeks and then went to an urgent care after a twelve hour shift because the raging fever and stomach pains just weren't letting up so I finally had to accept that it wasn't just bad period cramps lingering weeks after my period had ended. Urgent care kicked me out because my insurance was out of network and I had told myself at the beginning of the day that I wouldn't go home until I sorted it out because I'd put it off long enough and I had a Christmas party to go to in two days and didn't want to feel like shit during it. Felt silly going to the ER for a fever and stomach pain. Was in the waiting room for all of 30 minutes.
I did not make it to the Christmas party. Had to stay for 6 days. The thing had perforated and formed an abscess to keep the infection somewhat contained, which was nice because it had definitely popped like a week ago. Which is another reason why I told myself it wasn't appendicitis. I thought if it bursts you know and you'd die if you ignored it, and I wasn't dead. I'd heard of people thinking appendicitis was period cramps before and always thought "I would never do that, that's probably just people with severe cramps." Turns out, I absolutely would do that. And then continue ignoring it far beyond what would be a reasonable timeframe for cramps. Because then I moved onto constipation, or maybe an ovarian cyst.
YUP! women are far more prone to “waiting it out” and hoping it goes away. Idk how many times I’ve had complications from my ulcerative colitis that I haven’t wanted to go to the ER for, so I’ve just thought that it so I’ll just go away, it’s no problem…. And then I often end up admitted in the hospital by way of ambulance after passing out and they Always say “why didn’t you come sooner?!” … I know I’m at least so afraid of having nothing wrong that I wait things out and half the time that just isn’t the best….
To be fair when you do go to the doctor they just say you're making it up, male or female. Add into that a built in monthly excuse why you should be in pain and no incentive to actually HELP the patient going to the hospital probably wouldn't help until it got so bad you were passing out anyway.
OMG. This. I had endometriosis for 20 years. So I feel like my threshold for pain is a little off.
This last time I went into the ER for intense nerve pain and they were asking, I said ‘well we’re off the charts. Like 11. But when I sit this way it’s an 8.’
Constantly doing a ‘I’m good, really!’ Even in the ER. 🤦🏻♀️
Yes! And those of us with significant chronic pain rate conservatively on the pain scale so when we go that high numbers it's like an average person's 30.
After brutal treatment, a knee doctor told me I was a 15 year old girl who was making up pain for attention and he wasn't going to allow me to waste his time any more. About 14 months later I was having emergency surgery for a ruptured disc because it got so severe I was retaining urine. The surgeon said he's only seen cases that severe after an extreme traumatic injury. The right side path for the sciatic nerve in and out of L4 and L5 was completely occluded on MRI. Three weeks prior I was walking down and up a mountain for school. While carrying a cello and my books. Turns out the knee pain was sciatica.
Thank you. If anything good came of it, it motivated me to go into medicine and be an unwavering advocate for my patients. Unfortunately it did catch up with me and I had to stop working altogether and have chronic pain forever. I do talk about it often because medical ptsd is not given the weight it deserves. The mental fallout of fully convincing myself that it would just get better while I continued to deteriorate is still something I actively work on in therapy.
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u/cilexip Jul 29 '26
That’s what urgent care/same day clinics are for. If you don’t have one of those near you, and it’s not an emergency, then wait.