By Joy Pape
Many people have some confusion about the difference between an emergency room and an urgent care facility. Even I, a health care provider, wanted to clear up some confusion. So once again, I reached out to Dr. Warren Licht, Vice President of Ambulatory Operations for the Western Region of Northwell Health and Director of Medical Affairs for Lenox Health Greenwich Village (LHGV). Lenox Health Greenwich Village, located at 30 7th Avenue, is home to Manhattan’s first freestanding emergency room. In addition, Northwell Health, as part of a joint venture with GoHealth, operates five urgent care facilities in Manhattan, two of which are located below 23rd Street. (See Northwell Returns Doctors to St. Vincent Site, WestView News, November 2018, Volume 14, Number 11).
Joy Pape: Dr. Licht, before we begin, what’s with the names? What are the differences between emergency rooms, emergency departments and emergency centers?
Dr. Licht: (He chuckles.) Nothing. They are all ERs. ERs in the United States are called what they are by those who are speaking about them. Traditionally, patients, clinicians, hospital administrators, and insurance company representatives all have their own choice of word following “emergency” in their vernacular. And then, of course, there are the Hollywood television dramas.
In simple terms, the New York State Department of Health and the Federal Centers for Medicare and Medicaid Services defines emergency centers as locations accredited to provide emergency medical care and treatment to all persons in need of such care, who arrive at the entrance of the facility whether by ambulance or by walking in, regardless of the ability to pay before services are rendered. The facilities are typically accredited to receive ambulances via the local 911 call system. At Northwell Health’s Greenwich Village, the ER is truly a center, a facility that provides emergency care, with various certifications that span many departments, provided in many specialized rooms throughout the facility. Care for acute heart attack, acute psychiatric illness, sexual assault, and acute trauma are just a few of the emergency conditions that are treated by a team of multidisciplinary professionals from multiple departments in specialized areas (rooms) of the center.
Joy Pape: What is an urgent care? Are they called centers, departments, or what?
Dr. Licht: (He chuckles again.) All the above. I think as these facilities have become more common in the continuum of medical care, I believe most people refer to them as simply urgent cares. Urgent cares are ideal for most non-emergency medical situations, especially when acute illness occurs outside of normal business hours or on weekends. In addition, should you not have a primary care physician, or they are not available to see you, these facilities are very useful. They can treat a host of acute conditions including minor fractures, stitches, back pain, mild nausea, vomiting and diarrhea, minor headaches, fever, ear or sinus pain, cough or sore throat, burning with urination, sprains and strains, rashes and minor burns.
Joy Pape: What are the differences between emergency centers and urgent cares?
Dr. Licht: The major differences between emergency centers and urgent cares is that emergency centers like the one at Lenox Health Greenwich Village (LHGV) are open 24/7 and are staffed by emergency medicine certified physicians and nurses and other specialized staff. Urgent cares have limited hours and different staffing models. Emergency centers receive 911 activated ambulances. Many emergency centers, like LHGV are disaster-prepared with certified decontamination units. Emergency centers can treat major trauma. Specialists are available for care coordination, and there is specialized imaging (x-ray) equipment. All are welcome at emergency centers regardless of insurance type or ability to pay up front.
Joy Pape: Speaking of cost, there is a lot of confusion about cost. Is there a difference between the cost of going to an emergency center or an urgent care facility?
Dr. Licht: Yes. Urgent cares require the ability of the patient to pay before being seen. Emergency centers will provide and treat patients regardless of the ability to demonstrate that they can pay. This does not mean treated patients will not eventually get a bill for services received. There is more price transparency in an urgent care setting than an emergency center due to the limited services provided and personnel available in an urgent care. This can be a complicated discussion. And, in anxious situations patients are not necessarily thinking calmly. Clearly if a patient activates EMS by calling 911 they will be taken to an emergency center. Before they have even entered an ER, cost has already been incurred by calling for an ambulance. We all need to consider that expense.
If you are medically insured, not unlike having life insurance and car insurance, you need to know what your plan covers. What out of pocket expenses should I expect with different types of medical services used? What does my plan consider urgent, emergent, and routine? Do I have a co-pay, coinsurance, or a deductible? Many of us don’t know these answers. Know before a situation arises. Know this as part of a disaster plan for you and/or your family. If you don’t, and a heath situation arises and you have the time during a situation, I recommend calling your insurer first. As an example, you cut your hand with a knife while preparing dinner. It’s 7:00 pm. You quickly wash the wound, inspect it, and attempt to stop the bleeding by applying pressure. Your hand otherwise appears to be intact. You decide you do not need to call 911. Do you go to an urgent care or an emergency room? Since you already know where your closest urgent care is located and their business hours (if not, use the internet), you head to urgent care. The cost of care is likely to be as low as a $40 co-pay. Care will likely be delivered and completed within the hour. If you go to an emergency room, your minimum co-pay may likely be $200, that’s if the facility participates in your insurance plan. Patients with graver illnesses are going to be seen first. And if you electively request to be stitched up by an on-call board certified plastic surgeon, the bill you may incur, per stitch, will obviously be more expensive.
Joy Pape: Again, thank you Dr. Licht for enlightening us, and to Northwell Health for the services you provide to the residents of the West Village.
(Please read the letter to the editor on page 2 from Alice Connorton. We hope this will be helpful too.)
Joy Pape is an internationally known board certified family nurse practitioner, author, writer, and presenter. She believes every person is an individual and deserves personalized integrative
medical care and hope for a healthy and full life. She can be reached at 212-933-1756 or at firstname.lastname@example.org
Emergency Centers and Urgent Cares in the West Village
Lenox Health Greenwich Village
30 7th Ave
URGENT CARE CENTERS
Northwell Health-GoHealth Urgent Care
41 E 8th St
New York Doctors Urgent Care
65 W 13th St
CityMD West Village
331 6th Ave
UMD Urgent Care
110 W 14th St
CityMD Union Square West
14 W 14th St