Hi, my name is Dr. P. John Schanen, APRN, FNP-C and I am a certified family nurse practitioner with Sana Vida Wellness Center located in San Antonio, Texas. Like most family nurse practitioners, my goal is to keep my patients healthy and out of emergency rooms, if at all possible. I’ve worked in many ER’s around Texas and many of my friends work in the emergency room. I have the utmost respect for the care ER practitioners and the role they serve in healthcare. I have seen people in emergency rooms with life-or-death conditions such as chest pain and shortness of breath and am grateful we have skilled providers in this area of practice.
Why Not to Go to the ER
I meet many people who utilize an emergency room like it’s a one-stop-shop for all their medical health. People going to emergency rooms for dental pain, refills on blood pressure medications, common colds, and various other complaints that have been manifesting themselves over time. As a Direct Primary Care (DPC) family practice clinic, I promote and encourage longitudinal care with my patients. I encourage them to ask me for health advice or treatment that can’t be achieved in emergency rooms. Here is some free advice on why NOT to go to the emergency room.
1) The ER doctor doesn’t know YOU
The trust that develops over time between a practitioner and a patient (or family) is non-existent in the ER. It is also extremely helpful to have seen a sick individual or child when they were healthy, to know how far from their baseline they actually are.
2) You don’t know the ER doctor
Sick people are not happy people. It’s hard to do a physical exam on someone under stress. Familiar faces cause less distress and allows the practitioner to perform a better evaluation.
3) “Emergency” does not mean that you’ll be seen soon
The ER team takes care of the sickest patients first. That will never change. If you have a minor illness and a severely ill or injured person rolls in, you’ll be waiting a while.
4) It’s expensive
REALLY EXPENSIVE. It costs about $1,000 more to evaluate a minor illness in the ER than it does in an office setting, excluding tests. Post ER visit sticker shock is common.
5) You will probably have tests
This means needle sticks, radiation exposure, and increased cost. Often, a DPC provider can do a thorough physical exam and schedule a follow-up the next day, all at no additional cost to you. But the ER gets one shot, and they can’t afford to miss something, so they tend to over-order imaging and labs. I know this first-hand.
6) The ER’s job is to figure out what you don’t have
They are not tasked with figuring out exactly what is going on and solving every problem; the focus is on ruling out life-threatening conditions and deciding which patients need to be in the hospital and which can be discharged quickly to make room for others needing care. This frustrates patients who come in wanting answers. It’s true.
7) There are sick people there
In the summer it may be vomiting or diarrhea. In the winter, it’s the flu. Emergency rooms do their best to keep things from spreading. Viruses are good at survival. If you weren’t sick when you went in, you may be soon.
8) If the beds are full, really sick people can’t be seen
Altruism at its finest! It’s similar to vaccinating yourself so nobody else gets things like the flu or measles. It’s real. Every ER has a limited number of beds and when they’re full, they’re full. If they’re full of relatively healthy people, the really sick ones sit in the waiting room until a bed opens up. I’ve seen it time and time again.
So What Should You Do?
Find a Primary Care Practitioner that you trust & have easy access to routinely.
This is the most important step, and it’s one that you should take when you are healthy. A good practitioner can identify diseases and illnesses early, track a child’s growth and development, provide reassurance when that’s all you need, and handle the vast majority of acute illnesses. If, or rather, when you get sick, your provider has access to health records and history, avoiding expensive and unnecessary repeat testing. That healthcare professional will understand your personality and perspectives, and you will be less intimidated of a familiar face. Look for a Direct Primary Care practice, who routinely offers same-day sick visits, weekend hours, and phone availability even when the office if closed–a lot of ER visits can be avoided by talking through symptoms over the phone. Visit our website to learn more about my DPC model and how it can help you stay out of the ER. www.SanaVidaWellness.com