ER, Walk In Clinic, Family Doc, or Urgent Care Centre…Where do I go when I need healthcare?
Why are we all so disgruntled with health care. It doesn’t seem to matter where you live or who you are, how much money you have or don’t have, or what your health care needs are, we all have complaints and critiques!
Waiting for care is a huge complaint. Patients are very upset to have to wait for an emergency doctor to see them, or to wait in fracture clinic to be seen by the orthopod, wait for their surgery, test results, wait for a specialist visit. They are so frustrated that many end up coming to the hospital Emergency Room (ER) because they feel they have no other options.
As Canadians, our high income tax contributions to socialized health care allow us the privilege to walk into any health care facility in the country and ask for care.
Patients with extreme pain, major trauma, who are very ill or near death will always get treated first as Emergency Room resources are prioritized to care for these more critical cases.
Triage System for Emergency Care
In Canada, the CTAS-Five Level Triage system assigns patients who present to the emergency room with a number from 1 to 5.
Level 1 patients require immediate resuscitation and include “conditions that threaten life or limb requiring immediate aggressive interventions” by the ER doc and ER nurse.
Level 2 patients are considered “emergent” and include those with “conditions that are a potential threat to life, limb or function requiring rapid intervention” within 15 minutes.
Level 3 patients, are “urgent” and include those with “conditions that could potentially progress to a serious problem requiring emergency intervention associated with significant discomfort affecting ability to function at work or activities of daily living” and should be seen within 30 minutes.
Level 4 patients have “conditions that relate to age, distress, or potential for deterioration or complications” who should be seen within 1 hour.
Level 5 “non urgent” patients have “conditions that may be acute but non-urgent, as well as conditions which may be part of a chronic problem, with or without evidence of deterioration” and should be seen within 2 hours.
The reality of the situation…
OK, how many people reading this are saying “Ya right, 2 hours? Last time I was in the ER I waited 5 hours!” The reality of the situation is that on the one hand, ER’s are busy and may not see level 5 patients for many hours because of the sheer number of Level 1, 2 and 3 patients already being treated.
In addition, there may be an overwhelming number of Level 5 patients who present to ER for treatment who could better be served at an urgent care centre, walk-in clinic or their family physician’s office.
I am amazed by the number of swollen knees and sore shoulders that come through the emergency department and are referred to fracture clinic with a history of several weeks of symptoms. Back pain patients who have had issues for years and have seen every chronic pain specialist in the city, come to the ER to be seen–why? When I ask them why they came to the hospital instead of seeing their family physician, specialist or pain doctor, the answer is typically one of the following three:
1. I don’t have a family doctor.
2. None of the other doctors have helped me.
3. I’ve been waiting forever to see a specialist!
I find that many patients do not know their healthcare options. So they come to the ER to have the hospital “sort it all out”. Here’s another idea: Health Care Connect!
“Health Care Connect will find a doctor or nurse practitioner in your community who can assist you with your care needs.”
Remember the next time you take your long-standing complaint, strain/sprain or paper cut to the emergency department for care–you are taking up resources that are designed for people with acute, severe injuries or illnesses that need to be dealt with urgently. See the length of time you have to wait at an Emergency Room nearest you.
So let’s look at this another way…How would you feel if your mom had to wait to be seen for her hip fracture because the emergency doctor was busy seeing a patient with a bruised shin that happened 2 weeks ago? The hip fracture needs care. The bruised shin is taking up valuable ER time and could be better treated at a walk-in clinic or the family doctor’s office.
I don’t blame patients. I believe it is our job to properly educate patients on where to go for care. And our government is doing just that through the Ministry of Health website and campaigns to promote proper utilisation of services. There are urgent care centres and walk in clinics all over the GTA and other Canadian cities that are designed specifically to accept patients with minor injuries, chronic problems, or long-standing issues that are not in acute distress or danger.
Source: http://www. health.gov.on.ca/en/public/programs/hco/
Unfortunately web-links of information will not be seen by many of the people who look for care –the elderly, lower income labor workers who might not have access to a computer, immigrants with no computer skills or access.
See where the health care services are in your neighborhood!
Options for Minor Injury and Illness Care
So, here are the options for the walking wounded, tummy aches, headaches, joint pain patients, strain/sprains, small burns/cuts, and the chronic complaint patients who need help but don’t need to start at the ER:(if you have an issue that should be seen urgently, one of the health professionals at these organizations WILL direct you to the ER if needed)–
Where To Go When You Need HealthCare!
An Urgent Care Centre (UCC) can provide diagnosis and treatment for most injuries and illnesses through emergency trained doctors and other health care professionals.
Go Here If: You have an urgent, but non life- threatening illness or injury like sprains or strains, if you think you need stitches or have a minor burn that needs treatment.
Walk In Clinics or After Hours Clinics offer convenient access to advice, assessment and treatment for minor illnesses and injuries such as cuts, bruises, minor infections, sprains and skin complaints. Go Here if: You’re in a non-urgent situation; Your family doctor’s office is closed or if you don’t currently have a family doctor; You need care for minor illnesses and injuries including infection and rashes, fractures, emergency contraception and advice, stomach upsets, cuts and bruises, and burns and strains.
Telehealth Ontario is a free, confidential telephone service you can call to get health advice or general health information from a Registered Nurse.
That means quick, easy access to a qualified health professional, who can assess your symptoms and help you decide your best first step. Telehealth nurses are extremely well-trained, personably, knowledgeable and multi-talented folks who can help you decide whether to care for yourself, make an appointment with your doctor, go to a clinic, contact a community service or go to a hospital emergency room. They provide a valuable service and I have always been impressed by their excellent advice, care and direction.
TELEHEALTH: 1-866-797-0000 TTY : 1-866-797-0007
Need To Know Where To Go NOW?
And if you are stll uncertain where to go, CLICK HERE! for the Government of Ontario’s “HEALTH SERVICES IN YOUR COMMUNITY” website.
Have I missed anything? So, pop quiz: you sprained your knee last weekend and it is still sore….where do you go? If your answer is “The ER”, then you need to re-read this blog!
Here is a list of Urgent Care Centres in the GTA:
Nexus Health Urgent Care
Toronto, ON M5G Map location is approximate (416) 616-0300
Midland Urgent Care
1153 Ellesmere Rd, Toronto, ON M1P 2X6 (416) 285-4406
North York Urgent Care Centre
4646 Dufferin St, Toronto, ON M3H 5S4 (416) 222-9604
Etobicoke Urgent Care Clinic
25 Woodbine Downs Blvd, Toronto, ON M9W 6N5 (416) 741-2273
Malton Urgent Care
3530 Derry Rd E, Mississauga, ON L4T 4E3 (905) 672-2273
Mississauga Urgent Care Inc
1201 Britannia Rd W, Mississauga, ON L5V 1N2 (905) 826-2273
Markham Stouffville Urgent Care Centre
110 Copper Creek Dr, Markham, ON L6B 0P9 (905) 472-8911
Pickering Urgent Care Med
1450 Kingston Rd, Pickering, ON L1V 1C1 (905) 831-8333
Finally, for more information: For other health questions please call:
ServiceOntario, INFOline at 1-866-532-3161.
Hours of operation : 8:30am – 5:00pm, Monday to Friday.
In Toronto, TTY 416-327-4282