Telehealth vs urgent care vs ER: where should I go?

When is telehealth a good first stop?

Telehealth is most useful when the clinician can make a safe decision from your history, visual examination and available home information. Examples include many URI or sinus complaints, uncomplicated urinary symptoms, selected rashes, pink eye, medication questions, mild gastrointestinal symptoms and follow-up of known problems.

The goal is not to force every problem into virtual care. A good virtual visit should identify when the next step needs to be hands-on.

When does an urgent care or clinic make more sense?

Choose in-person care when the diagnosis or treatment depends on something that cannot be done reliably over video—for example, a detailed ear examination, certain throat or urine tests, wound care, injections, IV fluids, X-rays, splinting, or a physical examination for a concerning injury.

Americare patients may use any appropriate facility. In several Texas communities, in-person continuity may also be available through practices where Dr. Atudonyang or clinicians he works with provide care, subject to staffing and availability.

When telehealth is not appropriate

Warning signs need in-person assessment. This list is not exhaustive. Call 911 or go to the ER for severe, rapidly worsening or potentially life-threatening symptoms. Do not wait for an online appointment or a reply from our team.

Emergency symptoms

Chest pain, severe trouble breathing, fainting, stroke-like symptoms such as facial droop or new weakness, severe allergic reaction, confusion, uncontrolled bleeding, seizure or sudden severe headache require emergency care.

Severe illness or dehydration

Inability to keep fluids down, persistent vomiting with dehydration, very little urine, severe weakness or rapidly worsening symptoms require urgent in-person evaluation; use the ER for severe symptoms, fainting or confusion.

Pregnancy warning signs

Seek urgent in-person care for vaginal bleeding, significant abdominal or pelvic pain, fainting, fever, severe vomiting with dehydration, inability to keep fluids down or other concerning symptoms. Use the ER or call 911 for severe symptoms, heavy bleeding, fainting or rapidly worsening illness.

If you are pregnant and experiencing mild nausea or vomiting without warning signs, telehealth may sometimes be appropriate for evaluation. Contact your obstetric clinician or their covering team when possible. Medication choice and any limited refill require an individualized review; prior prescribing does not guarantee another prescription. Telehealth does not replace prenatal care.

Mental-health emergencies

Suicidal intent, danger to yourself or others, severe agitation or psychosis need immediate emergency evaluation. Call 911 or go to the ER if there is immediate danger.

Conditions needing a hands-on evaluation

Major trauma, suspected fracture or dislocation, severe abdominal pain or significant new neurologic deficits cannot be safely managed by video alone. Major trauma, severe pain or new neurologic deficits warrant emergency care; a stable suspected fracture needs prompt in-person assessment.

Why access gaps bring patients to the ER

From his emergency-room experience, Dr. Nicholas Atudonyang has seen patients come to the ER because they cannot reach their regular clinician or do not know whether a problem can safely wait. Some of these concerns can be evaluated by telehealth when there are no warning signs.

A simple way to choose

Can you start with Americare if you are not sure?

For non-emergency symptoms, yes. One useful role of virtual urgent care is helping patients decide whether the problem can remain virtual or needs a higher level of care. But patients with obvious emergency warning signs should go directly to emergency care.