There are different places you can take your child to for health care, and in this two-part article I will explore them in greater detail.

Part one: The ER

I will start with the ER first. Hopefully, your child will never need one. However, I understand that there is nothing as worrisome to a parent as having a sick or injured child, and the temptation to use one in these circumstances can be great. How do you decide whether or not your child needs an ER? I have a simple rule to help you decide:


Of course, no rule is 100%, and you still need to use your judgment, but this is highly reliable. This does not mean your child can avoid going to the ER; what it means is that you have time to look into the question further before making a decision. To help you decide, I suggest that you call our office. We have triage nurses available 24/7 who work under the supervision of the doctors, and who are trained to answer these questions, with set protocols. A doctor from the practice is always available (again, 24/7) as back-up if they feel we are needed. If the recommendation, following talking with us, is to go to the ER, you can feel comfortable that that’s the way to go.

Another source of reliable information is our webpage, which has useful links on pediatric conditions. Lastly, for those of you who have smart phones (which seems to be everybody but me), the app Pediatric SymptomMD ($2.99) is a very reliable resource on pediatric care that is meant specifically for parents.

There is a surprisingly long list of things which do not usually require ER visits, even after discussion. This includes: fevers, even if high; lacerations which stop bleeding on their own; head injuries where a child is not unconscious, even if there is large swelling; finger and toe injuries even if they look broken; vomiting if not yellow-green, even with abdominal pain; and croup. Call us; if we feel you should take your child to the ER, we will tell you so, but otherwise we can make arrangements to be seen in our office, if needed, in a more efficient manner.

Why do we try to avoid the ER? For one thing, we feel that it should really be just for emergencies. Every patient who shows up in an ER who does not need to be there is potentially taking time away from someone who truly does have an emergency. A second factor, quite honestly, is the cost. If you have a plan with co-pays, you will pay significantly more for the ER visit than being seen elsewhere. And for those of you with high deductibles, the average cost of an ER visit starts at around $1000 and can go much higher.

Please visit next week to read part two: Urgent Care Centers Versus Our Office