If you already know what is wrong and just need a doctor's note (and maybe antibiotics), go to the clinic.

If something is bothering you, but you can tolerate it for a couple weeks, schedule an appointment with primary care.

If you don't know what's wrong, or you need something more than a note and a prescription, and you can transport yourself, go to urgent care.

The only time you should go to the ER voluntarily is if urgent care sends you there. Any other trip to the ER should be because someone dragged you there without giving you a choice.

Since you're in the US I imagine my method won't apply to you, but just in case, or for other people reading: in my country there is a phone number you can call in situations like this. They have doctors, nurses and specialists on call, initially you talk with a nurse that asks triage questions once you've explained your problem they give you advice for home treatment, if relevant, or send you to the correct urgency level care, including already sending the information on the triage questions to wherever you are going.

Okay this is easy if you're an American. Whichever one's the cheapest, unless it's an obvious life or death situation or head injury. That's it.

Dude, if you're having heart palpations, go to fucking urgent care. That shit can be lethal. Atrial fibrillation? Atrial flutter? They can cause blood clots which can cause stroke. Urgent care will know what to do, even if that's just calling a cardiologist elsewhere to look at your EKG or even stuffing you in an ambulance and driving you to an ER.

Don't want to take medical advice from a rando on the internet? (You shouldn't!) Then call your goddamned nurse line. They will sort you out and tell you exactly where to go.

Good luck.

If it's new shortness of breath or chest pain , particularly the crushing variety that feels like something is sitting on you, do not pass go, do not collect money, straight to the ER. Same goes for sudden severe lower back or abdominal pain or sudden heavy bleeding out of your orifices (more than a super maxi-pad full every two hours if you've got that genital configuration). There's a few other little things like a continuous erection more than 4 hours. Also you should learn the signs of a stroke (Google "stroke FAST"). If you're not sure, look up the local ERs number (not 911) and ask for the "triage nurse" and ask them.

If it's been going on / steadily getting worse for over a month it can (probably) wait one more week if that's all it will take to see your primary care physician or see a specialist.

If it's sudden but you know exactly what you did like if you pulled a muscle or sprained a joint at work or cut or burned your arm while cooking (I specify arm, if you cut or burn your hand, face, or foot, measure how big it is and call that triage nurse, and if it's your genitals just go to the ER) or if you forgot to pee after sex or did it with somebody sketchy and now it hurts to pee, go to the urgent care. Or if your petri dish of a preschooler brought home something and you're not sure if it's strep but you almost definitely need a note for work. Or if you have an old cut but now it's looking puffy and oozing weird liquids (but it's still localized to that one little area, you don't have a fever or anything). If you can look at it and already have a general laymans idea of what they're gonna do to it, go to the urgent care.

My general hierarchy...

Something chronic, or changing, go to a Dr.

Something rashy, uncomfortable or parasitic, go to clinic.

If you call an ambulance, go to the ER.

If you are capable of driving yourself, it's 90% of the time not worth going to the ER. If it's actually during working hours and you have a primary care doctor call them first.

I once had an interesting conversation with a nurse at my GP's office. I was scheduling an appointment with my GP. The nurse asked what I wanted to see him about. I mentioned light headedness, dizziness, globus, chest pain, palpi-

She stopped me at "chest pain" and said "I'm going to write down chest pressure, because otherwise, they'll send you to the ER."

At the time, I was scheduled for all the heart tests you can think of and a few neurological tests and had been having chest pain daily for months during which I'd had plenty of heart tests already. And the nurse was familiar with my case. Had she not been, she definitely would have just sent me to the ER.

She made the right call. All the heart and brain tests came back fine. Nobody ever saw fit to give me a diagnosis beyond "your nervous system is too sensitive." (I asked if he was talking about "dysautonomia" and he agreed to that. Not a "diagnosis" per se, but better than nothing.)

You got the right idea. Heart problems are a bit of a mystery until you can get an EKG done. Urgent cares aren't usually equipped to do more that that. If it's ongoing, maybe look for a cardiologist. But if you're having any sudden shortness of breath then you might need to head to the ER.

For what it's worth urgent care will definitely tell you to go to the hospital ER if they deem it more emergency related. And of course they'll still bill you for coming in there to ask them :P

In other words urgent care is not emergency care, if that makes sense.

For anything heart related (including shortness of breath/lightheadedness) I'd go ER. If I had a nickel for every time some 'normal and fit' <30 year old fell over dead at a half marathon I'd go buy a beer. I mean it's probably and hopefully nothing but if you do have some very serious condition and your heart stops every second counts by a lot, and a lot of times it's basically punching the Konami Code, you're otherwise normal and a confluence of things just line up precisely and boom. And with anxiety and all it wouldn't hurt to just get a professional to rule that stuff out

Former EMT here: The body has a way of sending you to the ER lol

i tend to use the pain scale to give me a hint on decisions like this. so i guess the first question to ask before the pain scale is "am i in a state of shock?"

note: i am not in any medical field nor had intensive training.

PSA for those in the US; the Urgent Care type places that advertise “ER” in their title will be absurdly more expensive than “regular” Urgent Care places that do not advertise as such.

The reason is that the “ER” places have actual ER type equipment, but regardless if you use them or not, you will be charged as such.

Maybe this is common knowledge, but we learned the hard way when my partner went in for something very benign and we received a $1,000 bill, even though we had insurance.

These “ER” places are popping up everywhere, and there’s nothing to tell you that if you go down the road a block or so, it could make the difference between a cheaper co-pay and owing the full amount. In our case, almost $1,000.

This is why healthcare in the US sucks.

• A wealthy person will have a 24-hour hotline to connect with a nurse or doctor (immediately or through return call) with access to their medical history who will help them figure out what to do.
• A moderately well-off person will have a web/phone interface where they can send a message and someone will return their message in a day or two.
• Everyone else has to make a gamble: do I spent money to try to figure this out? Do I risk spending money and then it turns out to be nothing? But what if it's something and it's more expensive later on? What will my insurance pay for? How do I find someone that's reliable, but also inexpensive? All of this causes stress which makes things worse.

In your case, think of anyone who knows your medical history and who you can ask questions of. The doctor who prescribed your anxiety medications - can you call/message them and ask them? The pharmacist who dispenses the meds - can you go/call and ask a question about your medications? Some pharmacies also have nurse / clinic stations, too. If you have any kind of medical insurance, check out their web page - a lot of them have set up tele-medicine offerings recently. If your job has an HR department, this is actually one case they can be helpful; an HR person in my company helped me figure out what health resources I had access to, based on my plan. Finally, if you haven't been getting annual checkups, you should start thinking of doing so (especially as you get older), and ask them how you can contact them to ask questions like this.

Good luck fam, I hope it turns out OK for you.

Clinics are when you can call ahead to make sure they can handle your issue that can't wait for a GP appointment. Your burning genitals or deep cut will be seen at their earliest convenience. They can be used for GP services if you do not have a regular care provider.

Hospitals are for when you were referred there, have an on-going issue, or no clinics are open. You are not in urgent need of medical intervention, or are man enough to die in the waiting room with your 104° fever and almond smelling cut you got from a fence two weeks ago that has dark veins radiating from it because "it's nothing, just a cut". You can use them for typical GP services if you don't have a regular care provider and many offer clinic services.

GPs are for regular checkups or visits for something you are concerned about.

ER is for when dispatch calls ahead for you, severe pain, severe injury, unconsciousness, or OD. Expect to wait for hours if you are conscious and not leaking, because others are and you aren't the main character today.

If you have insurance, they typically have a hotline you can ask about stuff like this.

If it's bugging you not knowing and you don't want to wait until your clinic appt, then yes, urgent care would be able to at least tell you if it's an emergency cardiac event and send you on to the ER, or if it's something like afib and it can wait to follow up with an office visit.

Stitches don't necessarily mean ER.

Guess it really depends on your urgent care.

For the most part, I'll go to my urgent care unless I know damn sure ER is needed (the urgent care is in my network). It's no farther away, (ER is a couple blocks away), and urgent care is less out of pocket. If they determine ER is required, they'll say so (and recommend ambulance if they feel it's necessary).

Basically the triage nurse will assess and make a determination.

I've had family go there for cardiovascular issues (and be treated and sent home). They're fully equipped to stabilize someone if they need to go elsewhere. They have a full complement of equipment, including radiology (everything but CAT).

always the ER

the clinic in my area has no available appointments until several months out so it is the ER or hope your condition is something that can wait a long time before treatment