Health care problems always arise at the worst times. That annoying cough turns terrible at 9 p.m. on a Saturday night. The kid's fever kicks in Saturday night at 10 p.m. A UTI rears its ugly head first thing Sunday morning. While medical issues don't check the time or day of the week before wreaking havoc, most GP practices only operate from Monday to Friday, 9 to 5. This disconnect between when people need medical assistance and when it's readily available creates a real problem as people flood emergency departments for things that don't qualify as emergencies or, instead, suffer until Monday when it should've been addressed on the weekend.
Understanding what medical options are available during after-hours situations helps people avoid unnecessary waits, costs, and exposure to emergency department dynamics. But for many people, all that's available is either "wait until the clinic opens" or "go to emergency," and with such limited knowledge, when health concerns arise, poor choices are made.
Why After-Hours Is More Important Today Than Ever Before
It's a stark divide: if it's an emergency, go to the emergency department. If it's not, wait until you can see your GP. Unfortunately, emergency departments are overcrowded, wait times range from hours to days, and sitting in an ED with a sick child (or while you're feeling sick yourself) only exposes you to whatever else is swirling around that department. Furthermore, emergency care costs more than GP services and additional funds divert resources away from people who actually have emergencies.
Furthermore, GP appointment availability has decreased overall. Many clinics book days or weeks in advance. The expectation that people will "call their GP on Monday" doesn't help when Monday's slots were filled by the Tuesday before. As such, people needing treatment have nowhere practical to turn when real medical issues occur outside of standard hours.
Children get sick at night. That's just the way it is. Whether it's a bad fever, ear infection, or croup, those concerns don't wait for business hours to emerge. A parent who's stuck at midnight with a howling kid needs some guidance. Instead, if traditional methods apply, either keep everyone up all night hoping for the best or send them to the emergency department to spend hours getting treatment that might've been addressed sooner.
Emergencies Are One Step Away
When problems arise outside of normal business hours, most assume that they should go to the emergency department because there's no other option. However, emergency departments are designed for emergencies: heart attacks, stab wounds and breaks and serious acute illness. For anyone suffering from “lesser” problems, there isn’t much hope of getting seen quickly.
Emergency department wait times for non-urgent issues can last four hours or longer. That's four hours sitting in wait room chairs exposed to whatever respiratory viruses are going around these days. For someone dealing with a UTI or an injured toe, spending four hours sitting among people with real emergent concerns represents a miserable evening accomplishing something that could've been handled elsewhere in a shorter amount of time.
The cost differential impacts the situation as well. Emergency department visits cost more than regular consultations from one's GP. Even those with Medicare find an out-of-pocket expense for an emergency visit to be more than what a routine visit would've been. For families who are already struggling to make ends meet, this additional expense worsens matters, especially when had the family been able to assess the situation more thoroughly, they wouldn't have gone in for non-emergency care.
What Services Are Available
There are a number of services available besides "going to the emergency" or waiting until the morning, but awareness of these services is surprisingly low. After-hours clinics operate in different areas with extended hours into evenings and even weekends. These clinics function like GP services but with hours suited for when most people would need care outside of standard operating conditions.
After-hours clinics deal with standard issues that come up: infectious concerns like strep throat and UTIs (for adults), physical injuries like sprains, strains, and lacerations, or even minor issues like prescription refills, referrals and even notes or certificates needed for work or school. They aren't equipped for emergencies but for non-emergency situations that happen to occur at night, they deliver faster service than the emergency department.
Home doctor services bring doctors to people's homes. This is crucial for very young children, elderly individuals who cannot travel easily or situations where going out of the home may complicate something that's already complicated.
Telehealth services have increased tremendously by leaps and bounds. They provide patients with access to remotely connect with a doctor without leaving their homes. For those without concerns related to physical assessments, like cuts, this telehealth option allows patients access to prescriptions or notes without exposing them to emergency room waiting rooms which are full of sick people getting sicker. For patients dealing with conditions outside regular clinic hours, connecting with a Telehealth GP provides immediate medical consultation and treatment without the waiting times or illness exposure that comes with emergency departments.
Finally, many services provide nurse-staffed lines available where patients can get an advice nurse who helps provide potential options or triage whether what's occurring warrants emergency department care immediately, a GP consult after business hours, or if it can be soothed from home until morning.
Connecting Issues With Solutions
Not every option above fits every situation. Knowing which issue fits within which triaging option helps cut down on lagged responses and inappropriate attempts to seek care. Chest pain, difficulty breathing, major broken bones or sudden-onset complications still mean emergency department. Those are true emergencies requiring immediate intervention.
Infections, prolonged fevers (especially in children), ear infections in kids, UTIs and even rashes can mostly be dealt with through after-hours clinics, home doctor services or telehealth depending on patient preferences. These types of issues require intervention from medical providers but don't equate as emergencies.
Telehealth works well when it comes to contact that doesn't necessarily require assessment: prescription fills or adjustments, discussing lab results and mental health check-ins makes sense via telehealth avenues instead of taking up time at an after-hours clinic.
Parents find telehealth particularly beneficial for their children when it comes to assessing whether that cough can wait until morning or if that fever really does require immediate action.
Home doctor services make sense when someone cannot make it themselves: little children who can't walk themselves in (but maybe they should get checked out before it becomes worse), elderly folks who can't navigate waiting rooms. Those convenience measures make sense primarily when leaving the house would be difficult or dangerous.
Cost and Access are Key Players
After-hours treatment usually costs more than regular GP visits. After-hours GP clinics sometimes bulk-bill; some charge gap fees. Home doctor services usually incur higher fees than clinic visits due to travel time and interventions but find themselves more convenient and well equipped to deal with issues.
Getting treatment on Saturday night versus suffering until Monday morning also holds value but it's hard to quantify how appropriate quicker treatment amounts over suffering.
Finally, accessibility measures vary depending upon location. Metropolitan areas have access to multiple after-hours options. Regional areas have fewer options. Rural areas likely offer limited after-hours options beyond visiting regional hospitals that may have emergency care at best.
This geographical disparity creates real problems for people outside of metropolitan areas.
Planning Before the Problem Happens
Waiting until 10 p.m. on Saturday night after deciding "don't call the doctor" means decisions must be made under undue stress and duress without foreknowledge of options available.
Knowing what's available ahead of time like which hospitals operate in your area during off-hours, can be a great help.
Parents benefit from thinking through a situation before it happens. What happens if that toddler has a fever on Saturday night? Who do you call for advice? What means an emergency versus morning? Having those answers ready saves panic-riddled decision-making.
Furthermore, understanding what information a doctor would need during telehealth discussions expedites appointments when health concerns do arise. Including lists of symptoms, findings, numbers, whatever would be best makes any interaction, even if sending it digitally ahead of time to appropriate resources, make it easier.
Final Thoughts About After-Hours Care
The truth is emergency departments provide important medicine, but they're not the only access point with which anybody can use for after-hours medical needs, and they're often not the best option for those needs that unfortunately just happen to arise during inconvenient times.