Take your COVID-19 concerns first to your primary care provider | Expert Opinion

Emergency rooms and urgent care centers are overcrowded. Your primary care provider should be your first stop with COVID-19 concerns.

Last week, three especially worrisome messages from patients arrived at our primary care office. Two went to the ER with COVID symptoms, hoping to get tested and treated. Both patients assumed that, if they called our office, they would simply be told to “go get a test,” and they would end up in the ER anyway. Both waited for hours in an crowded ER waiting room before being treated. The third, an older man with heart disease, was having worsening shortness of breath, and was afraid to go to the ER because it was “loaded with COVID.” Many of our primary care colleagues have recounted similar experiences.

About the same time, news coverage was appearing about ER clinicians and staff who are overwhelmed with nonurgent COVID concerns, making it very difficult to manage seriously ill and unstable patients truly in need of emergency care. Increased exposure has also caused an uptick in COVID cases among clinicians and staff, resulting in a limited workforce to manage the surge. The current pandemic wave has caused more anxiety and confusion for patients, and is stressing our health system severely.

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Historic numbers of patients are presenting to emergency rooms in Philadelphia and across the country. In the ER, we pride ourselves on being able to take care of anything that comes our way, from a sprained ankle to cardiac arrest. The surges related to COVID have created new challenges. When hospital beds fill up, the patients in the ER who need to be admitted may wait many hours longer. ERs can adjust somewhat to small, rapid shifts but other times it challenges the systems and the people working within them.

Some of the strongest relationships people have today are with their primary care providers who have known them for a while, managed their health, and watched them over time. In the ER, we sometimes reach out to a patient’s primary care provider to learn more about them and see whether the physician can follow up through a quick call, email or visit. Often those quick conversations with a primary care provider offer an additional lens into a patient’s overall health.

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Today, these connections remain critical for patients who are feeling a sick or need nonemergency help. Consulting with your doctor is a tremendous first step, but waiting too long to get help is not the answer, either. If you need the ER, we are ready to help you.

In primary care, we are addressing COVID concerns through our patient portal, nurse triage, and phone messaging, and with telemedicine patient visits, reserving ER referral for only those with severe symptoms such as low oxygen levels, worsening shortness of breath, or confusion. Your primary care provider can provide clinical evaluation, guidance on testing, isolation protocols and both symptomatic and emerging disease-specific treatments. Perhaps most important, we offer close follow-up care.

Many primary care sites are also offering drive-through COVID testing for patients who require it.

During this public health crisis, it is critical that all of us work as a team. In the case of COVID prevention, vaccination and boosters are the best way to protect yourself while helping to limit spread in our community. If you are concerned that you may be infected with COVID, working with your primary care provider is the most expedient way to get excellent care, stay informed, and allow capacity for our ER partners to care for the critically ill who need them most.

Jeffrey Millstein, MD, is a primary care physician and regional medical director for Penn Primary Care. Anish Agarwal, MD, MPH, MS, is an emergency medicine physician and assistant professor of emergency medicine at the University of Pennsylvania.