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Headache or Migraine Emergency: ER or Urgent Care?




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Optimal health care
can be achieved
only when patients
are educated
about their health
and patients and
physicians work together as
treatment partners in an atmosphere of mutual respect.





Imagine this scenario... You've had a Migraine for three days. It's out of control, has lasted long enough to be classified as Status Migrainous, and you know you need help. It's also the weekend, and nobody is in at your doctor's office. Sound familiar? Unfortunately, that scenario or at least one that's similar, is familiar to all too many people who suffer from Migraine disease or severe headaches.

Over the years, I've "heard" many accounts of visits to the ER and urgent care facilities. Many of us have been treated well and with respect in both places, but some have met with the, "We don't treat drug seekers" attitude.

Recently, the National Headache Foundation (NHF) conducted an online survey to compare the care received and the attitudes met with during visits to the ER and urgent care facilities (UC). The study provided some interesting results:

  1. Wait time less than an hour? 67% waited less than one hour in the UC versus 33% in the ER during that timeframe.
  2. Was the medical provider was polite and respectful? 67% responded favorably about the UC compared to 54% about the ER.
  3. Was the diagnosis clearly explained? 58% answered positively for the UC and 38% for the ER.
  4. Was the treatment they received effective? 53% responded affirmatively for the UC against 36% for the ER.
  5. Were instructions about what to do if the headache/Migraine returned clear? 55% stated that the UC staff provided clear instructions, countering the 37% for the ER.
  6. Made to feel like a drug seeker? with 29% stating that they did not feel that way when treated in the UC, while 50% said they did feel that way in the ER.
  7. Placed in a quiet area? 76% said that was the case in the UC, while 60% answered the same for the ER.
  8. Provided with a home care plan prior to leaving? 43% of survey participants received one from the UC, but only 17% were provided with such a plan from the ER.
  9. Level of satisfaction with overall experience? 50% described their level of satisfaction in the UC as very good or good compared with 36% who visited the ER.
    (For a chart of these results, please see below.)

Dr. Roger Cady, vide president of the NHF commented:

"While the ER is familiar to many people, headache sufferers are encouraged to consider their local urgent care facility the next time they require immediate headache treatment."

In cooperation with the Urgent Care Association of America, the NHF also conducted a poll of healthcare providers about their experiences treating headache and Migraine patients in an urgent care setting. The results of this survey indicated that sufferers could help themselves by following the prescribed treatment regimen.

According to this healthcare provider survey:

  • 67% of patients have failed to properly use their home plan before seeking assistance at a UC facility.
  • 59% of those in need of preventive medication are not receiving them.
  • 85% of the people they see have been previously diagnosed by another physician.
  • The most common type of head pain with which patients present in the UC is Migraine.

Dr. David Stern, Director of Communications for the Urgent Care Association of America, offered me his comments on the survey:

"A migraine is much more difficult to treat effectively if the patient has waited several hours in the stressful setting of a hospital emergency department. This survey indicates that a more effective therapeutic setting is an urgent care center, where patients themselves report more timely and more effective migraine care. This confirms the mission of the Urgent Care Association of America ( to increase the quality of care and improve public access to urgent care centers."

The results of the NHF survey clearly show that the participants had far more positive experiences at urgent care facilities than emergency rooms. If you are a headache or Migraine sufferer who occasionally needs emergency care, this is absolutely something to keep in mind. If your healthcare is covered by insurance, however, it would be prudent to check in advance to see if care at an urgent care facility is covered by your insurance plan. Some plans cover ER visits, but not UC visits. Some will cover either, but only if you are referred there by your primary physician. To avoid these issues, check with your insurance provider before you need emergency care.


Interview. Suzanne Simons; Executive Director, National Headache Foundation. Chicago. July 5, 2006.

Interview. David Stern, M.D.; Director of Communications, Urgent Care Association of America. July 7, 2006.

Press Release. "Emergency Room or Urgent Care Center: A Headache Sufferer's Dilemma." Chicago. The National Headache Foundation. July 5, 2006.


Teri Robert, July 5, 2006
Last updated July 7, 2006.


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