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Need stitches without the ER
June 29, 2012 2:54 AM   Subscribe

My girlfriend just got a cut on her leg from a glass table, about 1/4" deep, maybe a little deeper. We think she needs stitches or at least antibiotics, but she doesn't have health insurance. What is the cheapest option to get looked at and treated?

We were moving a glass coffee table top and it broke and cut her. The bleeding has mostly stopped. It's about 6 am here in Columbia, SC and the urgent care places don't open until 8 am. We do not want to go to the ER since she doesn't have insurance and it will be so expensive.

Is it cheaper to go to urgent care? Should we call a normal clinic, will a "normal" doctor treat this wound for her? We've looked for low-cost clinics nearby and they seem to only offer preventative care, from what we've found. Can I call anyone before 8 am to see what we can do?
posted by nakedmolerats to Health & Fitness (23 answers total) 1 user marked this as a favorite
 
Urgent care. Google it for your area.
posted by discopolo at 3:02 AM on June 29, 2012


Sorry, I missed your last line.
posted by discopolo at 3:03 AM on June 29, 2012


And yes, it is way cheaper.
posted by discopolo at 3:04 AM on June 29, 2012


We'd also like to know if it would be more expensive to go to a hospital's urgent care center or one of the free-standing urgent care centers.
posted by nakedmolerats at 3:04 AM on June 29, 2012


When I went to an urgent care clinic, there was a $140 charge for the visit but if the doctor thought you needed an x-ray or some extra service, obviously you would be charged for that. I can't say for sure what they'd charge in your area but the Doctors Care FAQ (urgent care in SC) says they typically cost 1/3 or less of an ER visit. Definitely urgent care over ER - the wait will probably be a lot less as well. At the ER they will take in almost everybody else first over a gash on the leg (depending on the busy-ness of the place of course).
posted by bobobox at 3:31 AM on June 29, 2012 [1 favorite]


You do know that doctors only give stitches in the first six hours, right? I work with glass and while it's sharp it's also dirty. Wash that wound out real good.
posted by princelyfox at 3:33 AM on June 29, 2012


I can't answer your question really as I'm in the UK, but I cut my foot pretty badly a few weeks ago, thought it would heal itself and then got a painful blister full of foul-smelling gunk - I had to go to a walk-in centre the next day and get lots of antibiotics. Don't avoid getting a doctor to look at it.
posted by mippy at 3:51 AM on June 29, 2012 [4 favorites]


For some peace of mind: Since you say it's mostly stopped bleeding, she will be fine until you can talk to someone at a clinic.

The benefit of urgent care over a regular clinic is that the urgent care can definitely see her right away, just walk in. Regular clinics usually require appointments which may or may not be available and they may or may not provide the service you want. Since you will have to call them anyway to set up an appointment they should be able to answer your questions about whether they can provide the service your girlfriend needs. The benefit of certain regular clinics is that some may offer a sliding scale or free care if she is under the poverty line.

A. If you can afford ~150-200: go to urgent care when they open.
B. If you want to gun for free care: wait til 8, call and ask if they can help you. Be prepared to show she is under the poverty line.
If no: go to A.
posted by bobobox at 3:56 AM on June 29, 2012 [2 favorites]


The ER will be more expensive but it does have a requirement to treat her without consideration of ability to pay. That is not true of urgent care. Urgent care centers are allowed to require proof of insurance.

Wherever she is treated, they will be willing to set payment terms.
posted by megatherium at 4:27 AM on June 29, 2012


Here's a list of free clinics in South Carolina. Looks like some of them have income requirements, so make sure you call ahead and establish your eligibility.
posted by The White Hat at 5:41 AM on June 29, 2012


Go to the ER. First, they will treat her, and a 1/4" wound is significant enough (as you note) to need care lest it become infected or lead to more complications in the future. Secondly, they will work with her -- as an uninsured patient -- to figure out payment. Hospitals are more likely to have programs for people who cannot pay out of pocket than private urgent care clinics.
posted by ellF at 5:55 AM on June 29, 2012


I am not sure where you are, but some CVs pharmacies have something calledthe minute clinic, where a nurse practitioner is on duty, and they might be ankle to set you up right. I believe it costs $60.
posted by pazazygeek at 6:11 AM on June 29, 2012


My wife is an NP at a MinuteClinic. They could not treat a wound like this -- their scope of practice is very limited (by clinic regulations, not by the NP's skill). They would send you to the ER.
posted by ellF at 6:16 AM on June 29, 2012 [3 favorites]


My husband had a health savings plan type of insurance with a crazy high deductible and opted to get stitches at an urgent care. He actually got triaged first at an ER because he was worried about some numbness, but they said there was no nerve damage, so we left before registering and went down the road to the urgent care. It was much cheaper.
posted by Maarika at 6:26 AM on June 29, 2012


As for freestanding vs on hospital campus urgent care, it's super complicated as to which one could be cheaper. At my hospital place of enployment, there is an "express care" which is really just a different area of the ER for non-emergencies, and it is almost as expensive as the ER. They are legally prohibited from calling it an urgent care because of super complicated things.
posted by Maarika at 6:32 AM on June 29, 2012


princelyfox, do you know that for sure? Anecdata, I have waited longer than six hours to get stitches, and I was okay to get stitched up--it might depend on the type of cut.
posted by inertia at 7:21 AM on June 29, 2012


I would go with a nice splash of peroxide followed by some cyanoacrylate glue, but I am crazy like that.
posted by koolkat at 9:35 AM on June 29, 2012


I'm guessing you've long since figured out what to do, but just in case -- if you went ahead with urgent care, ask everyone you can for the possibility of a self-pay discount, and keep a close eye on the resulting bills. Also, if your girlfriend is given any prescriptions, be sure to ask about generics.

I'm uninsured and went to my local (hospital-affiliated) urgent care for a lingering sinus infection. Between the urgent care fee and the separate doctor bill (although I never saw the doc, just his assistant), it cost about $250. I was able to get a self-pay discount on the doctor's portion of the bill.

This urgent care won't just let you pay at the time of service; they insist on billing. They billed; I paid. They billed again weeks later, so I had to call and get that straightened out.

I was given a prescription for antibiotics, and one for Advair. I didn't realize at the time that Advair has no generic and costs about $130 at my local pharmacy. Next time I'll know to ask.
posted by QuickedWeen at 9:50 AM on June 29, 2012 [2 favorites]


Thanks for the advice, everyone - I was kind of panicking since it happened so early-morning. We got to the urgent care center at 8 am and my girlfriend now sports seven stitches as a final farewell from our city (we're moving tomorrow...) It looks like it closed up well. So an extra $200 in moving expenses, but money well spent.
posted by nakedmolerats at 9:54 AM on June 29, 2012


OP's 'stitchee' here; I just wanted to echo her thanks enthusiastically. Being without insurance and knowing nothing about who charges what in health care, it was really daunting to feel like we had to make a quick decision, with no real understanding of ER alternatives, on something that could have significant long-term impact on physical and financial health both (and on no sleep in a day and a half, to boot! Moving is ... not fun). It was really reassuring to get input from people who could give us an idea of what to expect in urgent care, and given the inevitable pangs of "gee, is this really bad enough to pay for medical help for?" that uninsured folks like me tend to feel, it was also helpful to get a few reminders/kicks in the pants that yes, this isn't something to leave unattended.*

As nakedmolerats said, we went to Urgent Care (DoctorsCare, specifically), and they were great. Super-friendly, reasonably quick, and cost FAR less than I feared - and we did get a self-pay deduction, which took a lot of the sting out of things. If anybody reading this thread is ever in a similar situation, I would whole-heartedly recommend the urgent care route.

*Not that I should have needed confirmation of this - the gap was big enough to look like a MOUTH on my leg ... I was making it talk until nakedmolerats made me stop ...
posted by DingoMutt at 10:16 AM on June 29, 2012


IANA health care professional. You should generally clean a cut immediately with lots of soap and water. Hydrogen peroxide is a good way to disinfect, and antibiotic cream promotes healing. You can get butterfly bandaids that are nearly as good as stitches for manageable cuts. If a wound is someplace where a scar will be a cosmetic issue, stitches are desirable. Not sure I would use superglue on my own, though I know someone who repaired a crown on a tooth that way.

and Yay, for your good outcome.
posted by theora55 at 10:18 AM on June 29, 2012


Hydrogen peroxide is NOT a good way to disinfect:

Studies show hydrogen peroxide is not a very effective treatment for small wounds.

And a different article:

multiple randomized, controlled trials -- the best kind of research -- show that hydrogen peroxide does not prevent or treat infections in wounds.
posted by GregorWill at 3:08 PM on June 29, 2012 [2 favorites]


So happy to hear about the good outcome, nakedmolerats and DingoMutt!
The intersection of health, health care and money is a scary place.
posted by bobobox at 5:49 PM on June 29, 2012


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