“Please excuse my dear Aunt Sally.”
Ring any bells? Even if you haven’t used this clever mnemonic device in years, you probably memorized the acronym during an elementary school math lesson all about the order of operations. Often abbreviated as PEMDAS — parentheses, exponents, multiplication/division, addition/subtraction — it dictates the order in which you should complete a multistep math problem.
You might not be doing much algebra these days, but did you know that the American healthcare system has its own order of operations? And just as forgetting about Aunt Sally can lead you astray in math class, ignoring healthcare’s order of operations will likely result in wasted time and money.
PEMDAS for Patients
When you and your loved ones need medical treatment, it’s easy to get caught up in the stress of it all. Imagine, for instance, your 8-year-old flies into the house after an unfortunate run-in with some angry bees. As their caretaker, you might be tempted to rush them to the emergency room for fear of an allergic reaction. Panic would be warranted, but you’d be left with a hefty bill and a few regrets if your child doesn’t actually need emergency treatment.
Instead, brush up on the below healthcare order of operations. The next time someone is sick or injured, you’ll be prepared to make a more informed decision on how and where to seek care.
Step 1: Call a Nurse Hotline
When you go to an in-person healthcare appointment, who do you talk with first? More than likely, it’s a nurse. Not only do nurses make up the biggest segment of America’s healthcare workforce, but they also have a wealth of knowledge that enables them to triage, examine, and counsel patients. But did you know that you can gain access to this level of expertise without even leaving your home?
Take out your health insurance card right now and turn it over. On the back, you’ll likely find a number for a 24-hour nurse hotline. This confidential hotline is great for getting quick, personalized answers to your health questions. Nurse hotlines are your first line of defense because they can help point you in the right direction. The role of a nurse hotline isn’t to diagnose — they can help you decide whether you need to seek out immediate care, schedule a next-day doctor appointment, or handle it yourself at home.
Step 2: See Your Primary Care Physician
Think of your primary care physician — or PCP — like your medical home base. This is the doctor you visit for general medical needs, such as yearly checkups, preventive screenings, and nonemergency illnesses. Establishing a relationship with a PCP is one of the best ways to stay healthy and keep your medical costs low. They can help detect and mitigate potential health problems as early as possible, and they tend to have a more well-rounded understanding of your health history.
For these reasons, they are the second step in our healthcare order of operations. If you’ve had a persistent cough and sore throat, for instance, it might be time to schedule a quick appointment with your PCP. You can also visit your PCP to treat minor injuries like a sprained ankle, receive immunizations like your annual flu shot, or get your prescriptions refilled. And if your PCP discovers an ailment that requires unique expertise, they can refer you to a specialist for further treatment.
Step 3: Visit an Urgent Care
Now, imagine you’ve been battling that same cough and sore throat for nearly a week. Maybe you’ve even developed a fever. The cherry on top? It’s Saturday night, your PCP’s office is closed, and you won’t be able to contact them until Monday morning. In a situation like this, your best option is to visit an urgent care clinic.
Urgent cares are walk-in clinics, which means you’re guaranteed to be seen by a healthcare professional the same day without a prior appointment. The doctor or nurse practitioner you see won’t be as familiar with your medical history, but the visit itself will be a lot cheaper than going straight to the emergency room. Urgent care clinics can treat numerous symptoms and conditions, including abdominal pain, non-life-threatening allergic reactions, ear infections, and urinary tract infections.
Step 4: Head to the Emergency Room
The thing about “urgent” and “emergency” care is that they both imply there’s a medical need worth addressing as quickly as possible. However, there are marked differences between the two — particularly in terms of the level of care. For instance, most urgent care clinics are not equipped to handle the advanced treatment needed for a compound fracture.
In some cases, you’ll want to head straight to the emergency room. If you are experiencing any kind of chest pain, for example, it’s a good idea to head directly to the ER. That pain might just be heartburn from too much pizza the night before, but it could also be an early sign of a serious medical condition. Other ER-worthy symptoms include excessive bleeding, severe burns, seizures, numbness on one side of the body, and difficulty breathing.
One last bit of advice: If you are experiencing symptoms of a heart attack or stroke, don’t try to drive yourself to the hospital. Instead, dial 911. Paramedics will be able to transport you safely, and they can begin to deliver life-saving treatment en route.
When you’re up against a tricky math problem, PEMDAS is there to help you. And while your dear Aunt Sally might not be helpful beyond mathematics — apologies to any Aunt Sallies in the medical field — you still have options. The next time you’re uncertain about where to go for a health issue, consult the healthcare order of operations to become a more informed consumer of care.