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When should you seek urgent medical care instead of booking an online appointment with us? Our frequently asked questions page covers the ordinary business of coming to see us; this post is about the other question, the one people don’t like asking out loud: is this safe to wait on? Online booking is a wonderful thing right up until the moment it isn’t. Somebody wakes up with something new and frightening, opens the schedule, sees Thursday, books Thursday, and then spends three days waiting for an appointment that was never the right appointment in the first place.
Here is the honest short answer, before anything else, because it matters more than everything below it put together. If you are genuinely unsure, that uncertainty is your answer. Get assessed. Nobody in health care thinks less of you for turning out to be fine.
There are three doors, not one
Most people are choosing between “book something” and “wait and see,” and honestly, that’s the wrong menu. There are three, and the whole point of this post is helping you work out which door is which.
Emergency. Call 911 or go to your nearest emergency department. Some symptoms need a hospital’s equipment and a hospital’s speed, and no amount of politeness changes that.
Urgent, but not an emergency. In Ontario that means 811, an urgent care centre, a walk-in clinic, or your own family doctor or nurse practitioner if you have one. More on those in a moment.
Ordinary musculoskeletal care. That’s us. Aches, stiffness, an old problem flaring up again, something that’s been building for weeks.12345
Please don’t wait: symptoms that need emergency assessment
I’m grouping these by what they involve, not by diagnosis, because you shouldn’t have to guess a diagnosis to make this call.
Chest and breathing. Heavy, tight or squeezing chest pain, particularly with sweating or going pale. Severe difficulty breathing.
Brain and nerves. Drooping on one side of the face, weakness in an arm, or difficulty speaking. Sudden confusion, drowsiness or disorientation. Loss of consciousness. A seizure.
Spinal cord warning signs. New or worsening weakness or numbness in an arm or a leg, especially if it’s spreading. Any change in bladder or bowel control. Numbness around the saddle area (the part of you that would contact a bicycle seat). These are the ones people most often try to wait out, and they are the ones I’d least like you to wait out.
Head injury and sudden severe headache. A headache that arrives suddenly and severely, unlike anything you’ve had before. Headache following a head injury. Headache with fever, with new neurological symptoms, or with a marked change from your usual pattern.
Injury. An obvious deformity. Being unable to put weight on a limb at all. Severe pain that isn’t touched by pain medication.
Everything else that means business. Bleeding that won’t stop. Rapid swelling of the face or body, or any sign of a serious allergic reaction. Feeling generally, systemically unwell alongside pain: fever, shivering, feeling ill in yourself.
And if you’re thinking about harming yourself or ending your life, call or text 988. That is a real, staffed line, and it counts as an emergency.
This list is not exhaustive, and it is not a diagnostic tool. It cannot be, and I’d be doing you a disservice by pretending otherwise. It’s a starting point for one decision (whether to wait) and nothing else.678910111213
The middle ground, which is where most people actually are
Not everything is either an emergency or a Thursday appointment, and the middle is honestly where the good decisions get made.
811 is genuinely useful and almost nobody uses it. Have you ever called it? A registered nurse, free, 24/7, who will talk through what’s happening and tell you where to go: home, your doctor, a walk-in, virtual urgent care, or an emergency department. If your situation needs immediate help, they’ll get 911 on the line with you. They won’t diagnose or prescribe, and that’s fine, because that isn’t what you need at 11 pm. You need somebody to tell you which door.
An urgent care centre or walk-in clinic fits the “this needs looking at today, and it isn’t an emergency” case. Provincial information describes urgent care centres as the option for urgent but non-life-threatening injuries (sprains, a possible broken bone, a cut that might need stitches), and some have X-ray on site. What’s available varies a great deal by location, so please check before you drive.
Your family doctor or nurse practitioner stays the right call for anything systemic, anything involving medication, and anything that isn’t clearly musculoskeletal.12345
When booking with us is exactly right
Most of what people bring us is not urgent, and that’s a good thing. Pain that’s been building, an old problem that’s flared, stiffness that’s limiting what you can do, something that started after a change in your work, your training or your sleep: that is the ordinary, welcome business of a clinic like ours. If what you need is chiropractic care in Waterloo, that’s me; if it’s physiotherapy in Waterloo, that’s our physiotherapist.
Part of what an assessment is for is working out whether you’re in the right place, and telling you when you’re not.6
Three reasons people wait, and why none of them holds
“I don’t want to waste anyone’s time.” Emergency departments are built to sort exactly this out, and being fine is a good outcome, not an embarrassing one.
“I’ve already got an appointment booked.” A booking is not a plan. If something changes between now and then, the booking doesn’t cover it.
“It’s probably nothing.” It very often is. But “probably nothing” and “safe to wait three days” are two different statements, and only one of them is a decision you can make from your kitchen.67891011121313141516
If it isn’t urgent, we’re glad to see you
Booking with us is the right move for the ordinary version: something’s lingering, something’s changed, you’d like it looked at by a person rather than a search engine.
If anything in the emergency section above applies, please use that section instead of the button below. I mean it.6
Take care of yourselves, and please don’t be polite about this one.
Dr. Katie