Between the two of us, we have spent years working in emergency medicine, urgent care, and primary care. We’ve seen thousands of patients walk through those doors — and if we’re being honest, a significant number of them didn’t need to be there.
That’s not a criticism. When you’re sick, uncomfortable, or worried, and you don’t have a provider you can reach quickly, urgent care feels like the logical answer. It’s open late. It’s accessible. It’s there.
But urgent care visits come with real costs — time in a waiting room, exposure to other sick patients, a provider who has never met you and has fifteen minutes to figure out what’s going on, and a bill that often surprises people. And for many of the most common reasons people go, there’s a better way.
We built Retro Health specifically so that our members would have somewhere to turn before reaching for the urgent care option. This post is our honest breakdown of what actually needs urgent or emergency care — and what doesn’t.
Sinusitis is one of the most common reasons people go to urgent care, and one of the most over-treated. The vast majority of sinus infections are viral — meaning antibiotics won’t help and the body will clear the infection on its own within 10 days.
When symptoms have been present for less than 10 days and aren’t worsening, the evidence consistently supports watchful waiting with symptom management: saline rinses, decongestants, rest, and hydration. If symptoms persist beyond 10 days, worsen significantly after initial improvement, or are accompanied by high fever or severe facial pain, that’s when a provider needs to evaluate for bacterial sinusitis.
A quick message to your Retro Health provider through Spruce gets you the right guidance without a waiting room.
UTIs are extremely common, especially in women, and most uncomplicated cases can be evaluated and treated without an in-person visit at all. A provider who knows your history can review your symptoms, ask the right questions, and in many cases call in a prescription — often same day.
What warrants more urgent attention: fever, back or flank pain, chills, nausea, or vomiting alongside urinary symptoms — these can signal a kidney infection that needs more thorough evaluation.
For straightforward UTI symptoms in an otherwise healthy adult, your concierge provider is the right first call.
Ear pain sends a lot of people — adults and parents of young children alike — straight to urgent care. But most ear infections in adults are either outer ear infections (swimmer’s ear) or resolve on their own. Current guidelines actually recommend a “watchful waiting” approach for many ear infections in children over two years old, particularly if symptoms are mild.
A provider who can review the history, discuss the symptoms, and make a clinical judgment call on whether antibiotics are appropriate — versus a default prescription to send you home quickly — is almost always going to give you better care than a rushed urgent care visit.
Most cases of pink eye are viral and will resolve without treatment within one to two weeks. Bacterial conjunctivitis can be treated with antibiotic eye drops, but it’s often difficult to distinguish from viral without a careful history.
Neither type typically requires an urgent care visit. A telehealth or same-day appointment with a provider who can ask the right questions and guide management is almost always sufficient — and faster.
Minor skin infections, contact dermatitis, mild allergic rashes, and most insect bites can be evaluated and managed without an urgent care visit. Photos through Spruce go a long way here — a provider who can see the rash and knows your history can often make a confident assessment and recommend treatment without you leaving the house.
What warrants faster attention: spreading redness with warmth and fever, red streaking, or any sign the infection is progressing.
This one surprises people, but a significant portion of urgent care visits happen because someone ran out of a medication, had a question about a drug interaction, or needed a prescription adjusted. These are exactly the kinds of things a direct primary care membership is designed to handle — quickly, directly, and without a formal visit in most cases.
Colds are caused by viruses. There is no antibiotic for a cold. And yet urgent care waiting rooms fill up with people hoping for one. The honest answer is that symptom management — rest, fluids, decongestants, honey and time — is the treatment. A provider can help you distinguish a cold from something that warrants treatment and give you a plan, but that conversation doesn’t require a waiting room.
Acute back pain without a history of trauma, numbness, weakness in the legs, or bladder/bowel changes is one of the most common musculoskeletal complaints we see — and one of the least likely to benefit from an urgent care visit. Most acute back pain resolves with rest, anti-inflammatories, heat, and gentle movement. Imaging is rarely helpful in the first few weeks.
A provider who knows your history can help you develop a management plan, identify red flags that would warrant imaging or specialist referral, and follow you through the recovery — something a one-time urgent care visit simply can’t do.
Palpitations, chest tightness, shortness of breath, dizziness — these symptoms can be frightening, and it’s important to rule out cardiac or other serious causes. But for patients who have had these evaluated before and understand their anxiety, a trip to the ER often results in a long wait, a normal EKG, a large bill, and a referral back to a primary care provider.
Having a provider you can reach directly — someone who knows your history and can talk through what you’re experiencing — can make an enormous difference in how these episodes are managed.
We want to be clear: some things genuinely need urgent or emergency care, and we would never suggest otherwise.
Go to the ER immediately for:
Urgent care is appropriate for:
The key distinction: if something feels truly emergent, don’t hesitate. But most of the everyday illnesses that send people to urgent care? There’s a better option.
When you’re a Retro Health member, you have direct access to us — not a call center, not a nurse triage line. You message us through Spruce and we respond. We know your history, your medications, your baseline. We can evaluate your situation, give you real guidance, and in many cases manage your issue completely — same day, without you leaving home.
That’s the promise of direct primary care. Not just a primary care provider you see once a year, but a medical relationship that’s actually there when you need it.
We left high-volume, insurance-driven practice because we believe medicine should work this way. And for our members, it does.
Message us through Spruce. That’s what we’re here for.
Gregory LaFontaine, PA-C is the co-founder and Director of Men’s Health & Wellness at Retro Health & Aesthetics. He has a background in emergency medicine, urgent care, and concierge primary care.
Dr. Bethany Recker, MD is the Medical Director and co-founder of Retro Health & Aesthetics. She practices concierge primary care and functional medicine in Worthington, Ohio.
