The decision that happens on the couch
The most important triage decision in medicine happens on a couch at night. Here is the two minute rule I give my own family.
Patients ask me one question almost every shift: should I have come here, or gone to urgent care?
The honest answer is that the most important triage decision in medicine is made on a couch, at night, alone. So this week I wrote down the two-minute rule I give my own family.
Minute one: could this kill or disable me today? Chest pain, stroke signs, serious trouble breathing, a bleed that will not stop. If yes, or maybe, call 911.
Minute two: does this need an ER today? Severe belly pain, a head injury on a blood thinner, a fever in a baby under 3 months. Go to an ER.
Everything else, from sprains to sore throats, usually does well at urgent care or with your doctor, for far less money.
I turned that rule into a free tool. Tick what is happening, and it tells you 911, ER today, or urgent care. No diagnosis, no account, nothing stored: ER or urgent care helper.
There is a bigger lesson here for anyone building AI for patients. The front door is where the stakes are highest and the help is thinnest. If your chatbot does not say "call 911" first, it is not ready for patients. I wrote more about that for hospital leaders in The front-door decision.
What is the hardest "should I go in?" decision you have faced? Tell me in the comments on my Substack.
Educational information only, not medical advice. In an emergency, call 911.
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