ER sent me home and said follow up with my own doctor in three days. I do not have a doctor. What do people actually do?

Yes, me again, and yes, I went in this time without the thirty five minutes of arithmetic.

Bad fall on the back steps on Thursday, my ankle swelled up like a balloon. ER did an X-ray, said a small break, put me in a splint, and gave me a sheet that says "follow up with your primary care physician or an orthopedic clinic in 3 to 5 days".

I do not have a primary care physician. I have never had one as an adult. I rang the orthopedic place on the sheet and they want $250 up front for a new uninsured patient before they will book. I do not have $250 this week. Is the follow up actually necessary if it feels OK in the splint? Or is that a thing they just say?

It is not a thing they just say, at least it was not for me. My wrist in 2024 needed a cast change I would never have known about. Health center first, they can see the X-ray and tell you what you need.

Cyn, glad you went in without the arithmetic. That matters.

The follow up is not a formality. An emergency department's job, and its legal duty under EMTALA, is to screen and stabilize you. It is not set up to manage the weeks after, which is why the sheet sends you elsewhere. With an ankle fracture the follow up is when someone checks that the bones are sitting where they should, decides whether the splint should become a cast, and confirms how long you need it. Some small fractures are simple; some need a specialist. I cannot tell you which yours is, and neither can the splint feeling OK.

What I would do in your position is ring a community health center on Monday morning, say you were seen in the emergency room with a fracture and need follow up, and ask to be registered and seen. You do not need an existing doctor there; that is what registering is. Bring the discharge sheet and ask the ER to send the X-ray report. The health center can review it, examine the ankle, and decide whether an orthopedic referral is needed, which is a better position to ask about specialist costs from. Community health centers in Texas covers registering, and getting care without insurance in Texas explains why a referral is billed separately if it comes to that.

Separately, go back sooner if your toes become numb, cold, pale or blue, if the pain becomes much worse, or if the splint feels too tight. Those are not wait-for-Monday signs.

Rang the health center at 8am, got in Wednesday. That is two days past the three, but the nurse said that was fine as long as nothing got worse, and nothing has.

And when the ER bills start arriving, there will be more than one, ask for the hospital's financial assistance application before you pay any of them. You know this better than anyone but I am saying it anyway.

Update for whoever finds this. Health center doctor looked at the X-ray report and my ankle, said it is the simple kind, and that the splint is enough for four weeks. No orthopedic referral needed, so no $250. I paid $40 on the sliding scale. Booked a recheck in three weeks.

I also now have a primary care doctor for the first time in my adult life, which is a strange thing to get from a fall on the back steps. And I put in the hospital assistance form for the ER visit before the first bill even came. Raylene, I heard you.