ER vs urgent care in San Juan: where to go when you're sick in Puerto Rico

When in doubt, treat it as more serious, not less.

At night: a doctor online 24/7 for anything that is not an emergency; for emergencies, hospital ERs are open 24 hours, every day. Many CDTs close at night or change their hours, so call before you go.

Go to a hospital emergency room, or call 911, for signs of something serious: chest pain, trouble breathing, stroke signs, bleeding that won't stop, a serious injury, seizures, confusion, or an allergic reaction with swelling of the face or throat. The full list is on when to go to the ER.

Emergency rooms at hospitals that take part in Medicare must screen anyone who arrives with a possible emergency and stabilize them, regardless of ability to pay (the federal EMTALA law).

A CDT (Centro de Diagnóstico y Tratamiento) is an outpatient health center; many are run by the municipality. Some have an urgent-care room and others only take appointments, and hours and services vary from town to town.

Need hands-on care in San Juan? A CDT or private urgent-care center makes sense for a cut that needs stitches, a sprain, a possible broken bone without deformity or anything that needs an X-ray the same day. Call first to confirm they handle your problem at the time you can go, and if you have insurance, ask which centers are in network. If you get worse on the way, go to an ER.

Plenty of what sends people to a CDT can be handled by video from home. Our urgent care in Puerto Rico by video is for non-emergencies: a cold, cough or flu without trouble breathing, a fever without warning signs, UTI symptoms, a sinus infection, allergies, rashes, a sore throat or earache, or a prescription refill for a medicine you ran out of.

You see Dr. Diana Nieves Castro, a general practice physician licensed in Puerto Rico with several years of emergency-department experience, in English or Spanish. She sees adults and children of all ages. If appropriate, the doctor prescribes and we send your prescription online to your pharmacy. If a test is needed, you get a lab order for a lab near you. And if you need to be seen in person, she tells you where to go.

How an online doctor visit works, in three steps:

Our video doctor visit has a published price, the same for every age, with no membership and a doctor's note included. You are charged when you request it, with a full refund if the clinic can’t see you. We do not bill insurance. See pricing, and if you have no coverage, seeing a doctor without insurance. The service is run by The Health Initiative, a nonprofit. What a CDT or ER charges depends on the center and your plan.

These emergency rooms in the San Juan metro area are verified against official sources. In an emergency, call 911 or go to the nearest one.

For the ERs, pharmacy counters and hours in each area, see the Condado, Santurce, Carolina and Río Piedras and Hato Rey guides.

General guidance only. When in doubt, treat it as more serious, not less.

Visitors are welcome by video while on the island. See sick on vacation in Puerto Rico for hotel-area ERs, pharmacies and a note for cruise passengers.