First published July 26, 2019.
"I stepped on a bee" goes to urgent care. "I stepped on a beehive" goes to the emergency room. That is the whole idea behind a set of roadside billboards from BayCare, a not-for-profit health system that runs 15 hospitals across the Tampa Bay area and central Florida. Each board shows two side-by-side panels with a simple icon, one labelled Urgent Care and the other Emergency Care, and lets the exaggeration do the explaining.
The campaign was created by the New York agency DeVito/Verdi and appeared on Florida highways in 2019, around the time BayCare was opening its first walk-in urgent care centres. Photos of the signs spread quickly on Imgur and Reddit, where nurses and emergency staff joined in with their own suggestions.
The underlying question is a real one. Urgent care centres handle problems that need attention the same day but are not life-threatening, such as colds and flu, sprains, minor cuts, stings and minor burns, usually at lower cost and with shorter waits. Emergency departments are for anything that could threaten life or limb. Below are the billboards themselves, followed by some of the best reactions and a short guide to what the jokes leave out.
The billboards
The first board, shown above with a comment from an emergency-room worker, sets the pattern: a single bee icon on the left and a stacked hive on the right. Here it is again on its own, photographed on an Outfront Media structure.
The bee-versus-beehive board is the best known of the series. One sting is usually a local, painful nuisance; hundreds of stings from a disturbed hive can deliver a dangerous dose of venom. It is worth adding one caveat the board cannot fit: even a single sting is an emergency for someone who has a severe allergic reaction.
"I need antibiotics" versus "I need antivenom". The first panel shows a medicine bottle with a cross; the second, a bottle with a skull. A suspected infection that needs a prescription is a typical urgent care visit, while a venomous bite needs a hospital that can monitor the patient and give antivenom if necessary.
"Stepped on a mouse trap" versus "stepped on a bear trap". A sore toe can be checked, cleaned and treated at urgent care. A deep crush injury with heavy bleeding or a possible broken bone belongs in the emergency department.
"I have the flu" versus "I have the plague". The flu panel shows a standing figure, the plague panel a figure lying flat, which some viewers found hard to read. The comparison is meant as a joke about scale, though, as several commenters pointed out, flu itself can become serious.
What people online said
When the photos were shared on Imgur by the user TheRussMartinShow, the comment section became a small gathering of healthcare workers. Their replies, captured below, are worth reading as a group: they are funny, but several make serious points.
An emergency-room worker wished the signs were everywhere, saying the department sees people arrive with trivial complaints. Overcrowding in emergency departments is a long-standing problem, and redirecting minor cases is exactly what campaigns like this aim to do.
An urgent care nurse said they had seen too many anaphylactic shocks, strokes, compound fractures and overdoses walk through their door. That is the reverse problem: people choosing urgent care for something that needed an emergency department, which can cost precious time.
One commenter turned the panels into a joke about who pays: urgent care on your own insurance, emergency care on everyone else's. It points to the cost difference that drives many people's choices in the US system.
A worker recalled a patient who came in demanding a medical certificate to stay home because of mosquito bites. It is a reminder that the minor end of the scale is very real for clinic staff, and that some visits are about paperwork rather than treatment.
A suggestion for a new board: "I stubbed my toe" versus the intensive care unit. The deliberately absurd jump shows how easily the format invites people to invent their own versions, which is part of why the campaign spread.
Another reader proposed stepping on a Lego brick, with the morgue as the punchline. Every parent who has crossed a dark living room barefoot understood the reference. It was one of the most upvoted replies in the thread.
A serious reply: some people cannot breathe after a single bee sting. It is the most important correction in the thread, because a severe allergic reaction with trouble breathing or swelling is an emergency.
A commenter observed that people are often criticised for overusing medical care, but rarely for avoiding it when they need it. Both mistakes happen, and the second can be more dangerous.
Two readers pushed back on the flu panel, noting that influenza kills many people each year and ranks among the deadliest infectious diseases in wealthy countries. Older adults, young children, pregnant people and those with chronic illnesses are most at risk of complications.
One reader was surprised that hospitals buy billboards at all. In the US, health systems compete for patients and advertise heavily, especially when opening new clinics.
A commenter joked that a plague patient should not sit in a crowded waiting room since pneumonic plague spreads through the air; another replied that bubonic and septicemic forms do not spread that way. Plague still exists, though cases in the US are rare and treatable with antibiotics.
A two-line reaction, "I'm alive, I'm dead", read the flu and plague icons literally. It summed up how many people understood that board at a glance: one figure standing, one lying down.
One reader simply wanted to know where anyone would find a set bear trap. It is a fair question for a suburban Florida highway, and a reminder that the boards rely on exaggeration rather than realistic scenarios.
Not everyone could decode the plague icon; one reply suggested it was a person lying on their back seen from the feet. Icons that work on a phone screen can be harder to read at highway speed.
And a final request for a public-health billboard aimed at people who reject vaccines. The reply shows how quickly a light-hearted campaign can turn into a wider debate about health messaging.
Why the campaign works
A roadside billboard is read in a few seconds. DeVito/Verdi's solution was to remove almost everything: two short sentences that differ by one word, two icons, two labels and a logo. Drivers do not need to read a list of symptoms to grasp the principle that the same kind of accident can be minor or major depending on scale.
The humour also helps memory. People repeat jokes, and every repetition carries the brand and the message further. The fact that the photos went viral far outside Florida shows how well that worked.
What a billboard cannot tell you
The signs are a starting point, not a triage tool. MedlinePlus, the US National Library of Medicine's health site, lists warning signs that call for the emergency department or an emergency call rather than urgent care, including:
- trouble breathing, choking, or a severe allergic reaction with swelling;
- chest pain or pressure, or pain spreading to the arm or jaw;
- sudden weakness or drooping on one side, or sudden trouble speaking or seeing;
- heavy bleeding, a deep wound, a serious burn or a bone through the skin;
- a head injury with fainting or confusion, or a seizure;
- poisoning or overdose.
When in doubt, call your doctor or a nurse advice line, and in a life-threatening situation call the local emergency number straight away. Nobody at an emergency department will mind that your problem turned out to be a bee rather than a beehive.
Sources: Ads of the World: BayCare "Urgent Care vs Emergency Care" by DeVito/Verdi; BayCare Newsroom (January 2019); MedlinePlus: When to use the emergency room. Image credits: TheRussMartinShow on Imgur and the commenters shown.
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