Obviously insurance coverage is first unless you are independently wealthy. If your pdoc has privileges at a hospital so he can treat you himself, that would usually be preferable. You can go to an ER yourself without your pdoc sending you, but understand, most hospitals are for emergency management and aren't designed to treat particular diagnoses. They usually only admit patients who are a danger to themselves or others, and the average stay is 3-10 days. There are some private programs that serve as more long-term, residential, treatment centers, but they are almost never covered by insurance. If you pdoc suggested hospitalization, was he recommending it for emergency care or was he recommending long-term treatment? Either way I would start with his recommendations and work from there. I have had very good experiences with hospitalization on an critical care unit.