Youâre not clear why it's an emergency.
Doctors want you to be able to clearly articulate why you need urgent care. âIf somebody hasnât called their primary care doctor or regular specialist, I wonder why are they here to see me?â says Leana Wen, MD, an emergency physician at George Washington University and coauthor of When Doctors Donât Listen: How to Avoid Misdiagnoses and Unnecessary Tests. âMaybe they called their doctor, but canât get in for a week. Maybe theyâre concerned they have a heart problem. Either way, tell me what youâre really worried about.â
You donât disclose all of your medical problems.
Hereâs a common scenario. âI ask a patient if they have any medical problems; they say no,â says Dr. Wen. âThen they tell me theyâre on insulin and I look on their chest and they have a big scar indicative of cardiac bypass surgery. So clearly they have some medical conditions.â You might not make the connections, âbut we need to know everything about your medical history otherwise we are spending all our time playing detective work when we could be helping you,â Dr. Wen explains. âWhen youâre stressed out, confused, weak, sick, or injured, itâs impossible to accurately represent your medical history to a physician,â says Myles Riner, MD, a retired emergency physician who blogs at The Fickle Finger
. âI even have trouble doing that.â Solution: Bring a card that lists medical conditions, past surgeries, allergies, and a list of all the medications youâre on (including dosages).
You donât know what medication you take.
Patients commonly tell Dr. Wen this totally unhelpful description: âI take this blue pill and I take this white pill.â She says, âWell, I have no idea what those pills are!â Write down the names and dosages, or bring them in with you.
Youâre looking for a third or fourth opinion.
Some people come to the ER because theyâre convinced other doctors theyâve seen have misdiagnosed their problem, Dr. Riner says. âItâs not the role of the emergency department to take someone with a chronic medical problem and try to second-guess all the other providers who have treated this patient,â he says. With these patients, âtheir expectation is that this new doctor is going to do all these tests, make a diagnosis, and get them instant relief.â Thatâs not to say that patients with chronic conditions should never go to the ER. âBut it takes a certain amount of self awareness to be able to say, âyou know this is just my same old back pain and it doesnât make sense to go the emergency department expecting a magical cureâ versus âthis headache is so much worse than all the other headaches Iâve had before, so itâs time to go to the ER,ââ explains Dr. Riner.
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You treat it like a primary care visit.
Donât expect emergency physicians to resolve a host of different, unrelated problems, says Dr. Riner. Itâs unrealistic to think this doctor youâve never met before who doesnât know your patient history will address all your medical concerns in an urgent care visit. Focus. Know the main reason youâre there, and let your doctor help connect the dots. âSome symptoms can be tied together, and weâre trained to review them and see if we can find a common cause,â Dr. Riner says.
You lie or hide the truth.
Itâs natural to want to conceal less-than-ideal habits to a doctor, but doing so could change your diagnosis. Be honest about smoking, drinking, drug use, and alternative remedies, says Dr. Wen. âIf you come in with a cough, Iâd be more likely to order a chest X-ray if I knew that you smoke,â she says. âIf somebody comes in with chest pain, it matters a lot if theyâve used cocaine.â
You beat around the bush.
âDonât ever be embarrassed about a symptom, no matter what it is,â says Alfred Sacchetti, MD, chief of emergency services at Our Lady of Lourdes Medical Center in Camden, New Jersey and a spokesperson for the American College of Emergency Physicians. âWhen people have a sensitive issue, they tend to dance around it, which could lead the doctor in a different direction.â Remember, the doctorâs seen and heard pretty much everything. Dr. Sacchetti recalls a doctor who once told some extreme (and gross) stories to a patient worried about her GI issues, adding, âThereâs nothing you can tell me about your diarrhea that would surprise me, so tell me honestly whatâs going on.â
You donât mention when cost is a concern.
âWeâre not providing you with good care if we prescribe a drug you canât afford to fill, but usually thereâs a way around it,â say Dr. Wen. âMaybe we can give a generic, a different medication, or maybe you donât need it at all. But if you donât bring it up, I wonât know itâs an issue for you.â
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You text, or are constantly on the phone.
âItâs very annoying, as a busy emergency care provider, to walk into a room when a patientâs on their cell phone,â says Dr. Wen, who says this happens a lot, especially with younger patients. âItâs not respectful not only for the providerâs time but for the doctorâs other patients. I might have 40 other patients [and your behavior is] not polite to them.â Texting while you wait? Fine. But when a care provider comes to talk to you, put down the phone.
You donât share when you're frustrated.
âIf you have an issue with the physician, nurse, or anyone else in the emergency department, donât be obnoxious about it, but donât hold it in,â says Dr. Riner, who insists that doctors appreciate knowing this information. âWhen youâre in the emergency department, thereâs a really good chance that thereâs somebody a heck of a lot sicker than you and that person has to be foremost on your physicianâs mind,â says Dr. Riner. âIf your doctor seem rushed or distracted, understand itâs because theyâre trying to juggle all these balls at once.â A polite way to say this could be as simple as, âI have to tell you, you seem so rushed. Could you sit down and just spend a few minutes to go over this?â or âDoctor, would you rather come back? Iâll be willing to wait if you need to do something else and return when you have more time.â