1. What's my diagnosis?
It's not always clear to patients why they were in the hospital. And this applies to both visits to the emergency room as well as admissions as an in-patient. You would think doctors would explain why you were admitted but that doesn't always happen. I often see patients who can't tell me why they were in the hospital. They know the symptoms they were experiencing but may not know what the diagnosis was. And there is a big difference between "chest pain" and "heart attack." But it's not your fault -- it's the health care system. With all the typing into the health record, no one talks to the patient anymore. And those forms that often go with home with you? Many of them don't say much and what they do say, patients often don't understand. So be sure to ask your doctor before you leave what's your diagnosis. He had to document it for reimbursement purposes so he should tell you.
2. What medicines do I take now?
This is one of the most common areas where there is breakdown in communication that causes problems. Despite e-prescribing and electronic health records, as well as "medicine reconciliation"initiatives, patients don't often leave knowing exactly what medicines they should take. Usually confusion occurs around what to do with medicines they were taking before they entered the hospital. And trying to figure it all out when one doesn't feel well is not the best time. Insist the nursing staff and the doctor write it all down for you. Don't assume that everyone talks to each other especially if you've seen different doctors. Ask exactly what you do about medicines you previously were taking. For instance, do you still take the same blood pressure medicine at the same dose before you entered the hospital? One reason to try to fill all your medicine through one pharmacy is that they often will monitor any interactions of your medicines or unusual dosing or pairing of meds. I have seen many patients a week or two after discharge and they just don't remember what they're supposed to do.
3. When should I follow-up?
It seems like everyone is told to "follow-up with your primary care physicians". Find out when --- is it two days or two weeks? And if you saw a specialist in the hospital, determine when you need to be seen again. Sometimes you do, and sometimes you don't. But please don't assume that if you need to make a follow-up appointment, they will tell you or make the appointment. Insist on making it before you leave..
4. What are warning signs that I need to come back to hospital?
Almost ten percent of patients discharged from an emergency room come back within three days. And believe it or not, they often go to a different hospital. Some of these visits are necessary, and honestly some don't require emergency level care. Along with when to follow-up and with whom, it's important to know when something might be serious enough that you need to return to hospital or emergency room. For instance, what if you have fever? Does chest pain mean you need to call 9-1-1 or should you simply call the doctor's office? Ask the doctor to be as specific as possible.
The emergency room and hospital can be a scary and stressful place. And many people just want to get out as fast as possible. But please be sure to get these questions answered before you leave. It will be worth your time.