Obviously, most people don’t plan to visit the ED—and, once there, they don’t have much control over and, once there, they don’t have much control over who is caring for them. However, there are some simple ways to set the stage for better care and improved outcomes.
The first and most important is to research your local hospitals. Which hospitals in your area have a good reputation? A diverse staff and programs for cultural competence? Which are leading the way in research and education? Don’t be afraid to ask questions—or even visit the hospital to talk to the nurses and desk staff! Ask questions about their experience with sex and gender disparities and always “go with your gut.”
The second is to be prepared with your information. I love when people come into the ED with detailed descriptions of their symptoms, lists of prescriptions, and a clear grasp of their medical history (even if that means looking at pictures of bowel movements!). Having all the relevant information at hand helps me make the best possible decisions about the patient’s care. When people are vague about their medical history (or worse, try to hide parts of it), don’t know what prescriptions they’re on, or can’t describe their symptoms beyond a vague “it hurts here,” it is harder for me to help them.
For example, not long ago, an eighty-five-year-old woman named Elise came in on a stretcher. She’d enjoyed a small glass of sangria while at lunch with her girlfriends, but after the check was paid and she went to stand up, she got dizzy and collapsed. When we checked her blood pressure, it was dangerously low.
“Do you know what medications she’s on?” I asked the friend who had ridden with her to the ED.
“I don’t,” she said, shaking her head. “But I can call her daughter.”
Thankfully, the daughter had lists of Elise’s prescriptions and a clear grasp of her medical history. I discovered that Elise was on several medications for a medical condition that could make alcohol affect her disproportionately. After a brief rest and hydration, Elise was feeling better and ready to go home.
If you are unable to speak when you arrive at the hospital—or even if you’re awake but nervous and in pain—having a friend or relative who has access to important information and can communicate it clearly can help us save your life. Here are some things you can do to make sure that, if you do need to be hospitalized, your providers have all the information they need to help you:
Make sure that at least one friend or family member has access to all your medical information, including your prescriptions, recent tests, diagnoses, surgical history, and so forth. List that person as your primary medical contact when you are being registered and be sure that phone number, address, and email information is up to date so we can contact him or her quickly in time-sensitive situations.
- Set up a power of attorney and other legal safeguards to be sure that the person you designate as your advocate can make decisions on your behalf.
- If you are taken to a hospital other than the one you’ve chosen as your preferred place of care, you can ask to be transferred.
- If you are able, make sure to be transparent about key information on your intake form, such as the following:
– Allergies—not only what they are but how they manifest, so your doctor can make better decisions around which medications are appropriate. For example, if you have an allergy to an antibiotic, but it’s not severe and only triggers a rash, we might choose to use that medicine anyway in a serious situation. On the other hand, if your reaction is anaphylactic, we need to know that too.
– Family history of disease, including the ages at which your family members were diagnosed. If your mom had a heart attack at eighty-seven, that’s a lot less concerning for us than if your mom had a heart attack at forty-seven.
– Any and all hormones that you use, including birth control, HRT, or hormones for gender affirmation.
– Any past or present pregnancy-related complications (such as preeclampsia, gestational diabetes, etc.) that could serve as risk factors for cardiovascular disease.
– Any history of medication reactions.
– Congenital long QT syndrome or other inherited conditions that could impact how medications work in your body.