Insider Secrets From a Top Emergency Room Doctor

18 tips to help you get better care, avoid common mistakes and navigate the emergency room with confidence

Eric Spitznagel,

AARP

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Published August 21, 2025

Emergency medicine physician Dr. Adaira Landry shares her insider advice on how to get the best possible care when you need it the most.

Amber Day

Older adults make up almost a quarter of all ER visits, according to a 2024 report published in the International Journal of Emergency Medicine. And nearly 80 percent of them claim they leave the ER with at least one health concern that they feel wasn’t addressed.

That’s just the beginning of what can be a frustrating ordeal. A 2025 JAMA Internal Medicine research letter analyzing more than 12 million visits across 1,600 hospitals found that 20 percent of older patients had ER stays exceeding eight hours — up from 12 percent in 2017.

When it comes to the ER, even the most seasoned patients can feel overwhelmed. That’s where Dr. Adaira Landry can help. She’s an emergency medicine physician at Brigham and Women’s Hospital in Boston and an assistant professor at Harvard Medical School, with years of experience treating patients in high-pressure, high-stakes situations. Landry shares insider tips, in her own words, to help you stay calm, ask the right questions and get the best possible care when every minute counts.

1. Know your ERs before you need one

Not all emergency departments are equal — some are stroke centers, some have cardiac catheterization for heart attacks, and some are academic hospitals where you’ll see trainees like medical students and residents. When you see your primary care doctor, ask about nearby hospitals. And if your PCP ever recommends you go to the ER, discuss which ER is best for the complaint you are having.

That said, I wouldn’t stress too much about having the “perfect” plan, because this info isn’t always easy to find and memorize. In a true emergency, the best hospital is often the closest hospital.

2. There is no “perfect” time to go to the ER

The best thing you can do is come in when symptoms first start to concern you or your loved ones. If you come in early for a urinary tract infection, for instance, you might leave with oral antibiotics. If you wait too long, you may become sicker and need IV antibiotics with an overnight stay.

ER wait times can be long, so have someone lined up to watch your pets or kids and cancel plans for the day.

Amber Day

3. Hope for fast, prepare for slow

It used to be that very early mornings (between 5 a.m. and 7 a.m.) were quieter, but that was before the pandemic, and these days ERs can feel busy all the time.

Hospital websites and apps like EmergConnect, Vital Emergency and Emergency Q can tell you how long the wait will be, but these should be taken with a grain of salt. ER wait times are difficult to predict, even for us inside the hospital. Instead of trying to avoid a wait, it’s better to prepare for it. Assume you could be in the waiting room for three to four hours (sometimes longer), and then another few hours in the ER while a plan is made.

I tell people to bring a phone charger, have someone lined up to watch the pets or kids, and expect to cancel meetings or plans for the day. It’s best to prepare for a longer visit.

Unless a condition is life-threatening, a trip to urgent care is generally a better use of a patient’s time and resources to treat injuries, fevers, infections and other ailments.

Amber Day

4. Twisted ankle? That’s urgent care. Chest pain? ER, please

Urgent care visits are usually best for less complex, more straightforward issues. A good example: You twist your ankle, and now it’s swollen and a little painful when you walk. That’s perfect for urgent care.

Going to the ER could be a better choice if your medical history makes complications more likely, you need advanced diagnostics like a CAT scan or MRI (some urgent cares don’t have these tools), you might need multiple specialists involved, or even an overnight stay. For example, you twisted your ankle, lost consciousness and fell, hit your head or landed on your chest, and now have shortness of breath. And maybe your ankle looks badly deformed. Maybe you are on medication that thins your blood, making a brain bleed more likely. That’s an ER case. It’s a much more involved situation.

5. Heart attack? Stroke? Step away from the steering wheel

Please call 911 if you worry you are having a heart attack or stroke. Not only could you injure yourself driving to the hospital, you could injure others if the condition progresses. The other added benefit of having an ambulance drive you is that they can give you medications en route.

6. AI can help — just don’t let it play doctor

We’re seeing less of “Dr. Google” now, and more of people using ChatGPT or other AI tools. That’s a double-edged sword because the quality really depends on the prompt and the source of the information. Overall, I’m supportive of patients using tools like ChatGPT as long as they remember two things: The info provided by ChatGPT might be wrong or incomplete, and even if it’s correct, it still might not all apply to your specific situation. So use it to get familiar, but don’t let it replace an actual medical evaluation.

7. Stick to the facts that matter

The ER is busy, and there is pressure to keep moving. If the doctor says, “Tell me about the car crash,” they are looking to hear about the speed and type of impact, and less about the name of the street you were driving on. If your doctor gently redirects the conversation, it’s usually because they’re trying to get to the most time-sensitive details quickly, not because they don’t want to hear your full story.

8. SSS: If it’s sudden, scary or stubborn, get it checked

There are some symptoms that should never be ignored, including new and sudden severe headaches, persistent nausea and vomiting, exertional chest pain and shortness of breath. However, this list can get quite exhaustive. What’s best is for patients to instead pay attention to how symptoms are disrupting their everyday life, increasing their anxiety or not resolving on their own. If a symptom is severe or persistent, your body is telling you, “Please look into this.”

9. Bring your paperwork to power up care

If you have any recent hospital discharge summaries or updated medication lists, please bring those. However, don’t delay emergency medical care digging through files for old records. The vast majority of information we need can be obtained from speaking with you and doing a thorough examination.

10. Bring a buddy to boost your care

Always bring a support person if you are able. If you are unable to have someone there in person, have someone on standby who can join in by phone. When the doctor or nurse arrives, you can say, “Excuse me, before you give me an update, can I call my friend to listen in?” Especially do this before you hear any big news, about a chest X-ray or labs, for instance. A support person can help explain, ask questions and advocate.

person in hospital with doctor and partner

Don’t be afraid to ask the name, title and specialty of your care team to keep track of who is taking care of you.

Amber Day

11. Take notes to keep track of your team

It is always helpful for you to know who is taking care of you. Their name, title and specialty are especially important. Take notes on your cellphone or paper. You can ask something such as, “Can you share your name, title and specialty with me?” It’s very confusing these days because many people wear white coats, face masks and surgical caps to cover their hair. It is OK to ask, “Are you a physician, nurse practitioner or physician assistant?”

12. ERs can also handle emergency prescription refills

Standard refills aren’t classically defined as an emergency. So overall, it is best to avoid the ER just for routine medication refills. That being said, if a patient comes in asking for a refill of a time-sensitive medicine, and their PCP is out of town , I suspect the vast majority of clinicians will offer to put in for a refill. While our training is geared toward the evaluation and treatment of emergencies, our job is also to help people who are struggling to get care in the outpatient clinical world. Bring your prescription bottle to the ER, or an updated list of both medication and dose. While the majority of ERs cannot dispense medication to you directly, they can evaluate and write for emergent refills that you can pick up at a pharmacy.

13. Discuss and formalize your end-of-life preferences before an emergency happens

ER doctors are trained and comfortable having end-of-life discussions with patients — I probably have one such conversation per shift. However, the formal, legal documentation that often accompanies these decisions is something we have less time to explore deeply in the ER setting. We are able to document these conversations in the electronic health record, but during moments of medical or traumatic crisis, the priority is often rapid decision-making. Ideally, these discussions should begin with the primary care provider or oncologist, given the longitudinal nature of that relationship. In a non-acute, outpatient setting, there is time to thoughtfully select witnesses, guardians, and power of attorney, and even involve legal counsel if needed.

14. You can’t shock us, we’ve heard it all before

I don’t think the majority of patients typically walk into the ER with the intent to lie and deceive. Patients, however, may feel pressure to give “acceptable” answers, especially about sensitive topics like diet, sexual activity or alcohol use. I like to remind patients that there is nothing that surprises me anymore. My goal is to normalize the idea that patients can be honest and we will not judge.

15. What to ask yourself before tackling a task

The vast majority of our visits are pretty standard: chest pain, abdominal pain, rashes, common colds, dehydration. But simple daily tasks, like cutting food or interacting with pets, can lead to surprising injuries, too. Many patients want a firm list of actions to avoid, but I recommend just asking yourself, “Is this the safest thing I could be doing with my body? Is there a better way to approach this task?”

16. Electric scooters can be treacherous, even with a helmet

Rentable electric scooters have popped up in many cities, but they’re risky, since they offer little protection in the event of a fall or crash. If you are going to use a scooter, do so on flat, smooth surfaces, at low speeds and while wearing a helmet. If you are on medication that thins your blood, then I would avoid hopping on one until you speak with your doctor first.

17. Alcohol can make every event more dangerous

When accidents happen during an event, alcohol is usually the culprit, especially around holidays and social activities that involve fireworks, swimming and/or boating. A little drinking can be social, but drinking to excess puts patients at risk for all sorts of trauma. Practice moderation.

18. Not every visit ends with a diagnosis

I wish patients didn’t feel that going to the emergency department was a waste of time if they didn’t get a firm diagnosis, like pneumonia or appendicitis. Much of what we do is gather a history and exam, assess for life- or limb-threatening emergencies, order and interpret relevant tests and provide reassurance. From there we often guide patients back to their primary care or specialty providers for follow-up and nonemergency evaluation. That detailed evaluation and management takes multiple years of training, and if the answer is “you aren’t having an emergency,” I’d like patients to consider that reassuring and not a waste of time.

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