> ## Content Index > See [/llms.txt](/llms.txt) for an index of available Markdown resources. # They didn’t do anything at the other ER - URL: https://emergencyroomexplained.com/articles/they-didnt-do-anything-at-the-other-er/ - Description: What does “they didn’t do anything” at the other ER really mean? Why prior testing, treatment, records, and what changed since then all matter. If you go to another ER, what happened at the first one matters. Here’s why prior testing, treatment, and even reassuring results can shape what happens next. ![Patient sitting on a hospital stretcher while an emergency physician reviews paperwork from another hospital.](https://emergencyroomexplained.com/media/posts/34/they-didnt-do-anything-at-the-other-er.png) ## “They didn’t do anything.” This is something we hear fairly often, especially when someone comes to the emergency department after being seen somewhere else earlier that day or the night before. Sometimes that may be a fair description of how the visit felt. You may still have the same symptoms. You may not have a clear diagnosis. You may not have understood why you were discharged, or you may simply disagree with the evaluation. But before we decide that nothing happened, it helps to figure out what actually happened. ## What did they actually do? Did someone take your vital signs? Were you examined by a physician, physician assistant, or nurse practitioner? Did they draw blood or test your urine? Did you have an ECG, X-ray, ultrasound, CT scan, or other imaging? Were you given medication, IV fluids, or a prescription? What did they tell you before you left? Did they give you a diagnosis or tell you what they thought might be causing your symptoms? Did they recommend follow-up with your primary care clinician or a specialist? Did they tell you when you should come back? If several of those things happened, then the other emergency department probably didn’t literally do nothing. What you may mean is that they didn’t find the exact cause of your symptoms, didn’t make you feel better, didn’t order the test you expected, or didn’t explain what they thought was happening in a way that made sense to you. Those are different problems, and it’s useful for us to know which one you mean. ## We may not know what happened there If you were seen at another hospital in the same health system, I may be able to pull up the entire visit in a few seconds. I may be able to see the clinician’s note, your laboratory results, the radiologist’s report, the medications you received, and your discharge instructions. If you were seen somewhere else, it can be very different. The United States does not have one central medical record that every hospital can simply open. Different hospitals and health systems use different electronic records and different ways of exchanging information. Sometimes other hospitals’ records appear almost automatically. Sometimes we can see only pieces of them. Sometimes we can’t see them at all. This isn’t simply because “HIPAA won’t let us.” Privacy laws generally allow healthcare providers to exchange information for treatment. The larger problem is that the healthcare system is fragmented. If the records aren’t available electronically, getting them may require contacting the other hospital directly. At 2 a.m. on a Sunday, that may not be particularly useful if the people who can retrieve and send those records aren’t there. So when we ask what happened at the other hospital, it’s often because we genuinely need you to tell us. Your discharge paperwork or patient portal can help. If you can show us what tests were performed, what the results were, what diagnosis you were given, and what medications were prescribed, that can save quite a bit of guesswork. ## “They didn’t tell me anything.” Sometimes the problem is not that no explanation was given. It’s that the explanation didn’t make sense. I once saw a patient who had been evaluated at another emergency department and diagnosed with pyelonephritis. She came to another hospital because she wanted to know whether she had a kidney infection. Pyelonephritis *is* a kidney infection. The first emergency department had, in fact, given her an answer and treated her. But somewhere between the medical terminology and the patient’s understanding of it, the answer had been lost. “Pyelonephritis” is perfectly reasonable terminology in a medical chart. It is a lousy explanation if nobody also says, “That means you have a kidney infection.” The same thing happens when someone leaves with a diagnosis on a piece of paper but does not understand what it means, what was ruled out, what is still uncertain, why they’re being discharged, or what they’re supposed to do next. From the medical record, it may look as though a lengthy discussion occurred. From the patient’s perspective, it may honestly feel like nobody told them anything useful. ## Tell us what was already done Going to another emergency department because you’re still worried isn’t unreasonable. Sometimes symptoms get worse. Sometimes something changes. Sometimes you simply remain concerned enough that you want to be evaluated again. But please tell us what was already done. If you had blood work and a CT scan three hours ago, that matters. If you already received antibiotics, that matters. If you had two troponins and an ECG, that matters. And tell us what’s happened since then. “They did blood work and a CT around 6 p.m. and told me they didn’t see anything dangerous, but since I left I’ve started vomiting and the pain is much worse” is enormously more useful than “they didn’t do anything.” A reassuring test at another hospital does not stop being useful simply because it was done somewhere else. We still have to decide how much that result tells us now, based on what was tested, when it was done, and what has happened since, but it remains part of the evaluation. ## More testing is not always safer There’s also another reason not to hide testing that has already been done in hopes that the second hospital will start over. Repeating everything is not automatically safer. Another CT scan may mean another dose of radiation and, depending on the study, more IV contrast. More laboratory testing means more needle sticks and more blood drawn. Every additional test also creates another opportunity to find something incidental or slightly abnormal that may have nothing to do with your symptoms but leads to still more testing. Sometimes repeating a test is absolutely appropriate. Your symptoms may have changed. Enough time may have passed that a test needs to be repeated. The first study may not have answered the question we are asking, or we may be worried about something different. The point is *not* that tests should never be repeated. The point is that we should know what has already been done so that repeating them is a deliberate medical decision. The goal of a second emergency department visit is not to pretend the first one never happened. It is to take what was already learned, look at what is happening now, and decide whether anything else needs to be done. Sometimes the second emergency department will find something different. Sometimes it will repeat testing or change the treatment plan. And sometimes, after another evaluation, it will reach the same conclusion. The most useful thing you can tell us is not, “They didn’t do anything.” Tell us what they did, what they found, what they told you, and what has changed or still concerns you. ## Further reading - [The Guide to Getting & Using Your Health Records](https://healthit.gov/get-it-check-it-use-it/) — Office of the National Coordinator for Health Information Technology - [Your Medical Records](https://www.hhs.gov/hipaa/for-individuals/medical-records/index.html) — U.S. Department of Health and Human Services - [What are the Radiation Risks from CT?](https://www.fda.gov/radiation-emitting-products/medical-x-ray-imaging/what-are-radiation-risks-ct) — U.S. Food and Drug Administration ## References - U.S. Department of Health and Human Services. [Uses and Disclosures for Treatment, Payment, and Health Care Operations](https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html). - Gabriel MH, Richwine C, Strawley C, Barker W, Everson J. [Interoperable Exchange of Patient Health Information Among U.S. Hospitals, 2023](https://healthit.gov/data/data-briefs/interoperable-exchange-patient-health-information-among-us-hospitals-2023/). Office of the National Coordinator for Health Information Technology. Data Brief No. 71. 2024. - Lammers EJ, Adler-Milstein J, Kocher KE. [Does health information exchange reduce redundant imaging? Evidence from emergency departments](https://pubmed.ncbi.nlm.nih.gov/24374414/). Medical Care. 2014;52(3):227–234. - Vest JR, Kaushal R, Silver MD, Hentel K, Kern LM. [Health information exchange and the frequency of repeat medical imaging](https://pubmed.ncbi.nlm.nih.gov/25811815/). The American Journal of Managed Care. 2014;20(11 Spec No. 17):eSP16–eSP24. - U.S. Food and Drug Administration. [What are the Radiation Risks from CT?](https://www.fda.gov/radiation-emitting-products/medical-x-ray-imaging/what-are-radiation-risks-ct).