This single center study asked patients about barriers to health carrier after ED discharge (example transportation, lack of PCP, inability afford medications, trouble with ADLs) and then surveyed EM residents about those same patients' barriers. Resident physicians way under perceived barriers to care in their patients. ("20.4% of patients reported they had no primary care physician (PCP) and 9.8% of residents reported their patient had no PCP . Limited health literacy was identified in 59.0% of patients and reported by 37.6% of residents . Abnormal cognition was present in 53.6% of adults age ??65 and reported by 16.7% of residents .")
Another example of if you do not ask, you will not know. Be careful of assumptions.
References
T. K. Hagerman, F. I. Mowbray, T. Lang, et al., “ Overlooking Barriers to Safe and Effective Emergency Department Discharge,” Academic Emergency Medicine 33, no. 5 (2026): e70320, https://doi.org/10.1111/acem.70320.