Patients discharged from the emergency department (ED) are often unaware of their diagnosis, the expected course of illness, or indications for returning to seek further care. This qualitative study analyzed audiotapes of more than 800 ED discharges conducted by physicians or nurse practitioners, and found that most providers gave only minimal instructions and failed to use techniques such as teach back to ensure patient comprehension. As hospitalized patients have also been shown to lack understanding of their illness and plan of care, the onus is on clinicians to use recommended approaches to improving patient–provider communication.