Doctors are increasingly crunched for time and it’s very easy to experience a flurry of activity and information during an office visit and walk out realizing that you really didn’t get your concerns addressed and/or questions answered. There are several things people can do for themselves and family members in their care before and during an office visit to make it more productive:
Know your health history (and be specific!)--I am often amazed at the lack of specific information people have about their own health history and that of their families. For example, it’s common for me to see a patient who has had a hysterectomy, but doesn’t know if her ovaries were removed. Many patients tell me that a closely related relative has “heart problems” or “some kind of cancer,” but no idea exactly what the problem is. Before a visit, list all of the medical problems, hospitalizations, and surgeries you have had in the past, and bring it with you. Make a few phone calls to family members to get the specific diagnoses of your blood relatives. First degree relatives are the most important.
Know exactly what medicines you are taking and why--Too many (often elderly) patients, and their caregivers, don’t know this information. Simply stating that your current medications are “all the same” is not helpful, and dangerous. Your doctor often doesn’t know if another doctor changed medicines, or that you decided to stop a medication several months ago because you thought it made you sleepy or it cost too much. You may have thought you told your doctor at the last visit, but maybe you forgot, or the nurse made an error and didn’t update your medication list properly. The best bet is to bring in ALL of the pill bottles you are taking (including OTC meds) to EVERY visit. I am always happy to see the big bag of pill bottles because I know I am dealing with accurate, up-to-date information.
Younger, healthier people are guilty of this as well. A common example is a patient that comes in to see me because the cream or antibiotics that were given at the urgent care aren’t working, and–you guessed it—s/he has no idea what the ineffective medication is!
Put together a cohesive story of your symptoms and concerns—Thinking of it as a story is helpful. The time frame and sequence of events is extremely important. For example, abdominal pain that has been occurring daily and worsening for the last 3 weeks is very different from intermittent pain for 6 months. It’s important to know if you were nauseated at the onset of the pain or if the nausea started after you tried to treat the pain with some ibuprofen. If you have already sought medical care, know what tests were done, the results, and what was prescribed. It’s best to have a hard copy of test results (discharge papers from the ER are not enough). Go over the story in your head and try to make it as clear and succinct as possible.
Write down your concerns before the visit—
Doctors try to address all of your concerns, but we can’t read your mind. If you are worried your symptoms might be related to cancer or you think you have a disease you read about online, say it! If you have 2 or more unrelated complaints, make a list and tell the doctor you have a list before you start talking.
Be aware that more than one visit may be necessary—As people become responsible for more of their medical bills, I understand the desire to cram everything in to one visit, but this really is not in your best interest. If you have more than 3 separate complaints/concerns, you probably need more than one visit to have them fully addressed. Insisting on addressing all of them in one visit may cause your doctor to rush through and miss important information. It may also cause you to get unnecessary tests because your doctor hasn’t had the time to get the whole story and determine which tests you REALLY need.
Ask questions--If you don’t understand what was said, or you just need it repeated, say it! Doctors often have been speaking “medicalese” for so long we don’t recognize when we are using words/phrases that are only understood in the medical community. We also may unknowingly make assumptions about your underlying medical knowledge that cause us to gloss over details that are very important. Don’t be intimidated or embarrassed to ask “stupid” questions. It’s your doctor’s job to explain things and make sure you understand.
Take notes—What seems very clear and simple when sitting there listening to the doctor can quickly become confusing after you step out of the office. Even if you understand everything, just write it down. You will be glad in the future that you have notes to reference.
Shari S. Phillips, M.D.