Make the Most of Your Next Doctor’s Visit

June 10, 2010  
Filed under Health & Wellness

By Sandra Gordon

When you think you’ve come down with something, simply telling your doctor you don’t feel well won’t provide enough information to help. And regarding him or her as the authority on medicine can keep you from taking an active role in your own health care. To get the most appropriate diagnosis and treatment, it’s crucial to adopt a “team player” attitude. Your doctor may have the specific scientific knowledge to analyze your condition, but it’s your job to provide the story. Here’s what you can do as a proactive patient to help yourself move faster from diagnosis to recovery.

• Learn the rules of your health care plan. “Become informed about how your health plan works,” says James Underberg, M.D., a clinical assistant professor of medicine in the Division of General Internal Medicine at NYU Medical School. Some health plans, for example, require members to obtain a referral from a primary care physician before seeing a specialist. Knowing the ins and outs of your particular plan can keep you from putting your doctor in the precarious position of having to bend the rules—a situation that can later affect your partnership. It can also help you avoid paying out of pocket for medical services that you otherwise wouldn’t be required to cover.

• Be on time and come prepared. Although the medical profession has a reputation for keeping patients waiting, “You’ll now find more physicians on time for appointments,” says Dr. Underberg. “So don’t be late for your appointment anticipating that your doctor will be, too. If you do, chances are, he or she will be on time and your appointment will be rushed.”

• Get specific about your symptoms. Besides promptness, you’ll need to be clear about your symptoms and when they started. To gain clarity, before the visit, make a detailed list, putting the main symptoms at the top. Bring the list with you so you won’t forget anything. Include on it the following information:
– How bad the pain or the symptoms are on a scale of one to 10.
– Whether the symptoms bother you every day or flare up only occasionally.
– Whether the symptoms are related to a specific action such as only when you lift something heavy or only when you go outside.
– How the symptoms interfere with your daily life. For example, do they keep you from going to work or are they keeping you awake at night?

• Know your health history. Keep a notebook containing your medical history. This is especially helpful to bring with you on a first-time visit. Your notebook should include dates and reasons for previous doctor visits, test results, immunizations, childhood illnesses, past medications you’ve taken and those you’re now taking, their doses and any reactions they’ve caused.

In addition, list as many chronic conditions you have and the current health status or cause of death of your parents and grandparents. If you’ve spent time in the hospital, include a copy of your lab work and records of tests or surgery. Medical office staff can help you to obtain copies of these documents. Also, bring a list of all the prescriptions and over-the-counter medications you’re taking, including medications you don’t necessarily take all the time, such as Zantac, Pepsid, Motrin, Tylenol, St. John’s Wort and gingko. Know what you’re taking them for, what the dose is, and how often you take them. Bringing your medication list to all of your appointments can also help coordinate your care if you’re seeing more than one physician and prevent overdosing. “Tylenol (acetaminophen) overdoses, for example, are on the rise because the drug is hiding in so many products,” says Matt Grissinger, RPh, director of Error Reporting Programs at the Institute for Safe Medication Practices. Besides straight Tylenol, it’s in cold medicine and prescription drugs such as Vicodin, Percocet and Darvacet. If you take a combination of these products, it’s easy to take too much acetaminophen (more than four grams/day), Grissinger says. Over time, an acetaminophen overdose can lead to acute liver failure.

• Speak up. The goal of a visit to the doctor is to get your condition, issues and questions out in the open. Even if a subject or question is embarrassing, if it’s relevant to the reason for your doctor’s visit, mention it. The information you provide about your condition or your lifestyle could be a key element to your treatment. To overcome any shyness, you might want to practice at home what you need to say to your doctor. Also, be sure to ask questions, such as:
– What are the risks and side effects of the recommended treatment?
– What are the odds of experiencing a bad outcome?
– Are there any alternate treatments to consider?

A good question to conclude your appointment with is:
– If you were in my position, what questions would you ask to understand the situation better?

• Take notes. A visit to your doctor can be stressful, which can impair your ability to listen and think clearly. That’s why it’s a good idea to jot down the details about your condition that your doctor mentions during the post-examination discussion. If your illness is particularly complex, you might even consider tape recording this part of your visit (but first ask your doctor for permission). Or bring your spouse, a family member or a friend along to get the facts for you. Having as much information as possible can help you ask appropriate questions on subsequent visits so you can make the most informed decisions regarding your health care. Don’t leave the doctor’s office or hospital without knowing what to do. In your excitement to go home, don’t forget to get the following instructions:
– How long you should take any prescribed or over-the-counter medication.
– Whether there are any foods or beverages that you should avoid that might interfere with the effectiveness of the medication.
– How long it will be before you should start to feel better.
– When to call your doctor if you don’t feel better as expected.
– When to schedule a follow-up appointment.

It’s generally acceptable to call your doctor when you get home if you later don’t understand a medical concept or have a question that didn’t occur to you at the time. But because doctors only have so much time to spend on the phone, try to avoid calling your doctor about an issue that’s unrelated to your initial visit. If a new problem plagues you, “make another appointment,” Dr. Underberg says.

• Do your homework. Although it might sound like a lot of effort, researching your medical condition can enable your doctor to discuss the matter in more detail. You can also educate yourself about issues related to your condition that your doctor may not have time to discuss. Furthermore, Underberg says, “Patients who have time to research can bring issues to the doctor’s attention.” To better understand your diagnosis, consult medical books such as The American Medical Association Family Medical Guide or The Mayo Clinic Family Health Book. Both are written for consumers and are available at local bookstores and public libraries. The Internet can also be a useful tool.

If you run across an article that mentions a new study related to your condition, you might want to present it to your doctor. To save time, make a copy so your doctor can read it later.

All told, although having an illness can be a frightening experience, taking a more active role in your health care can give you a feeling of control. More importantly, says Dr. Underberg, “well-informed patients who are involved in their health care and recovery may take less time to get well.”

 

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