Tuesday, January 24, 2012

How to talk to your doctor

Author : Dr Jennifer Frank University of Wisconsin School of Medicine and Public Health Appleton, Wisconsin

2009-08-18

How to Talk to Your Doctor Getting : the most out of a short-but-sweet office visit

We all, unfortunately, have to go to the doctor now and then. Usually, the doctor is rushed and can use a lot of big words and say things really quickly. It is easy to forget all your questions, mix-up what he or she said, or leave the visit without feeling like you got what you needed. Read below for a 10 point how-to approach to your next doctor's visit.
Image : CDC

Getting Ready for the Visit


The first step is to figure out why you are going to the doctor.  Is it for an annual "check-up", to get a diagnosis, for a medication, or to figure out why something isn't going right?  Maybe you were referred to a specialist or maybe you are just trying to establish care with a new doctor.  Whatever the reason, don't walk into that office unprepared!


What to Bring With You to the Doctor's Office

  1. All of your medications in the bottles.  Include over-the-counter medications that you take weekly (or more often).  
  2. Old medical records from previous doctors, including things like previous mammograms or EKGs.
  3. A list of what you want to accomplish at the visit.
  4. A list of any questions or concerns you have.
  5. Your immunization record.
  6. A friend, spouse, or family member if you anticipate that the visit will bring up complex or difficult issues.  Someone else being present can help remind you to ask all the questions you wanted to ask and can help you remember what the doctor said when you get home.
  7. A good book or your iPod - in case the doctor keeps you waiting!


10 Steps to Making the Most Out of Your Doctor's Visit


1. Identify your Agenda

    There is nothing doctors dread more than to hear "Oh, by the way..." from a patient as their hand is on the doorknob at the end of the visit.  As you can imagine, when the visit is over and the doctor is already thinking about the next patient, it is not the best time to bring up a serious concern. 
    Most of the time, the doctor has an idea of what he or she wants to accomplish during the office visit based on the "reason for visit" noted at the time you make your appointment.  So, if you have more you want to discuss, make sure that everyone from the receptionist to the nurse to the doctor knows what is on your agenda. 


2.  Make a List

    Write down the top 3 things you want to discuss plus any others (if there is extra time).  Make sure to think about the things you want to discuss before you get to the exam room.  This way you will have all the information you need at the time of  your visit.  Maybe you have a question about something you read in the paper - bring the article along.  If you want to know something specific about your medication - bring the bottle along.  You get the idea.  It is kind of like going grocery shopping.  If you don't write down everything you need,  you will inevitably forget the milk or eggs.


3.  Ask for the Time you Need

    Expecting too much from the limited amount of time allotted for your office visit is another way to sabotage a successful doctor's appointment.  In general, a 15 minute visit is about enough time to address one or at the most two concerns.  Make sure to let the receptionist know everything you want to discuss at the visit.  This way, enough time can be scheduled to make sure you get a chance to get to everything on your list.

4.  Be Honest

    Let's be honest...some of the things you talk about in the doctor's office are downright embarrassing.  Sexual dysfunction, hemorrhoids, vaginal discharge, a rash "down there" are all things that can be hard to discuss with your doctor.  However, and let me be very clear here, there is nothing we haven't heard as doctors.  And I do mean, nothing.  So, feel free to spill all the gory details about whatever it is that is concerning you.  It is the best and fastest way to get better.


5.  Be Patient


    It is understandable that after you have suffered with some type of ailment for weeks, months, or even years, you want an answer today.  Usually it will take some time for the doctor to make a diagnosis (maybe after getting a lab, xray, or other test) and to formulate a treatment plan.  In fact, you may want to be wary of any doctor who jumps to a diagnosis and treatment before giving your adequate time to share your history, do a careful exam, and get other needed information.  It is also important to give the treatment (whether that is physical therapy or a medication) time to work. 

6.  Be Nice to the Office Staff

    I am amazed sometimes to find out that a patient who was perfectly nice to me was yelling at my receptionist just minutes before.  Most of the time, the people who are working in your doctor's office actually like people and want to help you.  They understand that nobody is at their best when they are sick, but the receptionist, nurse, lab people, and administrative staff do want to be treated just like you do - politely.   In my clinic, I have a very low tolerance for any patient yelling at or cussing at my staff.  So, if you can't be nice, you may be looking for a different doctor.

7.  Make Sure You Understand

    It is hard to remember what the doctor said even 15 minutes after you have left the office.  A lot of doctors are great at explaining things and writing them down for patients, but a lot of doctors go too quickly through complex information.  This really struck me when I had eye surgery.  Even though I am a doctor and should know all this stuff (yeah right!), I was given 4 different eye drops to use and couldn't remember which one was just to use "as needed" and which one I was supposed to take every day.  If you need to remember more than one thing, it is usually best to write everything down.  Ask Me 3 is one approach to making sure patients understand what is going on at a doctor's visit.  It recommends that patients ask (and write down the answers to) 3 questions:

  1. What is my main problem?
  2. What do I need to do?
  3. Why is it important for me to do this?

8.  Tell the Doctor about Barriers

    This is a super-important, often over-looked part of the visit.  If you can't read or can't read well (this is actually very common), let your doctor know.  You may do better by watching a video or getting one-on-one nursing teaching than by reading a pamphlet.  If you can't afford your medication, let your doctor know.  What is the point to getting a prescription you can't fill?  If you are not willing to engage in lifestyle change (losing weight, quitting smoking, etc), let your doctor know.  That way he/she can come up with Plan B to get your chronic diseases under better control.

9.  Follow Up as Directed

    If your doctor asks you to come back in 3 months to get that little spot on your arm checked, make sure to do it.  If you are not any better after one month on the medication the doctor started, follow up.  This is the only way to make sure that you get the care you need, that things don't get worse, and that if the first remedy doesn't work, you move quickly to the next.

10.  Be the Coach

    You are in charge of your health care team.  Make sure that you act as the coach.  Get input from and advice from your doctor, but take an active role in managing your health care.  This incorporates steps 1-9 listed above.  Do not be a passive bench-warmer as your health care is decided for you. 
    


Additional Resources

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