Make the most out of your visit to the doctor

PRIME – November 2014 By Victor Acquista, MD Author Pathways to Health: An Integral Guidebook As a primary care physician, I want my patients to receive the best care. I think that is true of most doctors. In order to make the best use of your health provider’s time, it’s helpful if you are prepared for your visit. Taking good care of you is a collaboration between you and your provider; one of the ways you collaborate is by coming prepared. In general, there are three types of medical appointments and each may require different kind of preparation. I am excluding emergency care and will focus on medical appointments set up for: urgent care/new problem, follow up on a known medical problem, and preventive care. The urgent care/new problem visit Something new or different has occurred and you feel the need to see the doctor to get it checked out. It might be something serious or not, but you are concerned and are seeking medical advice. It might be something with some urgency such as you are feeling ill with a fever or something less urgent such as a new pain that isn’t very severe, but hasn’t gone away. Some common reasons to see your medical provider under this sort of circumstance might be a cough, a rash, a change in bowel habit, fatigue, a new ache or pain of one sort or another. Part of any medical appointment includes history taking, so it is helpful for you to review the history of this particular concern. When did you first notice it? How have things changed or evolved since you first noticed? What have you done to try and self-treat? Have other family members, co-workers, etc. had similar symptoms? Are there things you do that tend to make the problem better or worse? Have you ever had this sort of thing in the past and if so what details can you provide? Have you done anything different lately such as start a new supplement, change your daily habits or routines, started using new household or personal products, travel somewhere, etc.? In general, the better history you can provide, the more likely your health care provider can zero in on the reason and nature of the problem you are seeking care for and determine the best way to address the problem. Some common general types of questions your provider might want specific details about include the intensity, frequency, location, duration, mitigating/exacerbating factors, and associations. The better prepared you are, the more likely the visit will go well. Follow up visits It might seem pretty obvious what sort of information is needed for this type of visit, but years of experience lead me to believe otherwise, so let’s review how you can best prepare for this type of visit. It’s not a bad idea to ask your provider what information he/she would like you to bring when you come for your next scheduled appointment. Often, it depends on what kind of problem you are there to follow up on. If it was a recent urgent care/new problem that needs to be checked up on whether it has improved or not, much of the same information above is needed. How, if at all has the condition changed since you last were seen? If a medication or treatment was prescribed, what has the effect been? If you have a chronic medical condition such as high blood pressure, asthma, diabetes, etc. and your appointment is to follow up on that chronic condition, the information your provider needs relates to the specific problem. For example, have you been monitoring your blood pressure and if so what kind of readings have you obtained? If you are on a special diet such as low salt, have you been sticking with it? For asthma, how often are you using your rescue inhaler? Are you wheezing and if so under what circumstances? Do you get out of breath easily and if so give an example. If the appointment is to follow up on diabetes, have you been monitoring your blood sugars, what are the results, have you been following a diabetic diet, etc.? Without solid information, it is difficult to make informed decisions about care. In computer programming they use the expression, “Garbage in, garbage out!” You want your provider to have the best possible information and he/she is relying on you or a trusted informer to provide that information. I also must mention it’s important to be honest. Don’t minimize or hype your symptoms. Be honest regarding whether you are compliant with your medication or following recommendations. A medical visit is no place for dishonesty. Preventive care visits Any visit to the doctor represents an opportunity to discuss the importance of preventive care, but certain visits are scheduled purely for that purpose. While it is common practice to ask about the status of any known chronic medical problems at these visits, the focus here is really on preventive measures including cancer screening, immunizations, diet, exercise, counseling on risky behaviors such as smoking, alcohol abuse, etc. To come prepared for this type of visit in part is related to whether or not your provider has seen you before for this type of visit. If your provider does not have historical information about what vaccines you have received, what previous cancer screenings you have had, etc. it is very helpful for you to have this information ready. Be prepared to answer questions about your health habits and lifestyle including sexual behaviors and partners, diet, exercise, social supports and so on. This is also a great opportunity for you to ask your doctor about things you can do to improve your health. Perhaps you read an article somewhere or heard about something on the Internet. Prepare a list of questions. It is a lot easier to care for healthy patients than sick ones so this type of visit is your chance to collaborate on staying healthy. Providing care at the point of visit is not always cleanly segregated into one of these three types of visits, and often there is some overlap. But the principle of coming well prepared to get the most out of your visit to the doctor does not change. A long time ago, I was in the Boy Scouts. The Scout’s motto is a good one, “Be prepared.” Stay healthy! Victor Acquista MD is author of “Pathways To Health: An Integral Guidebook”. For more information on Dr. Acquista’s book, visit http://pathstohealth.info/