I’ve been on both sides of the exam table, as a patient and as a nurse in a busy internal medicine practice. I’d like to share some tips on how to prepare for a visit with your doctor.
Keep a list of all prescription medications you take and ask for refills for them all, even if some are not due yet. This saves you and your doctor precious time and ensures you won’t deplete them, which can be a major adherence factor to medication regimens.
Have you stopped taking any medications because of side effects or minimal effectiveness? Come clean when you talk to your doctor. How will she know that XYZ drug doesn’t agree with you if you pretend you are still taking it just to reinforce your image as a “good patient?”
Make sure your list includes herbs, supplements and over the counter medications you take regularly, as there can be side effects, interactions and long-term repercussions.
It’s difficult to think on the fly, and you want to make the most of this time with your doctor, so write down the things that are aggravating you or you are worried about.
For example, is urinary leakage normal at my age? How do I best handle my arthritis pain? Should I have this giant skin tag removed or name it and claim it as a lifelong friend?
When you are describing an issue or problem to your doctor, try not to go back to 1965 when you had the first twinge or clue that a problem was developing.
Exclude details like, “I was at a New Year’s Eve party at my cousin June’s. We were having a terrific time and I saw so many people I hadn’t seen in years. I wasn’t going to go, but I was glad I forced myself even though the roads were icy.”
While your doctor is working on her patience she may interject, “What can I help you with today?” This is code for “get to the point.”
Do not reply, “I’m trying to tell you. As I was saying, I probably ate too much. The food was delicious. And after six hours of laughing, talking, eating and a couple of glasses of champagne, I felt an odd sensation in my chest. Sort of a burning.”
Doctor inquires (looking weary), “So you had chest pain?”
You respond, “Not exactly. It was heartburn and when I took a Tums it went away.”
If you had allowed your doctor to get a word in edgewise, she would have elicited information using a framework called, History of Present Illness, or HPI.
Let’s take the example above and place it into this structure.
Onset/duration: After eating or drinking at a party for six hours
Context: Overate rich foods
Modifying factors: Tums relieved the pain
Associated signs and symptoms: Heartburn
See how much easier it is for your doctor to get the key facts she needs to evaluate your problem?
There is a lot of emphasis today on screening tests as a cornerstone of “preventive” care. Let’s be honest. Preventive care involves a healthy diet of whole foods, exercise, forgiveness, sleep, laughter, gratitude and satisfying relationships.
The only screening test that can actually prevent an illness is a colonoscopy since removing precancerous polyps can thwart development of colon cancer. Otherwise, screening tests are looking for diseases in someone who has no symptoms.
Decisions about screening tests should be shared between you and your doctor. For you to be an active participant in the discussion it behooves you to be aware of the pros, cons, risks and benefits of the screening tests.
If you are scheduled for a wellness exam, tell the staff when you arrive if you have an acute issue you need to discuss instead. It is disheartening for your doctor to hear these words as she completes your wellness visit, “By the way, for the past two weeks I’ve noticed stabbing chest pain when I shovel snow.”
Can she pretend she didn’t hear you while praying you don’t collapse from a heart attack before this problem receives the attention it deserves? No. But don’t be offended if she heaves a sigh, knowing this is going to put a major constraint on her schedule and the satisfaction of patients in the waiting room who are reading magazines with breaking news about Apple’s debut of the iPhone.
What tips can you share to make the most of a visit with your doctor? Do you already prepare lists of medications and concerns to prepare for a doctor’s appointment? What additional questions do you have about good communication with your doctor? Let’s start a conversation.
Tags Medical Conditions