Our very own, Dr. Williams, has come up with some helpful and effective ways to make the most of your next visit with your doctor.
“Your doctor is your healer, advocate, teacher, coach, cheerleader, counselor, confidant, and hopefully, your friend. Help your physician to be all of those for you.”
Decide, before the visit, why you are there and what you want your doctor to do.
Convey to the appointment receptionist all of the issues to be addressed in order for them to properly assess the time needed for your appointment.
Your doctor has 3 important responsibilities:
- Collect information,
- Make an accurate assessment or diagnosis,
- Select appropriate management and therapy from a wide range of choices.
Bring ALL of your medications and herbal supplements in their original containers to your appointment.
Make a list at home of your medications and what they are for, and bring it in for review by the nurse.
Make sure the nurse knows the drug names and dosages for anything prescribed by another provider.
Write down at home which medications need a new prescription, prior to your appointment.
Ask the nurse (or doctor if there is time) for an explanation concerning the reason for certain medications.
Keep small talk to a minimum. Don’t ramble or go out on a conversational tangent.
If you are a “work-in,” don’t expect extra time to address anything other than the most pressing issue.
Bring up the most important topics first.
Be prepared to schedule another visit if there is insufficient time to deal with all of your issues.
Before you leave, determine if the reason for the visit was properly addressed.
Most of the diagnostic information comes from the history. Physical exam, lab, x-ray, and other tests are secondary and are much less important.
Body language interpretation goes both ways. It is a diagnostic tool and a means of conveying empathy.
Mind reading was not part of the medical school curriculum.
If a yes or no question is asked, answer it with one word. Extra dialog gets in the way.
Be prepared to answer the 6 W questions:
- WHAT is the symptom? (Nouns are most helpful here.)
- WHERE is the symptom located?
- WHEN did it begin?
- WHAT makes it worse?
- WHAT makes it better?
- WHAT has been done at home to help the problem?
The physician must ask pertinent questions, elicit answers, interpret their significance, study body language, convey interest and empathy, and document the circumstances of the visit. It is very difficult to do all of them in a time efficient manner. Extra information provided impairs that process. Remember Jack Webb from Drag Net – “just the facts ma’am, just the facts.”
A major flaw in our health care delivery system is the change of the medical record from a patient care document to an insurance reimbursement tool. If the record is audited by an insurance reviewer , it has to contain certain elements. That is the reason the provider may ask questions not related to the reason for the visit. Answer those questions concisely. That is also why the note has an abundance of filler unrelated to the reason for the visit. Doctors don’t need it, but must add it because of insurance.
The time with, and devoted to, each individual patient is a precious commodity. If too much time is expended getting to the root of the issue for which the visit was scheduled, other important health concerns must be skipped. Also, if extra time is taken for an individual patient, others on the schedule will be shortchanged or delayed.
No matter how much your doctor wants to do for you, there are external limits which are beyond his or her control. There is a tremendous shortage of primary care providers in the US. That often results in long waits for appointments, extended waiting room time, shortened visits, the need to work in “emergencies,” the limiting of some practices to accepting new patients, and high levels of stress for everyone. Your doctor is your healer, advocate, teacher, coach, cheerleader, counselor, confidant, and hopefully, your friend. Help your physician to be all of those for you.
“When going to the doctor, be prepared. Know why you are going and have realistic expectations. As with every other aspect of life, you can’t get everything you want.”
Written by Marvin T. Williams, M.D.