January 16, 2019
As doctors, we often hear how patients (sometimes even our own) don’t have the interaction they want when they go to a physician’s office. Maybe that means you realize as you’re driving home that you’ve forgotten to ask an important question or mention a nagging symptom, or that you don’t fully understand the plan for your care or the instructions you were given about medication changes. The reality is that we have a set span of time to spend talking together about what’s going on with you, and it can be all too easy to feel rushed or to forget things. We also know that our offices are not usually a patient’s favorite place in the world to be, and sometimes stress or anxiety means people don’t hear or say everything they needed to. In fact, a research review by the Royal Society of Medicine showed that 40-80% of what we hear from a healthcare provider is forgotten immediately, and nearly 50% of what we do remember is incorrect. We want to help you have a truly meaningful interaction with us and to feel better when you leave. Since knowing is half the battle (or so I learned watching G.I. Joe as a kid), here are some things you can do to get organized ahead of time and make your visit as productive as possible:
Jot down a list of things you want to discuss, and set your personal goals for your visit. Try to keep your list realistic, as even the best physicians may find addressing 10 problems in one visit difficult, and it would be impossible to do so with any real depth. Remember that most follow-up visits are scheduled for about 15 minutes, so prioritize the 3 most important things that you’d like to focus on. Do your best to make your list targeted to the particular type of doctor you are seeing (while a kidney specialist may empathize that you’ve had a head cold for two weeks, it may not be the problem you’re in their office to address). And, of course, always write down on your list any questions you want to be sure to ask us before you leave.
Keep us in the know. Some other important things to write down and tell us about might include new or worsening symptoms, unintentional changes in weight, changes in sleep habits, appetite changes, or any new diagnosis you’ve received since we last saw you. If you had any recent tests or labs done at a facility not connected with your doctor, bring a copy of your results with you, or fill out the appropriate request forms at your doctor’s office to have them obtain your records. If you use any health tracking tools at home, like a blood pressure or blood sugar log, or a symptom diary, bring them along with you.
It’s also a good idea to use your list to take notes during your visit. You can jot the answers to questions you may have, and any points you especially want to remember.
Always have an updated list of your medications with you when you come — in the era of computers and electronic health records, you would think this automatically happens, but I’m sorry to say it doesn’t (no matter how hard I wish on my lucky star). Don’t assume another doctor sent their up-to-date notes to the doctor you are seeing. Even the most efficient practices can have delays in getting records sent out. Either bring all of your medications in their prescription bottles, or bring a current written list with the name of the medication, dose, how many times a day you take it (and when), and whether you get 30 or 90 days of the prescription. Please don’t forget to include any vitamins, herbs, or other supplements such as fish oil that you take regularly; these may cause interactions with your prescription medications. Also remember to write down the name and address of your preferred pharmacy.
Let us know if you think a particular medication is giving you side effects. Even something as simple as fatigue or decreased appetite could be related to a new medication, or an interaction of medications, and could interfere with your quality of life. There may be an alternative available that would be better suited for you. Please talk to us before you stop taking a medication we prescribed, and let us know as soon as possible if another doctor recommends that you stop a prescription we gave you.
Never be shy about asking any questions at all. If you don’t understand something we have said (we’re all guilty of slipping into medical jargon now and then, and we do apologize for that), ask us to explain further or in a different way. If you’re not comfortable with anything that we say or have recommended, it’s always okay to tell us so, and we can discuss your concerns and look at other options. It’s your healthcare we are planning, and building that plan should always be an open and honest partnership between us.
If you’re going to be late or can’t make it, call us and let us know as soon as you can. We all understand that there are times when these things just happen. Some doctors leave times in their day open for emergency visits or walk-ins, but not showing up without giving us a heads-up may delay your rescheduling depending on the severity of your medical conditions.
If you have a complex or chronic medical condition, or physician visits make you anxious, consider bringing a family member or trusted friend with you to your visit. It can be helpful to have another set of ears and eyes with you to make sure you get all the information you need, or to ask questions you may not have thought of.
Ask your doctor for the best, most trustworthy resources to do your research. There’s plenty of good and bad information on TV and the internet. You can find many good, medically-accurate websites geared toward patients with chronic conditions (high blood pressure, diabetes, atrial fibrillation, etc.), but they can be hard to identify unless you know what to look for. Often, doctors will have a list of websites they feel are worthwhile that they can recommend to you. Doctors also usually have printed information in their offices for the most common conditions they treat.
Make sure you understand what happens next before leaving the office. Do you need additional testing (lab work, stress testing, imaging studies, etc)? When and where will this be done, and when will you get the results? Are you clear on how and when to take a new medicine? If you just received a new diagnosis, do you understand your treatment options? Do you need to see another specialist?
If you are getting lab work, a stress test, or any other in-office procedure, make sure you also fully understand the preparation for the test. Some procedures and lab tests require you to take your medications, but others may require that you do not. Ask whether or not you should eat beforehand. Unfortunately, if such restrictions are not followed, the test or procedure will often have to be rescheduled.
Make sure you know how to get in touch with your doctor if you have questions or concerns later. Immediate or urgent concerns can always be answered by the on-call physician. However, they may not be completely familiar with your particular care, and if it is not an emergency, it may be better to wait until the next business day to speak with your regular physician. Most practices now have the capability to handle requests via their websites or email. These can often be answered in a more timely fashion (and directly by your doctor) if you follow the recommended channels of communication.
We at CIS want to give you the best patient experience possible and understand you have a choice where you get your cardiovascular care. While this list is by no means all-inclusive, it goes a long way toward helping both you and your physician to use your visit time effectively and making sure that there’s good communication on both sides. You are your own best advocate, and it is important for you to speak up in our conversation. We are here to help you make the best choice for you, and only you can tell us what that is.