What You Should Know Before Your Next Doctor Visit
By Lynn Rogers, PhD
HOW TO TALK SO YOUR DOCTOR WILL LISTEN
The research is in. If you are a man, your doctor is likely to interrupt you within the first 40 seconds of your meeting. You have even less time if you are a woman. Less than 40 seconds to tell your doctor what seems "not right" physically, to express your concerns. Less than 40 seconds to give your doctor some idea of who you are, your values, how you want to be treated, and to let him or her know that you are not a statistic or a disease, but one human being in need of help.
Unfortunately, this highly trained specialist has precious little time to choose which tests to order, diagnose the problem and plan your treatment.
This means that for you to be heard you need to help your doctor listen. It helps to be specific and provide useful information.
Prepare for your next visit and bring lists:
SYMPTOMS – be as specific as possible:
- Fever: Sometimes? Always? How high? When?
- Pain: Severity, frequency, location, description (sharp, dull, ache, feels like needles). How long have you had it, and has it changed?
- Specific symptoms: Describe them clearly. For how long?
- Changes: What’s new, different? Since when?
You get the idea. Become an expert on your body. The more information you provide, the less detective work the doctor must do.
- Keep and update a list that includes prescriptions, over-the-counter drugs, alternative medication, vitamins and herbal supplements.
- Include amounts taken, any adverse reactions, medication allergies, what has and has not worked, and why.
- If you need refills, don't forget to ask that they be called in during your visit.
SUMMARY OF MEDICAL HISTORY
Be concise. Rank the most important conditions first. Give dates if possible.
Include dates, medical center location and specific findings. Bring copies of any test results to your appointment so that the doctor has all pertinent information (in case these reports have not been sent to the office or have not yet been reviewed by your doctor). This will reduce the possibility of tests being repeated needlessly. In addition, different specialists might interpret specific test results differently.
You, your relatives and caregivers all may have questions. Getting them addressed is vital to your understanding, compliance and comfort with your health care team. Keep a pad of paper or a small notebook with you. Write down your questions down as they arise. Before your appointment, look over what you’ve written and list your questions in order of importance.
Before your visit you might phone the doctor’s office and ask if the doctor would like the questions faxed before the appointment. This lets the office know that you have questions and will need the time to have them answered. Bring two copies of your list – one for you and one for your doctor – so you are BOTH sure all the questions have been addressed.
Bring any forms you need your doctor to complete – insurance, social security, workman's compensation, medical history, etc. If the forms are to be submitted by your doctor’s office, supply them with a stamped, addressed envelope and information about how to reach you.
Become the expert on your body. Let your doctor know of any changes in symptoms or side effects of medication. If changes are significant, DON’T wait for the next visit. CALL!
What are your goals for this visit in order of importance?
You may not have enough time to address all of your questions during your appointment, so make sure to ask about most important issues first. It's also important to sense if you are becoming overwhelmed with too much information at once. Work out an agreement with your doctor to address remaining questions or concerns in a way that works for both of you.
HOW TO LISTEN WHEN YOUR DOCTOR TALKS
WHAT MAKES IT DIFFICULT?
Going to the doctor when you even suspect that something might be wrong provokes anxiety for most of us. Visiting your doctor for a diagnosis or to manage a life-threatening or chronic illness can be even more stressful. Information provided by your physician may involve unfamiliar language or inundated with too many details.
Your feelings about what the doctor says may make it difficult to focus and remember what he or she says about your condition. The surprise and shock of a new diagnosis, or feeling intimidated, afraid, embarrassed or forgetful can confuse your thinking. If you are in pain or tired, you are not likely to be functioning at your best. Here are some suggestions to help:
BRING AN ADVOCATE
Bring someone with you to your appointments – a family member, neighbor or friend – to serve as a second pair of ears. If you're comfortable doing so, empower them to ask questions on your behalf, to confirm that you understand all that’s being said, to take notes, check the spelling of new words, etc.
It does not need to be the same person all the time. In fact, it may be good to have a team of two or three people who can go to different appointments, making it more likely that someone you trust will be available. At any rate, you'll find you receive and retain more information if you have support during your doctors’ visits.
RECORD THE SESSION
Consider bringing a smart phone or digital recorder to the appointment. Let your doctor know that you wish to record the session so you can listen to it fully later and won’t need to take notes. This can help reduce anxiety and confusion, and allows you to be fully present during the meeting. It's also a great way to share the visit with a partner, friend or caregiver who might be unable to attend the appointment with you.
You have the right to remain silent, but don't! Communication is a two-way street that starts with you. You have the right to understand your diagnosis, symptoms, tests, procedures and all the risks and options. Your doctor has the responsibility of treating you with respect.
Being part of a team requires trust and open communication. Voice your ideas and raise questions as soon as you think of them.
Talking about feelings
If you find emotions interfering with your ability to speak or listen, tell the doctor how you feel. Just expressing your feelings can take some of the punch out of it. Ask for a moment to compose yourself. Breathe.
Talking about pain
Mention where it hurts, intensity, what makes it better or worse, description (tingly, achy, knife-like), medications used, and most importantly, the impact on your daily functioning. Decide on your pain management goals. "I need better pain control" could mean completely pain-free (but possibly sleepy) or it could mean enough pain control to be able to play with your grandchildren, work 20 hours a week or sleep comfortably. You and your doctor need to be working toward the same goals.
Talking about tests
Discuss the reason for the procedure, how you will be tested, what you need to do to prepare, how much, if any, pain to is involved, when to expect results, test accuracy and insurance coverage. Test results are written in medical-ese. Ask your doctor to explain the wording in simple terms. Don't settle for a glossing over such as "that's nothing to worry about."
Talking about medication
Ask about the medication's purpose, how to take it (with food, time of day, when to stop), adverse effects, interactions with other medications, when it should take effect.
Just as "straighten your room" has a different meaning for parents and teens, failure to clarify medical directions may result in different expectations for you and your physician. Ask: How will this help me? What will happen if I don't do this? When you say to increase activity, what kind and how often? What do you mean by "come back if not better"? When and how much better?
Don't assume that your test results are normal just because you haven't received a call. Ask specifically. If you learn best by seeing or reading rather than hearing information, ask your doctor to draw a diagram or give you a brochure. Ask him/her to slow down and confirm details. Repeat the instructions to make sure that you understood them correctly.
BECOME THE CAPTAIN OF YOUR TEAM
As the patient, YOU are the one having a unique experience of your illness. What is most difficult for you will depend on your family situation, support system, locus of control and other factors.
To captain your team does not mean doing everything for yourself. It does mean that you can:
- Be honest with yourself and assess your personality strengths and struggles. Some of us are good at speaking up for ourselves, feel better when we are in charge and can separate logic from emotion when needed. Others would rather leave decisions to the experts, and feel overwhelmed by information and decisions. Whatever your style, you CAN captain your own team. You get to decide from whom and what kind of help you want – do what makes you feel good, strong and supported, and delegate the rest as best you can. The magic word here is DELEGATE.
- Decide the kind of relationship you want with your doctor and make sure you articulate your wishes.
- Remember that "doctors will get off their pedestals when patients get off their knees."
What you CAN do about your illness is to choose how you cope with it. And remember, you do not have to do this alone.
© 2006-2016 by Lynn Rogers. All rights reserved. You may reprint this article to share in any noncommercial use.