You arrive at your scheduled appointment with a list of things you’d like to talk about. You spot your doctor dashing from room to room as you study the clock wondering how long you will be waiting this time. You glance at a sign pasted next to the administrative assignment: ‘Only one issue will be discussed per visit. Thank you in advanced.’ You sit down and begin to fiddle with your phone. 5 minutes goes by. 15 minutes. Where is this person? 20 minutes goes by. When your name finally gets called you feel frustrated, tired, and irritated. And the appointment hasn’t even started yet. Sound familiar? How will you get all your concerns addressed? How can you explain them while maintaining your sanity? Straight from the horse’s mouth, here’s some thoughts on how to make the most out of your time with your doctor:
Come prepared with an up-to-date list of medications.
I’m not a betting woman, but if I were I would place money on your doctor asking for a list or clarifying the medications they already have documented in your chart. Write them down in advanced or take a picture of them with your phone. This simple act will save you both from having to guess the names of the little blue or white pills you’re taking. Don’t forget to include any vitamins, herbal remedies, or over-the-counter medications!
Have a game plan.
Typically people don’t show up to their doctor’s purely for social enjoyment. What is it that’s been bothering you? Do you have multiple complaints? Which are the most pressing? If your doctor isn’t able to get to them all in one visit, are there any which can be followed up in the next week or month? You don’t need a medical degree to know what’s been troubling you the most. Let your gut be your guide and we’ll help you take care of the rest.
Think like a doctor.
I’ll let you in on a little secret. In medical school, we are taught a basic approach to characterizing complaints. You can improve the efficiency of your appointment by reflecting on some of these points even before seeing your physician. Let’s take knee pain for example. Things you can expect to get asked are: Onset (When did the knee pain begin?), Palliating and provoking factors (Is there anything that makes the knee pain better? Anything that makes it worse?) Quality (What type of pain is it? Throbbing? Stabbing? Burning?) Radiation (Does it spread anywhere?) Severity (How bad is the pain?) Time (When is the pain the worst? At night? When you wake up? Has the pain changed over time?). Put it altogether and here is how I might respond to my doctor when asked what brings me into the clinic today: “Well, I seem to be having this pain in my right knee which started yesterday after a bike ride. Walking on the knee makes it a lot worse, while staying off it makes it a little better. I feel like the back of my knee is throbbing and it’s only gotten worse. The pain doesn’t spread anywhere“. This format doesn’t give your doctor all the answers, but it does give them a great foundation to figure out what’s going on.
Be your own health advocate but maybe leave Dr. Google at home.
It is incredible the wealth of information online for us to learn more about different health problems and treatments available. You can plug a symptom in on Google and within seconds have a differential diagnosis of 100+ medical conditions. I think the internet can be an empowering education tool for patients and physicians alike; however, it can also be overwhelming and create trust and communication barriers between both parties. Patients can feel frustrated that physicians aren’t taking their concerns that they have X disease seriously; physicians feel irritated that patients are self-diagnosing. How can we work through this? Here’s what I think – If you want to do some of your own research – go for it. Try to avoid websites based on other individuals’ personal testimonials and instead search for resources that are based on more reports. Your doctor should be able to recommend some resources if you are having difficulty finding some. If you choose to do your own research, try to avoid using diagnoses when asking for assistance with symptoms. That being said, it is perfectly reasonable to discuss what your particular concerns are after your symptoms have been appropriately characterized. For example: Instead of telling your doctor that you have Guillain-Barre Syndrome, maybe say that you are concerned that the increasing numbness and weakness in both of your feet could be related to Guillain-Barre.
Know your learning style.
Some people can remember ever detail of a conversation just by listening to it. Some people are more visual and need things written down. Try to reflect on how you absorb information best and advocate on your behalf. If your doctor is rattling on and on about atherosclerosis and you know you are a visual person, ask if they can draw you a picture or direct you to some print resources. Depending on your physician’s learning style, they might not have considered that you might benefit from a different teaching aid.
Keep an open mind.
I can be an inpatient person. When I show up to an appointment, typically my expectation is that I will be seen around that time (or why bother scheduling appointments at all?!). I used to become really edgy and crusty while waiting for physicians – can anyone else relate? However, since starting to practice medicine, I have developed a little more empathy. Undoubtedly, there are some physicians who are better than others at managing their time. They are a conversation for another day. For the majority of physicians who are usually endeavour to keep to their schedule – the universal fact is that things happen. People are unexpectedly unwell/in crisis and as a physician you are obligated to respond. When these unexpected “bumps” happen (and boy do they happen), they typically take up a fair bit of time. Am I suggesting that you should be all “sunshine and roses” with your physician who is consistently four hours late? No. But for your own sanity, and that of your doctor, maybe pause to consider what events might have lead up to the delay. When I feel frustrated by the wait (frustrated is the politest descriptor I could think of), I try to have a gratitude moment – I am not the person in trouble.
Final thoughts: Communication is a two way street. Some doctors are better communicators than others. Following these steps doesn’t guarantee that you will have a productive and fulfilling appointment; however, they are guides to help you, as the patient, use your time as efficiently and effectively as possible. I hope they are helpful! Any other tips or strategies you have learned? I would love to hear them!