A Partner in Your Medical Care
Have you ever left the office after a doctors appointment feeling frustrated? If so, you are not alone. It’s often very difficult to feel “in charge” when you are partially disrobed, sitting on an exam table in a sterile room, and waiting for 20 or 30 minutes (or more) to see the doctor. By the time the exam takes place, your anxiety levels have increased 
considerably. The bottom line is, the time you spend with the doctor may not be satisfactory. This article is designed to help you understand what goes on behind the scenes, and also to help you get the most out of the time you have with your doctor.
To understand how to get the most out of your time (and the doctor’s) is to accept that medicine is “an art as well as a science.” Dr. Therese Southgate, Senior Contributing Editor of JAMA, explains it this way, “Medicine is itself an art. It is an art of doing, and if that is so, it must employ the finest tools available — not just the finest in science and technology, but the finest in the knowledge, skills, and character of the physician.” That is why the information you bring and your communication with the doctor is so essential. You become part of the medical team during your appointment, and you need to take charge of your role.
Before we talk about your part, it is helpful to understand what goes on “behind the scenes.” Most physicians’ offices schedule appointments at certain intervals, and leave some open time for unplanned appointments. When you call in about your problem, the intake person attempts to discern whether or not the symptoms you describe constitute an emergency. If so, you take up one of those spots as they try to fit you into a schedule that is generally very busy. Unfortunately, there is no way to predict how many people may call in that day, or if a scheduled appointment takes longer than the time slot. This is the reason appointments do not always run on time. In any case, there is little you can do to change it, so plan for the wait by taking in good reading material (like this magazine) to pass the time.
Now, for your role: Prepare ahead of time. It’s generally a good idea to write out all your questions and symptoms, as it is easy to forget. Remember to be as clear and concise as possible. You want to convey the essence of your problem, and you generally have a short time to do so. Describe your symptoms, including pertinent details such as frequency, duration, and degree. Make sure your description addresses the following questions:
• When did the symptoms start?
• How often do you experience them? (constant, once a day, etc.)
• How long do the symptoms last?
• Are the symptoms getting better or worse?
• Does anything seem to make it better or worse? (i.e., “It seems to get worse after eating,” or “Lying down makes the symptoms improve.”)
• Do the symptoms affect your daily activities? If so, how?
• Has anything changed in your life that might affect your health? (Job status, sleep patterns, emotional stress, etc.)
• Have you seen another doctor?
• Have you tried any medications to alleviate the symptoms? (If so, list them)
Additionally, bring a list of any other medications you are taking (prescription and over-the-counter.) Include the dosage and prescribing physician’s name and number. (It’s also a good practice to maintain your own personal health records, and bring them with you to the appointment.)
Now you are prepared to have a conversation with your doctor. Take notes when the doctor starts to talk, or if you find it’s difficult to take notes during your visit, write the pertinent information down as soon as you leave the office. Understanding your doctor’s responses is essential to good communication. Ask questions if you don’t understand. For example:
• “Can you tell me more about that procedure?”
• Or paraphrase: “So, you’re saying I shouldn’t drink alcohol when I take this medication. Is that correct?”
• “About my treatment . . . how long it will last?”
• “How long should I wait to call you back if I don’t improve?”
• “What are the benefits? What are the risks?”
• “Should I avoid any foods or activities while on this medication?”
• Finally, ask if he/she has any printed material about this topic for you. It’s also helpful to research topics and terms on a reliable website.
This approach creates a partnership with your doctor. Remember, you are an active participant and “in charge” of your health! Your role is to help the doctor focus his/her time on the exam, and ruling in or ruling out a diagnosis. That is the art.
Tara O’Connor LaRose, RN, CCM is a licensed RN and Certified Care Manager, facilitating and optimizing patient interactions with medical professionals for over 25 years. She is the CEO of Age Navigation, offering guidance and support to families coping with the care of their older loved ones.
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