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    Making the Most of Your Doctor’s Appointment

    Ankita Bahuva, MD Internal Medicine, Deaconess Clinic Downtown 10/10/2017

    Your doctors’ appointments are an important and valuable time to connect with your doctor, share your perspective and information, and learn from your doctor’s expertise. I really enjoy connecting with my patients and find that the best appointments happen when patients are very prepared.
    Here are some tips on how to maximize the benefit you get from your appointments.
    When Scheduling an Appointment

    Know your coverage - Before your appointment, look at your medical insurance documents to make sure the doctor you’re seeing is listed as a preferred provider by your insurance. Also find out where your plan covers lab work or imaging studies (x-ray, MRI, CT scan, etc.).

    Be specific - When you make an appointment with your primary care doctor or specialist, be clear about the purpose of the appointment. Being specific is important because different health conditions require different appointment lengths and most insurance plans have rules about what services are covered.

    For example, insurance often pays for an annual physical. However, if a patient makes an appointment for a physical, but actually has a health concern to bring to the doctor’s attention, the visit may not be listed as a physical and therefore, not covered by insurance.   

    Provide information - If you’re seeing a doctor for the first time, be sure to let the staff know where they can request your prior medical history, records, testing, etc. so the staff can get that information gathered prior to your appointment. You’ll need to give direction (doctors’ names, prior hospitals you’ve received care at, etc.) You may need to sign some forms to get records released (due to privacy laws). Your doctor’s office can help facilitate that.

    It can be helpful to your doctor and the office staff if you identify a friend or family member with whom they can share your medical information. This is especially important if there are power of attorney or health care representative documents in effect. If necessary, complete the consent form to designate another person who can receive your health information.
    Before Your Scheduled Appointment

    To truly be prepared for your doctor’s appointment, it’s important to do some homework.

    Know your medications – Create a list of all the medications you take, even over-the-counter drugs and vitamins/supplements. Also know the dosage/how much you take for each medication. Your doctor needs to know about everything you take because medications can interact, causing unpleasant and even dangerous results.

    At Deaconess, our electronic medical record tracks your medication history, but if you’ve seen a provider outside of Deaconess, or you’ve started taking over-the-counter medications or supplements, those need to be added to the list in your medical record.
    Know the details - If you are experiencing symptoms that you want to talk about with your doctor, make a log or diary prior to your appointment. These notes should include information that will help you answer questions like:
    •          When did the symptom/problem start?
    •          How often is it happening?
    •          Is there anything you’ve noticed that helps it?  Makes it worse?
    •          How have you been treating it?
    •          Is there anything else associated with the symptom or problem?
    The more you can note these types of things, the better/more quickly your doctor will be able to help make a diagnosis and identify a treatment plan.
    Know your history – Knowing family histories of cancer, heart disease, neurological issues, autoimmune problems, etc. can become helpful as we get older. I’ve often had patients tell me they don’t know anything about their family history. In some cases that information is not available but I highly recommend taking the time to ask questions and find answers to your family’s health history. Identifying diseases and conditions that have affected your family over time helps your doctor know what preventive tests may be needed.
    Know your condition - If you have a chronic condition, you should be keeping a log of relevant details, and bring that information to your appointments. For example, if you have diabetes, bring information about the food you eat and how it affects your blood sugar levels. Someone with congestive heart failure should be weighing themselves daily to monitor body fluid levels, so a record of daily weight is important.
    Know your questions – It happens all the time. A patient comes into the exam room and forgets all the questions they had thought of ahead of time. Write your questions down in a notebook or make a list on your phone so you don’t have to depend on your memory. I also recommend prioritizing your questions, as the answers to them may lead to additional questions such as medication, treatment, tests, etc.

    If you’ve been doing some of your own research about a health topic, and it’s something you think may apply to you or your health problem, bring the information with you and discuss it with your doctor. I like it when patients are informed but I need to know what is on their mind and where they are finding information. Sometimes what they read online is helpful, and sometimes it can be harmful because there are other factors involved that the patient may not have considered. 

    The Day of Your Appointment

    Be early - Arrive 15 minutes early for your appointment, and allow yourself extra travel time. Because appointments may only be 15 minutes long, arriving late can cause lots of back-ups, and sometimes your doctor may not be able to give you much time because they need to move on to other patients.
    Take a friend - When there are serious health issues to discuss, such as a cancer diagnosis/treatment, the need for heart surgery, etc. bring another person with you to the appointment. This is helpful for support, but also for hearing and understanding everything that’s being said. For older patients who may have memory problems, or anyone with hearing issues, having a friend or family member at the appointment is critical. I recommend taking notes during the appointment as well.   
    Be honest - Always be honest with your doctor. We are your partners in health, and we can’t do a good job if we don’t know what’s going on. If you are sneaking cigarettes or using illegal drugs, please tell us. If you’re not taking medicines that you’re supposed to or are taking other medications not prescribed for you, tell us that as well. We also need to know about any sexual problems or changes in sexual partners.  And if you are experiencing mental health struggles, we absolutely want to know.

    Don’t wait until the end - So often people save the biggest, most worrisome or embarrassing symptom to bring up just as the appointment is ending. It happens more than you’d think and makes the appointment less successful for both the patient and the doctor. If you have been experiencing occasional chest pains, start the appointment with that information. Don’t wait until I’m wishing you a good day and opening the door to leave. New, worsening, or concerning oms are important and should not be an afterthought.

    Repeat the information - At the end of your appointment, make sure to repeat back the information you’ve learned from your doctor. It helps your doctor to know that you understand any tests you may need, any diagnosis that’s been made, or treatments that will begin.
    Also, health care is filled with many medical terms, and even though doctors try to use “everyday language” as much as they can in discussing your care, sometimes terms or test names can be confusing, so be sure to ask for clarification on anything you may not understand.
    Planning for the Next Appointment

    Based on the information received at your doctor’s appointment, make a plan. For example, if your cholesterol is high and you want to try some lifestyle changes before taking medication, you and your doctor should come up with a reasonable and clear goal for you to try to achieve before your next appointment. Or, say a patient knows they should quit smoking--perhaps a reasonable six month goal is to cut back by half. Every patient’s goal will be different, but work with your doctor to set a health goal that is reasonable and achievable.

    Before you leave the office, know when you’re supposed to be back. Do you need to follow up in two weeks or three months? Are you scheduled for another wellness check-up in one year? As soon as an appointment is set, add it to your calendar. Reminders via phone calls or MyChart messages are usually just a few days ahead of time so write down your appointment now.

    And if something comes up and you need to reschedule your appointment, call your doctor’s office as soon as you know you need to move the appointment. Advance notice gives you a better selection of other appointment times, and it frees up the appointment for other patients who need it.

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