If you’re an experienced user of the American healthcare system, please share your tips for getting good results out of your doctor visits.
Background: I’m currently experiencing my first significant medical problem and finding it very difficult to get it resolved. Because I’ve been healthy most of my life, I haven’t had much contact with doctors. As a result, I’ve had some misunderstandings and made some mistakes. I hope to hear from people more experienced than I am, so that I don’t have to learn everything the hard way!
What have you learned from your experiences with doctors that you wish you had known ahead of time?
When describing symptoms and concerns, get right to the point.
Studies have shown that after about 30 seconds of listening, doctors’ attention shifts away from hearing what’s still being said and towards dealing with what’s already been said. A long “from the beginning” story with all possibly relevant details could be counterproductive as its most important elements may not be recognized. Start with the essentials, and fill in history and details as called for.
If your problem is straightforword–i.e. your specific symptom complex is easily summarized in a few sentences–be able to summarize without rambling. Be able to cut to the chase.
This: “I get a vague nausea and some fluttering in my chest, especially if I am lifting something heavy and have to hold it a while”
Not this: “My supervisor decided our assembly line was too inefficient so they took some of the people and reassigned them to the cutter area. One of the guys they reassigned was a big burly ex-NFL guy and because he was also a lifter, he’s the guy that used to grab the carcasses and transfer them to the stripping table…well, anyone once he wasn’t there anymore somebody else had to be assigned to transfer the carcasses, and because I didn’t have any seniority it became my job… blah blah blah…” (with the potentially significant and relevant part of the story completely lost in the noise of detail).
Have your medicines and any relevant past history written down on a piece of paper.
Don’t floof your symptoms in the hope the doctor will take you more seriously.
Ask clarification questions but don’t expect to be taught medicine. Find out what the basic working diagnosis might be or what the purpose of any tests are, and educate yourself on your own time around the specifics. Don’t spend a lot of time in the office with “What if?” questions because it wastes time talking about a permutation which may not come to pass.
If you can be an efficient patient you’ll get more time with your doctor, and that’s the number one complaint of patients–not enough time spent. She’ll trust you to have a conversation with her. If you exaggerate or ramble, your doctor will find a reason to be busy elsewhere.
One thing I don’t do enough is document what my issue is. When did the symptom start? Do I notice it getting worse at particular times? Has this every happened before? When, exactly?
That’d be my advice. And write it down so you have it handy.
I need to puzzle all that out beforehand and know the answers, and not sit there being vague and unsure when I get the doc in the room. My son had a whole cluster of symptoms that never got treated adequately because we weren’t methodical about simple stuff like this. Finally we lucked out when I happened to mention something that clicked for my doc, and boom, we got almost everything resolved with dietary change. I think we could have fixed it all a lot sooner if I had been more methodical about keeping track of symptoms and the like.
I have a notebook - First page is a precis of my medical history - operations, dates and who my current doctors are, and a list of my current meds with dosing.
Next page is a list of why I am there - symptoms, commentary [when I do this it splorts green but if I drink water it splorts yellow … you know, your problems] Make sure it is complete. Even if it is a silly tiny problem [I always get up at 245 am to Piss, if it is something you didnt do previously] get fairly detailed. I have a series of pages, each for a previous existing condition. On my current page, I may comment that I have been having x symptom, but it is worse/better now.
Being normally healthy, it should be simple to write down everything that is now not normal for you …
I have [with the damned Navy docs] had the habit of printing out a second sheet and handing it over to the idiot. I hate the whole 'but you never mentioned this issue … Why yes I did, SEE it on that there page <thwack>
Make a page of any and all questions you might have [why am I splorting green and yellow?] and copy the doctor on it. Make sure he answers all your issues before you let him escape…
Another voice from the “medical provider” end of things (IANAD/N but I do work with patients involved in medical research studies, and am pretty indistinguishable from our nurses/techs in the clinic):
When you write up a list of past medical history/medications/etc., please be complete. Also, if you’re telling them to a nurse/assistant, don’t save the “important” or “embarrassing” stuff for the doctor. I don’t mean write every cold you’ve had; I mean don’t leave out important medical conditions, even if they’re under control and you’re doing fine on current treatment. This happens a lot. I asked a new study subject this morning about his medical history and medical conditions, and he dutifully told me about his arthritis, his joint replacements, etc. Then I asked about his medications, and he handed me a list of drugs that I recognized as high blood pressure and diabetes treatments. When I pointed this out to him, I got a “oh yeah”-type realization look from him.
I mentioned this to one of our clinic techs, and she said recently she was going through a medical history, medication list, etc., with a new patient. She prodded a couple times to be sure this was complete, then left the patient for the doctor to see. The doctor came out after the exam and asked why she hadn’t recorded that the patient was HIV-positive. :smack: Because the patient didn’t tell her, and specifically denied that there was anything else wrong, only to offer up that information to the doctor later when the doctor noticed something wrong where HIV is a potential contributing factor to that problem.
I know that the level of professionalism varies, but please trust your healthcare providers with info that you may find embarrassing. I assure you, we’ve heard and seen worse. It’s important to be honest.
Also, your medication list should not just include daily medications - if you’ve taken anything very recently (say during or right before the onset of symptoms), note that too. A list below it of any dietary supplements may be useful information.
Make a list of your questions. I’ve noticed that even an impatient-seeming doctor will make sure that you’ve had a chance to ask all your questions if they’re written on a piece of paper that you’re holding in your hand.
And, like others have said–be efficient and get to the point.
If you have the option given your insurance and your situation, don’t be afraid to fire your doctor. Your doctor is providing a service to you, just like a car mechanic or a restaurant owner or a gardener. If you are unhappy with the service, find a new provider. Doctors vary widely in quality of care just like other professions, so don’t be afraid to cut ties and find one you trust and can have a good relationship with.
That doesn’t mean go somewhere else if your doctor doesn’t give you all of the pain pills you want (but probably don’t need), or tells you to lose weight when you weren’t quite ready to hear that. It just means that hopefully you are in a situation where you have some choices, and don’t think you are locked in to one person.
I type my medicines and allergies and various bits that I think are important. In fact, I have a “medical” file on my computer that I update when my medicine changes, or I become allergic to yet another antibiotic (I’m allergic to FIVE antibiotics now, lucky me). I print out this file for each new doctor, in larger than normal font. I make two copies of the list of problems, one for me, one for the doc. I guess that a handwritten list would be better than nothing, but I like being able to hand over a list of what I take, how much of it, and when, in a clearly printed page or two.
I’ve had to go to the ER a few times, and I’ve always had enough time to print out (or have my husband print out) the medical file. A good thing, too, because usually they want to give me antibiotics, and when I’m sick enough to go to the ER, I’m usually too sick to remember the ones I’m allergic to.
Be an active, involved, observant patient. Know what drugs you take, and how much and how often. “Blood pressure pills” is not much help to someone taking a medical history or trying to check for drug interactions. If at all possible, actually bag up your medicine bottles and take them with you.
Keep track of your symptoms. If they seem better or worse at certain times or after certain things, mention that to your doctor. How symptoms react to various stimuli can be an important diagnostic tool. And be specific about them. Don’t say you have a cough or something hurts. Be able to describe what kind of cough or pain, because they indicate different problems. For the love of Og, know how long you’ve had the various symptoms.
And have your medical records transferred if it’s at all physically possible. If you’ve had tests or previous treatments, your new doctor needs to know what you had done and what the results were. Otherwise, you’re kind of wasting everybody’s time. And your money.
Best way I’ve found to deal with doctors: Have a medical degree yourself. Preferably from a better school than your doctor went to. This will encourage them to want to prove that their clinical skills are just as good as yours.
If that’s not practical, I second Chief’s recommendations.
And don’t have a hidden agenda. Be clear and up front with your concerns.
Three words: write shit down. Organize your thoughts. Detail your medical history. List your meds (better yet, bring them). It keeps you on track. Give this to your doctor to keep–he’ll be grateful when he goes to dictate your note.
Try to summarize your problem in one sentence, and lead with that. You’ll have a chance to tell the whole story and give more details, but you want to set the tone. This is how we write our reports–they start with a one-line “Chief Complaint” and then go on to a “History of Present Illness”.
If you have old pertinent medical records–particularly if you’ve seen other doctors for the same problem–arrange for those records to be sent in advance. You can bring the records with you if you want, but try to make it a copy the doctor can keep.
If tests are being ordered, talk with the doctor (or, preferably, his nurse) about how you’ll be informed of results. Will he call you one way or the other? Or just with abnormal results? Will the doc want to wait until your follow-up visit?
Above all, don’t expect that the doctor will be able to fix your problem, or even figure out what it is, in a single visit. This is especially true if the problem has been going on for a long time. And prepare for the possibility that the doctor may just not be able to figure it out at all. It doesn’t mean he’s a bad doctor, and it doesn’t mean there’s nothing wrong with you; we just have our limits.
This is an excellent suggestion which is also appropriately applied to the information which you receive from your health-care professional. For instance, if or when a treatment plan is developed, there a number of studies that demonstrate that written instructions and plain-English dosing information is far superior to trying to memorize complex care plans or information via simply remembering it the first time through, even if the health care provider asks the patient to repeat or parrot back their understanding of the information.
Do your homework; understanding symptoms, diseases, and treatments as best you can going in will serve you better than sitting down and saying ‘here I am, fix me.’
Drama-ing up the situation in order to get a more satisfying response, will not get you a more satisfying response.
Thanks for all the great suggestions. This is very helpful.
I’m the type to write everything down. I even have a spreadsheet for keeping track of my symptoms. I had thought of bringing a written summary of my problem, but decided against it for fear that it would make me seem too high-maintenance, I guess. After reading your suggestions, I think I will bring it after all. Thanks, everyone.
