Be a Better Patient: What Your Doctor Recommends When You Visit

Your relationship with your doctor is one of the most important you have. Still, visiting the doctor can often be kind of a hassle. There's a lot of information to process, protocols and insurance to deal with, and let's face it: if you're spending time at the doctor's office, you're not always at your best. Here's what a doctor advises to help things go their smoothest.

I talked to Dr. William English, a primary care physician practicing in Northern Alabama, and Lue English, who managed a multiple-doctor practice for many years, about how patients can be more organized and efficient when it comes time to visit the doctor. It's about more than just organization and productivity, though. Better communications with your doctor (and their staff) means better outcomes for you.

Start Off Right when Scheduling Your Visit


Your first opportunity for a good visit to the doctor comes when you schedule your appointment. Taking the time to talk to the staff about your visit helps ensure that they schedule enough time and can take care of anything that needs taking care of before the visit happens.

Here are the things you'll want to consider when scheduling:



Prescription refills. Let the office know if you'll be needing refills of any prescriptions so that they can make time for that to happen. If you're running out of any medicines (or will before the visit), they need to know that too. For some medications, they may be willing to give you a small prescription to carry you over until your visit. This may not be true if it's your first time visiting a new doctor, but it's still important they have the information. Prescriptions for controlled medications will be considered a special case and likely require a visit (or even multiple visits) and some background information.

Number of concerns. It's best to let the staff know what you need to see the doctor for so that they can schedule the right amount of time for your appointment. Dr. English suggests: "If, for whatever reason, you're uncomfortable listing your concerns, at the very least let them know how many things you need to talk to your doctor about."

Special needs. If you have any special needs, let them know. This includes special medical needs (such as wheelchair access) or interpretive needs. If you're hearing-impaired, they will need time to arrange for an interpreter. If English is not your primary language and you need a translator, they may be able to provide one. If not, you'll need to arrange to bring your own along with you. A friend or family member that you trust will work just fine.

Office policies. Find out what policies the office has in place for missed or rescheduled appointments. Most offices will charge you if you miss an appointment or don't give them a full day's notice before canceling. Also check into their prescription refill policy. Different offices require different amounts of time and some charge a fee if the refills happen outside an office visit.

Excuses. Let them know when you make the appointment if you'll need a work or school excuse. Most offices can do this when you check out after the visit, but it can make things go a little smoother if you do it during scheduling.

Advance appointments. If you have a new and somewhat urgent issue come up, you can usually get a quick appointment or just show up at the office for a walk-in visit. But this can mean long wait times, since they have to work your visit with the doctor into an already-packed schedule. When you can, try to make your appointments at least a couple of weeks in advance, or even longer if it's your first visit with a new doctor.

Multiple appointments. Depending on what you're seeing the doctor for, you may require multiple
appointments.

According to Dr. English:
" Understand that you may need multiple appointments if you have a long list of concerns. Scheduling a large block of time for an appointment can mean having to schedule a month or more in advance. If you have urgent concerns, let the staff know. They can probably schedule a shorter visit sooner and then a longer visit later.

If we need blood or other labwork done, we may need to schedule that before your actual appointment, as well. Whatever you do, don't schedule a short visit with a single concern when you really intend to talk to the doctor about multiple issues. We call those "Oh, by the way" visits. They throw off the doctor's schedule but, more importantly, you may end up not getting the time you need to have your all your concerns addressed. "

On a similar note, if you have somebody else (like a child) that needs to see the doctor, schedule a separate visit and don't try to slip it in during your visit. With some advance notice, you can schedule back-to-back appointments.

Lue English was also kind enough to provide a few scheduling tips you may be able to take advantage of:

• " For the shortest wait times, try to schedule your visit in the first slot in the morning or the first slot after lunch. At most private offices, doctors try to clear their morning schedule before their lunch break.
• Also avoid Mondays and Fridays if you can. Those are the days people are most likely to take off work (or take their kids out of school) for an appointment. Mondays are also bad because we see a lot of walk-in patients who had something start over the weekend, but didn't want to waste a weekend day at the ER.
• Avoid the first few days after a major holiday. Those are some of our busiest days of the year.
• Believe it or not, at walk-in clinics, especially during busy times like flu season, you may get seen faster if you come in for a late afternoon appointment. Docs are keen on getting through afternoon appointments quickly so they can get home. This one is kind of hit-or-miss, though. "

Now that you've scheduled your visit with your friendly physician, it's time to get organized.

Get Organized Before Your Visit

Almost every time you go to the doctor, they ask you to fill out a medical history and a complaint form. This is especially true for an establishment, or first-time, visit. These forms include the basics, like your contact information, but also ask for information you may not know off the top of your head.

It pays to do a little research first. Lue English recommends the following:

" The history form especially is going to ask for some information you may not know. You're likely to be asked for:
Doctors. The names, addresses, and phone numbers of your other doctors. If you don't already have it, a quick Google search is all you need.

Hospitalizations. The dates and reasons you've been in the hospital or had out-patient procedures performed. You don't have to go into a lot of detail unless it's pertinent to your visit or there were complications you want to talk about. It's enough to say something like "Appendix removed. 1982. No complications."

Diagnoses. They'll also want to know your previous diagnoses. There may be a checklist or there may not. Either way, do a little research so you can answer this stuff quickly.

Family history. Get your family history sorted. What they are looking for is whether family members (usually mother/father, grandmother/grandfather, children, and siblings) suffer from (or died from) particular diseases like diabetes, cancer, and so on. It also helps to know what age they were when they were first diagnosed or when they died."

In addition to preparing information for filling out your history, there some other things you should know before your visit (or plan to bring with you). Your doctor is likely to ask you for a lot of this, but there's so much information flying around in most visits that it's easy for things to get overlooked:

Write down your concerns. Make a written (or printed) list of anything you need to talk to your doctor about. Be sure to leave space to write down any answers and advice you get. And make an extra copy for your doctor. Lue English suggests some things to include: when did the problem start, does it come and go, how severe does it get, and what makes it better or worse.

Bring your data. If you've been monitoring anything at home, like your blood pressure, bring your records in with you. If you use a monitoring device like a blood pressure cuff, you may want to bring that with you, too. It can be helpful to see whether your equipment agrees with the equipment at your doctor's office.

Know your insurance policy. You should understand what's covered and what's not. Even if you haven't made time to read the giant manual they sent you, at least familiarize yourself with basic information like your co-pay amount and deductibles. Also make sure your doctor accepts your insurance or is included in the list of approved providers from your HMO.

Bring your prescriptions. The history form you're given when you visit will include space for you to list your prescriptions, but it can be hard to remember exactly what you're taking and how much.

In fact, Dr. English goes as far as to say:
" If there's one piece of advice I could give to patients to make office visits go smoother, it would be this: Take all of your medications to every doctor visit.
Get a big plastic Zip-Loc bag and put your actual prescription bottles in there—every medication from every doctor you see. Bring in supplements and over-the-counter (OTC) meds, too. There's so much information on those bottles (the drug, the prescribing physician, dosage, frequency, the amount of medication you have left) that it's almost impossible for people to remember everything accurately when they're filling out their history—especially if you're taking more than just a couple of prescriptions. That one thing would make visits so much easier and prevent so many complications. "

Information from other doctors. If you're seeing other doctors and have information they've provided, bring it along. Doctors can always request what they need directly from other offices, but that takes time.
Says Dr. English:

" It's important for doctors to communicate when they share in a patient's care. If I'm taking over your care from another doc, I may need a transfer of your records. I can initiate that during our first visit by having you sign a HIPAA agreement, so you don't really need to try getting all your records on your own. But, if you're seeing specialists, your previous doctor may not send some of the communications along to me because he considers those notes part of the specialist's record. That's why it's important to let me know what specialists you're seeing so that we can get communication established.
Also, remember that as a patient, it's perfectly reasonable to ask for a copy of any of your records if you want them. You have the right to that information."

It's a lot to consider, but bringing these items along can really help. The doctor may or may not want to see all the stuff you bring, but it makes things easier if you've got the information when it's needed.

Make the Most of Your Visit
While taking some time to get prepared is important, the actual visit with your doctor is the time you get to really establish your relationship and address your concerns. Depending on the nature of your visit, it can be an anxious time, but even for routine visits there are things you can do to make it a more effective encounter.



Bring someone you trust
Having someone with you can take a lot of pressure off, especially if you're facing bad news, a complicated diagnosis, or even if you just get flustered around doctors. Whether it's your partner, a family member, or a trusted friend, they can offer support as well as a second set of eyes and ears.

Lue English advises:
" Medical conversations can get complicated. There is a lot of information being exchanged. You have to talk about what's going on, remember when things started, think about environmental cues. It really helps to have someone else in the room that's been with you."
And let's face it. Many people are simply not reliable reporters. People get nervous. Sometimes they don't understand what their doctor is saying and are too embarrassed to ask for clarification. And sometimes people understand, but don't really attend in a way that helps them remember. Record things for yourself, sure. But having a friend in the room is invaluable when it comes to remembering and interpreting the conversation "

Ask for clarifications
If you miss something or don't understand something, speak up during your visit. You may be tempted to let things go, thinking you can look them up later. Or you may be embarrassed about not understanding advice, knowing how something works, or remembering something your doctor has said to you on a previous visit. But there's just no place for that when it comes to your health. Speak up!

Make a record
Use that concerns sheet you printed to record your doctor's advice. You are simply not going to remember everything. Your doctor may give you a summary report of the visit, but even that isn't the best record of the visit.

Dr. English notes:
" I was taught a general rule early on that you can't expect a patient to remember more than three things. In my experience, that's held true. It's especially true if you're anticipating or receiving bad news. If I tell a patient their diagnosis is something awful, that's the only thing they are going to hear for the rest of the visit. It's why many doctors request that you bring someone else along when they have to deliver that kind of news"

Be truthful
Let your doctor know everything that's going on with you. If you smoke, drink, use drugs, or engage in other risky behaviors. let them know. Remember that your conversation is private and privileged. If you haven't been good about remembering your medication, let them know. It is vital to your health for your doctor to be fully aware of anything medical related.

On the subject of mistakes, truthfulness, and not following advice, Dr. English elaborated:
" We are partners. I will make errors and I expect to be corrected. Sometimes I'll fail to communicate something to you properly. I appreciate it when you stop me and ask for clarification. It is so much easier to clear up miscommunications in the moment instead of trying to clear them up down the road when they've caused problems.
I also expect to be disagreed with. You've hired me for my opinion. My job is to give it. If you disagree with my opinion, it's my obligation to clarify what that disagreement is.
But please remember that it's important I know what medical decisions you have made. If you decide to not follow my advice, I need to know that. If it's important, we'll talk about what we can do to alleviate your concerns. But in all honesty, if I think it's a matter of life and death, I may feel obligated to let you go as my patient so that you can get the help you need elsewhere. "

Your relationship with your doctor is an important one, so here's a parting word of advice. Make the effort to get it right. If you're uncomfortable with your doctor, for whatever reason, know that you're not stuck in that relationship. There are as many different styles of providing care as there are doctors providing that care. Perhaps you like your information straight and to the point or perhaps you like a little more hand-holding. Whatever the case, you deserve a doctor that you get along with, that listens to what you have to say, and that isn't afraid to show you a little tough love when you need it.

Yes, it's a lot to think about, but as with anything important in your life, getting organized when it comes to your healthcare really pays off.

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