Optimizing your doctor visit

Going to the doctor is not the highlight of your week, and it probably never will be.  You don't want to be there.  We get it.  But there are ways to optimize your visit so that you can convey your message, receive your advice, and leave with minimal confusion.  Besides arriving on time (I know, I know...doctors run late), there are some steps to improving your visit:

1.  Be a good historian.  You have a medical issue and we are trying to diagnose it.  Before any of us ever spoke to a "real" patient, we were taught to obtain the best history possible.  While patients believe that a physical exam is the most important part of a diagnosis, most physicians agree that there is nothing as important as an accurate history.  This is the reason we ask so many questions.  Some of the most common questions are:  How long have you had this?  What have you tried for it?  Does anything make this better or worse?  Has this ever happened before?  What symptoms are associated with it (fever, chills, cough, congestion, sweating, bowel changes)?  The point is, the more information you can give us, the easier it is for us to diagnose it.  We don't need an hourly log for the past six days, but an accurate and concise description is crucial.

2.  Know your medications.  If you're taking medications, know what they are and how often you take them.  If you take a bag full of medications, bring them with you or bring an active list.  Medications and their interactions with each other can be responsible for many medical problems.  This includes over the counter medications, vitamins, supplements, herbal/natural drugs, and cultural home remedies.

3.  Read up, but don't self-diagnose.  A lot of times, a physician will ask a patient what brings them in today and the response they get is "I have bronchitis" or "I have tonsillitis."  This can bias the physician's history-taking, diagnosis, and treatment.  Report your symptoms, have your physical exam, and then ask if it can be a possible diagnosis that you read about.  Most physicians are open to discuss your ideas because in many cases, you may be very well informed of certain medical conditions and can provide valuable insight.

4.  Limit your list of chief complaints.  This one is hard to do, but it is one of the most important.  Most physician visits are limited to a 20 minute time slot.  This includes the process of having your vitals taken by the nurse, the visit, and any paperwork that needs to be done after.  Believe it or not, one chief complaint can take more than 5 minutes to address.  Something like chest pain can take longer due to the many things that can cause chest pain, the most important being heart disease.  If you have a list of 5 or 6 things to talk about, you can bet some things will be brushed off lightly due to time constraints.  If you do indeed have multiple concerns, schedule a follow-up appointment to have your needs adequately addressed.  Trust me on this one, walking in with a list of problems will lead to a disappointing visit for you both.

5.  Be patient.  Medicine is an ever-evolving art.  It does not have a cook book and it will never be mastered.  Sometimes patients and physicians alike want an answer and they want it immediately.  We live in a world of drive-thrus, delivery service, and online everything.  This doesn't work in medicine.  Many office visits are only a starting point, not the finish line.  Medicine requires testing, thinking, formulating, and sometimes guessing.  We as physicians and patients may not get our answer today, tomorrow, or ever.  A 150 years ago, Charles Darwin was trying to figure out genetics by mating pea plants.  Today we have the human genome mapped out.  Some things just take a while.

The ways in which medical care is administered has come a long way.  Long gone are the days of home visits by your neighborhood doctor.  They are replaced by double-booked office visits and self-diagnosing internet sites.  This isn't so much a problem of the patient or the physician, but more likely a product of a distressed health system.  Whether we like it or not, it is here to stay.  So the next time you visit your doctor, empower yourself and have a worthwhile visit.  Your clock starts...now.