Appointment Prep
It’s a brave new world when it comes to medical technology, treatments and terminology. But when you are meeting with your physician, it is still a matter of trust and clear communication. Two USC physicians give you a Top 10 list for getting the most out of your doctor visits.
by Bob Barnett
We are no longer patients, we are medical consumers. We navigate complicated health plans and coverage, deal with HMO gatekeepers, work our way through confusing paperwork and watch TV ads promoting prescription medications. One thing has not changed: the overwhelming importance of a medical appointment—and making the most of it.
“It’s still two people in a room talking,” points out John Brodhead, M.D., associate professor of internal medicine at the Keck School of Medicine of USC.
It still starts with trust. “It’s what allows us to go to a stranger, take our clothes off, and tell our most intimate secrets. That hasn’t changed,” says David Goldstein, M.D., Keck School chief of geriatric and general internal medicine and vice chair for clinical affairs.
What has changed is the nature of the relationship between patient and physician. “It used to be paternalistic,” says Goldstein. “Now it’s more like a partnership.”
Like every successful partnership, both sides have to bring something to the table to get the most out of it. As a patient, here are 10 points to keep in mind the next time you step into an examining room:
1. Be clear why you are there.
Physicians are not mind readers. Know why you are there and tell the doctor. “Is it to set up a relationship?” Brodhead observes. “Is it a referral? A second opinion? It makes a big difference if patient and physician have the same expectations. Doctors are under a tremendous time pressure. You want to make the most of the time you have with them.”
2. Candor first, candor always.
“You need to be open and candid about medical problems, behavior, and how you relate to medical care,” insists Goldstein. “It’s about truth-telling. There has to be an acceptance that your physician is going to treat you and your medical condition appropriately.” In other words, the more your physician knows, the better the care that can be provided.
3. Organize your concerns.
“Write down your questions and issues,” advises Brodhead. “You don’t want to slap your forehead on the way home, ‘I should have asked…’” Also prioritize your questions.” Goldstein adds, “As your doctor, I may not be able to get to all of your concerns on a long list, but I might say, ‘Let’s cover the top six.’ We’ll get to the rest the next time.”
4. Bring questions, not printouts.
Both Brodhead and Goldstein agree that the Internet has increased patients’ medical knowledge. “It can be counterproductive,” says Brodhead, “when a patient comes in with a whole stack of printed articles.” Goldstein concurs, “I advise patients that bringing in their questions is more effective than bringing in printouts.”
5. Bring all your medications, every time.
“Bring all your medications, from all your physicians,” stresses Brodhead. “Bring them with you every time,” adds Goldstein, “even if it’s only been two weeks since your last appointment.” This helps you and your physician guard against possible and future harmful interactions.
6. Ask, ask, ask.
“It is usually difficult to remember the answers to all of your questions,” Goldstein says. “Bring a pad and write down what the doctor says, particularly if the diagnosis is emotionally difficult to deal with. Then you can look over the notes later on to make sure you understand everything that was said.” Repeat back what the doctor has told you in your own words to make sure you understood what was said. If the patient is young or old, bring a family member or close friend to assist. If there is a language or cultural barrier, bring someone to interpret or provide advocacy and support.
7. Get a second opinion.
Never be afraid to ask for a second opinion. “It’s putting the patient first,” Brodhead points out. “If it confirms the initial diagnosis, it buttresses faith and trust in the doctor. If it doesn’t, it’s in the patient’s best interest to find out.”
8. Go over your treatment plan.
Make sure you understand what your treatment plan entails: medications, when they are to be taken, potential complications, changes in diet or activity. Again, take notes so you can refer to them once you get home. “I always advise patients that we summarize what we’ve discussed,” says Goldstein, “and I ask one last time, ‘Do you have any questions?’”
9. If your treatment plan is not working, let your doctor know.
“Doctors assume a treatment plan is working unless they hear otherwise,” counsels Brodhead. And if it isn’t…
10. Pick up the phone, if there is a problem.
E-mail may be today’s mode of communication, but if you are having a medical complication, call your doctor. Many physicians only review their e-mail at the end of day or first thing next morning. If you think you have got a medical emergency, it could be too late by the time they check their messages.
For more great articles go to http://www.usc.edu/hsc/healthnow/