Are you tongue-tied when you go to the doctor?

Think about three steps...

1. What you bring to the doctor

2. What you do when there

3. What you take home

STEP 1: WHAT YOU BRING TO THE DOCTOR

I like to think of things in threes, so here goes:

1. A Shopping List
2. ALL of your current medications
3. Records

Shopping list
If you go to the store, you bring a shopping list. If you don’t, you forget some things you need, and sometimes get things you don’t want, and you can get the wrong thing. So bring a list of what you want. Some suggestions: questions, refills, forms.

Current Medication
This includes anything you take everyday. Start with your prescriptions, both from the doctor you are seeing and from other doctors. Your doctor needs to know them all. Many drugs interact. Your problem may be related to one of the other medicines. Not just pills, but inhalers, creams, and sprays can make a difference. Then, throw in any non-prescription medicine you regularly take, or take often. Think of laxatives, vitamins, herb supplements.

Records
Check when you make the appointment if there are any records from other doctors, letters, or x-rays you should bring. Bring the address of your previous doctor, especially if you are a new patient and your previous doctor is in another town. Many doctors always want to look at certain tests themselves, but some tests do not need to be brought in. The person who makes your appointment should know what your doctor prefers. Bring the information your doctor will need: what allergies you have, any medications that have caused problems. Try to have a list of any surgeries or other procedures since the last time you saw this doctor, any new events in your family medical history. 

Jane is going to a new doctor because of some chest pain. She brings:

                Her questions:

•  What is the cause of my chest pain?

•  Should I worry about it?

•  Should I take aspirin?

                Her current medications:

•  Eye drops (from the eye doctor)

•  Multivitamin

•  Ibuprofen (over the counter)

                Details about her medical history:

• Father had a heart attack when he was 42.

• I am allergic to penicillin and sulfa.

• I had a normal EKG and other labs when I had a mole removed three years ago.

• Copies of the EKG and labs.

• I don’t know my cholesterol level, but my blood sugar was okay last year.

Finally, you may want to bring a friend or family member. This way you can have some help remembering what was said. If you are shy about asking some questions, you can ask your friend to ask for you.

So bring a shopping list of questions, a shopping bag of medicines, prescriptions, and supplements, and the details of your previous medical diagnosis and treatment.

STEP 2: WHAT TO DO WHILE YOU ARE AT THE DOCTOR’S OFFICE 

Now you are in the doctor’s office, with your list of questions, your bag of medicines, and everything about your history.

What is the first thing that is going to happen? On average, the doctor interrupts you 19 seconds after you start talking. It has nothing to do with what you said, so don’t worry about it. Here are some clues about how to manage the situation so you can still get out of the meeting what you want.

Jane  has now been weighed, measured, interviewed by the nurse, and has returned to reading the two year old issue of TIME magazine, when there is a knock at the door. The doctor enters, and asks, “What can I do for you today?

1. SUMMARIZE your needs:

• I am having some chest pain,

• I would like to know if I should be worried,

• And I need some refills.

This is not the time to ask for off work forms, disability forms, or other paperwork. It is very easy to forget to complete the form while involved in evaluating the problem. If completing the form is the purpose of the visit, such as a driver’s medical evaluation, provide the form now. 

2. Depending on the specialty of the doctor and the type of problems, you can now TELL YOUR STORY. Try not to worry if you get interrupted, this is just the doctor’s way of thinking about your problem while you are telling it.
3. THE EXAM: Try not to add details during the exam unless the doctor asks you a question. It is difficult to pay attention to performing the exam and listen to you at the same time.
4. There are three tasks at the END of the visit:

• Make sure you UNDERSTAND any changes in your treatment.

• WRITE DOWN THE DIAGNOSIS or get written information from the doctor.

• Get any guidelines for return to work, return to activity, etc. and the FORMS necessary, should you require them.

5. Before leaving the office:

• If a test is necessary, find out when its results should be available and what kind of FOLLOW UP you need.

• LOOK AT YOUR PRESCRIPTIONS including the name, date, your name, and signature. Is everything there?

• Make your NEXT APPOINTMENT.

There is a reason I did not mention payment. While medical issues are consistent, payment plans vary too much to say anything meaningful.

STEP 3: WHAT YOU TAKE HOME

After you have been to the doctor, you are almost done. You may need to fill prescriptions, get tests done, or the most difficult task, change your habits.

Prescriptions:
Try to fill these at the same pharmacy as much as possible. Even if you mail away some prescriptions, let the pharmacy know you are taking them. This way, when the pharmacist fills your prescription, you get a second check for drug interactions, allergies, or other contraindications. A good local pharmacy relation can often keep your medicine stocked, remind you when you are due for a refill or a doctor’s visit, even help out when medicine might run out a few days before your appointment.

Tests:
Blood tests can take a long time or a little time, depending on whether they are performed every day, whether they need to be sent out of town, and whether the lab sends results by direct connection, fax, or mail to your physician.

X-rays, ultrasounds, and scans require interpretation of a specialist in reading these studies. Even when they are read the same day, there is a delay because the interpretation has to be typed and sent to your physician.

Other tests, like stress tests, require still other specialists to interpret. Sometimes the specialist will be there during your test. While occasionally they can give you a rough idea of the results, the final interpretation can vary if they compare your results to other studies, or have more time to look at the results closely. You should get a final interpretation sometime after the test.

Remember, the purpose of a test is to make a diagnosis, follow a condition, or identify a problem before you have symptoms. You deserve to know the outcome; no news may just mean no news. 

Lifestyle changes:
There are many ways to approach this, including help from friends, commercial help, help from your family, organizations, and individual counseling (such as a dietician). While these changes can be the most difficult, they can be the most effective in keeping you healthy. Once you have started to attempt changes, return to your doctor with your results: the smallest changes can have a big impact. Change the things that are easiest to change first. Negotiate with your doctor to see whether a change you plan is worth trying, and if bigger, smaller, or more specific changes will work best.