I’ve had around 50 medical visits over the last 12 months while dealing with chronic illness. I’d like to share what I’ve learned from that journey. There’s a lot of information here. I hope you’ll find that at least one or two ideas help you.
The Setup
1. Make the Appointment.
When I decided I wanted to figure out my muscle pain problems, my primary care referred me to a neurologist. The wait? 6 months.
Schedule doctor’s appointments as soon as you can to shorten the wait. If you got referred to a specialist, ask for the specialist’s phone number. Call the specialist if you haven’t heard from them in 2-3 business days, even if they said it would take a week for the referral. This helps you get scheduled faster and resolve problems.
If you want to get in sooner, you can also ask to be added to a cancellation list. If someone cancels, you’ll get notified. Ask them to confirm they have added you to the list while you are on the phone with them.
If you’re desperate, check other locations to see when you can make an appointment. If I was desperate to get in, I wouldn’t mind driving a bit further.
2. Write Down Talking Points
I write down questions and symptoms I want to ask the doctor on index cards. I have a good memory, but often forget important details without my notes. There’s just something about doctor’s appointments that makes my mind take a vacation.
I usually just write down a word or phrase that reminds me of what I want to say. It’s meant to be a reminder, not a ton of detail. You may choose to divide this into questions and statements.
The goal is to keep you focused on the main answers you want from this appointment. It is your responsibility to make sure that you come out of a medical visit with the information you need. Can you get a bad doctor? Of course, get another one.
If you try to make the doctor’s job as easy as possible, you’ll accomplish a lot more. This is a team effort.
I’ve found that writing down what I want to say allows me to more easily address the main questions I have. This is true even when I forget my notes. I start this process a week to a couple months before an appointment so I’m not relying on what I remember in the day before.
3. Refine Your Talking Points: Questions for Your Questions
Sort your list in order of priority:
What is bothering me the most?
What do I worry about the most?
What can I find out by calling the nurse line or doctor’s office?
What are the 1-2 most important concerns I want to address in this appointment?
Is this the best doctor to answer this question? If not, move it to the list for another doctor.
Nurse Line
Most insurance companies have a $0 24/7 nurse line you can call to get answers to health questions. The nurses aren’t as knowledgeable as doctors, but it’s a great resource for determining the level of care needed. They can also give recommendations for less advanced problems.
Doctor’s Office
You can also call doctor’s offices and ask to talk to a nurse or medical assistant (MA). What you’ll get will vary by the doctor, but this is a great resources for questions that can be answered over the phone or by a message. If you have an urgent concern, you can call their after-hours line and talk to a doctor.
That said, if you are experiencing a medical emergency, call 911.
The dermatologist office I go to has a bunch of MAs that are very responsive and have given me good recommendations. They’re no replacement for the doctor, but they are familiar with what has helped other patients.
Why 1-2?
Why only 1-2 concerns? Doctor’s appointments are usually 20 minutes long and major items of concern usually take at least 10 minutes to properly address.
There are three exceptions: 1. Small concerns. 2. New patient appointments 3. Some specialists.
- Small Concerns. I’ve had as many as half a dozen small concerns addressed in a single appointment because they didn’t take long to cover. Be sure to come in with a prioritized list when you take this approach. You might not be able to get through your whole list. I’ve had one “small concern” take up a whole appointment because it turned out to be a major concern.
- New Patient Appointments. These are usually 30 minutes long, but can be as long as an hour depending on the doctor. You can always ask about length when you make an appointment.
- Certain Specialists. When I go to physical therapy, the appointments are 45-60 minutes long. They’re really 60 minutes, but sometimes I’m late so they’re 45…
The actual length of the appointment depends on the doctor. Some doctors are more willing to fudge appointment times than others. I’ve gone to a nurse practitioner who regularly turns 30 minute appointments in 50 minute ones. I’ve also been to a doctor who turns into a pumpkin if he’s not out of the room 20 minutes after he comes in.
The length of your appointment may be influenced by what happened before you got there. If the doctor is late, and they have another patient after you, they probably want to make the appointment shorter if they can. And that stinks. It wasn’t your fault they’re running behind, but they don’t want to be late for the next patient either.
One way to avoid this is to try to get the first appointment (or as early as you can) on the day you want to be seen. There have been several studies showing that doctors are generally sharper in the morning anyway.
The Appointment
A Cautionary Tale
Last October, I went to get an ultrasound of my foot. I was late and hurrying to get to my appointment on time. I had forgotten something important, but didn’t realize it.
At least, I didn’t realize it until I was standing in front of my car and was unable to open it. In my hurry to try to get to my appointment on time, I locked my keys in my car.
I thought I had dropped them somewhere, I searched everywhere I had been to no avail. I called my dad, he came and unlocked my car, and my keys were under a jacket.
Moral of the story: Come early to your doctor’s appointments. You’ll have a better mental space and be less likely to miss important details.
Check-in
If they let you fill out your paperwork online, do that before your appointment. It will streamline the process.
Hospital complexes have a lot of different buildings, floors, and offices. It can easily take 15 minutes to get from the entrance of the complex to the doctor’s office if you’ve never been there before.
The attendants on the ground floor are there for a reason. Ask them where to go even if you think you already know. It’s easy to end up in the wrong place by accident.
If you come late (or sometimes even on time if there’s paperwork), you may have a shorter appointment or have to reschedule. They generally won’t make you reschedule if you come on time, but if you’re late and have paperwork to do, that can really mess up a doctor’s schedule.
The Examination Room
The Roadmap
As soon as you get to the exam room, the doctor’s assistant is going to ask you why you came in. This is your opportunity to share the 1-2 most important topics you want to address. Communicate these as briefly and as accurately as possible.
“Don’t bury the lead”. Give them a roadmap: “1. I’ve had acid reflux for the past few months. 2. My left foot is red”. Wait till you’ve given the doctor your roadmap before you into all the gory detail.
This allows them to focus on the problems that could be the most serious. Doctors’ tend to focus on the symptoms that could be caused by something that could kill you. Y’know, boring stuff. They want to make sure you’re not dying before they deal with your (hopefully) more minor concern.
That was hyperbole, but the point still stands. They need your information to do their job.
Notes
Remember to bring your notes with you. Bring an extra sheet of paper or index card so you can take notes during the appointment. The idea is to write down a word or phrase that will remind you to say something, follow-up later, or do what the doctor tells you to do.
I often think of things that I should have done or should try while the doctor is talking about something else. I try to quickly write a word or phrase about these action items while trying not to miss what the doctor is saying.
Bring Someone With You (If You Can)
I know this isn’t always practical, but it can really help to have another brain processing information. It can be hard to manage learning about chronic illness while dealing with the symptoms. Some days, I’m just brain dead, and it would be nice to have someone else there to remember what I can’t.
Conclusion
I hope you got some helpful ideas on preparing for and working through your doctor visits. If you have any questions, don’t hesitate to ask. Next week, we’ll be looking at what to do after the appointment is over. The work is not done when the appointment is over, it has just begun.
Josh