Plan, Prioritize, and Communicate
If you’re like most people, you’ve probably accumulated more medical issues and concerns than you had earlier in life--some acute, some chronic; some may be serious and others may simply be nagging little problems. For many folks, it can seem like there’s never enough quality time with the doctor to talk about everything. So I’d like to give you some pointers, from a physician’s perspective, about how you can work with your clinician to make the most out of every visit.
First things first. It is extremely helpful if you plan ahead for your visit by making a list of everything you’d like to discuss with your provider. You may wish to keep it on the refrigerator or by your chair so you can easily add things as you think of them. A day or two prior to your visit, go through your list and prioritize—pick the top two or three issues that are absolutely the most important to you. While there may be six or ten things on your list, it’s likely the clinician will only have time to address a few items at each visit. Don’t forget to bring your list along, and be sure to give it to your provider up front, at the beginning of the visit, so they’re aware of your concerns.
I suggest the following order of importance:
- Bring up any new symptoms, concerns, or questions that you have not discussed previously.
- If you’re not following orders or taking your medications as directed for some reason, absolutely let the physician know!
- If there’s something the provider is already aware of that has recently become a greater concern to you, let him/her know.
- Although you may not get to them in this visit, include any other things you’d like to talk about at the bottom of your list.
I don’t want to upset dad. If you are the spouse, son/daughter, or other family member of the patient who has concerns about your loved one, you may wish to communicate them to the clinician in private. For example, perhaps your mom or your husband tends to be in denial and gloss over symptoms that worry you. And you know from experience that bringing it up in front of the doctor will only make matters worse. In this case, it’s ideal for you to write a letter or a note to the physician ahead of the appointment so they are armed with the information needed to tactfully approach the situation. You can do this whether or not you are present at the appointment. It’s a reasonable and helpful way to voice your concerns.
You know, doc, I was wondering…It used to be that the physician’s word was taken as gospel and never questioned. Today, patients are becoming savvier and learning about their health from a variety of sources: discussions with friends, magazines, television, and especially the Internet. As a result of this wealth of information, it is possible that you may have questions about a medication, course of treatment, or advice your provider has given you. As a physician, I think this is fantastic! I love it when my patients are curious and ask questions about my recommendations. Ultimately, your health and well-being are your responsibility, and only you know what it’s like to live inside your body. So it’s very appropriate for you to probe until your concerns are adequately addressed and you feel comfortable with the information you’ve been given. This is especially true if, for whatever reasons, you’ve decided not to “follow doctor’s orders” with regard to medications.
I’ve come to understand over the years that some patients can feel intimidated or worried about pushing back or asking too many questions. If you are hesitant to have an open discussion with your clinician on any topic that is on your mind, one approach is to put your questions and concerns in writing. This may make the situation more comfortable both for you and for the provider. It’s a good way to get the discussion going and take it to a deeper level.
This is going to take awhile. If there is a “big,” yet non-urgent, item on your laundry list of health issues (e.g., incontinence, diabetes control, dementia concerns), let your physician know and ask if you can spend some significant time on it at your next appointment. Most providers are pleased to spend time educating you about the condition and the treatment options and helping you figure out what it means for your life. With a bit of advance notice, your clinician can properly plan and schedule for this type of appointment instead of rushing to squeeze it into a regular follow-up visit.
Be sensitive to your hard-working clinician. Now, in the Senior Care practice, because we’re set up to see only older adults, our providers are usually able to spend plenty of time with each patient (especially if they know ahead of time that you have extra or special concerns to address). Many primary care providers (family practitioners and internists), however, especially in rural areas, do not have that luxury and may only be able to spend 15 minutes or so with each patient. When this is the case, it’s essential that you, the patient or family member, are realistic, understanding, recognize the physician’s time constraints, and set expectations accordingly with a prioritized list. There will always be another opportunity at your next appointment to get to the additional items you want to discuss.
So, how do you make the most of every visit? Plan ahead for your appointment, prioritize your list of issues, and communicate openly and honestly with your primary care provider.