A Checklist for Your Checkup
Published Oct 1, 2015 8:00 AM
A visit to your doctor will be more effective if you prepare before you go.
So many questions, so little time. We’re bombarded with health information online, through social media and in casual conversation with friends — so that when we visit our primary care physician, we have a host of things to discuss. Is this symptom something to worry about? Is that diet a good idea? Should I go on this medication? Get that test? More than ever before, we are engaged in decisions about our health. But one thing that hasn’t changed is how much time our doctors can spend with us — if anything, it’s even less than in the past.
“Ideally, we could spend as long as we needed to go through everything regarding the patient’s health in one visit, but the way medicine is structured, that isn’t possible,” says Dr. Jennifer Logan, a family physician at UCLA Health Redondo Beach. “So it’s important for patients and their doctors to make the most out of the time so that patients don’t leave frustrated, and potentially serious issues don’t go unaddressed.”
We have a lot on our minds — this is our health, after all — but we can’t always get to it all. And, from the doctors’ perspective, we aren’t always as forthcoming as we could be with the information they need in order to provide counsel about our health and make decisions about our health care. Logan and Dr. Amruti Borad, a family physician at UCLA Health Palos Verdes, offer these tips on how to get the most out of the limited time.
The typical allotment for a returning patient visit is 15 minutes. If you don’t want your doctor to seem strained for time, make sure you’re not putting him or her under the gun by arriving late. “I advise patients to arrive early so that they can do the check-in, fill out any paperwork, and go through medicines and get vital signs done with the nurse or medical assistant in time for their physician not to have to rush through the visit,” Logan says. “Otherwise, you’re shortchanging yourself for an appointment that took a lot of energy to get to.”
Particularly on a first visit, be ready to discuss your medical history and your family health history, especially involving first-degree relatives. Know what medications you’re taking and the dosages — bringing in the bottles is a good idea — including over-the-counters, supplements and alternative remedies, which can have unwelcome side effects when mixed with certain drugs. Know what your insurance does and doesn’t cover.
State Your Case
For Logan, one of the most common sources of physician/patient communication breakdown is patients’ failing to mention something important until near the end of the visit. “The best thing patients can do is to bring a list of all the issues they need addressed and go over that list with the doctor at the beginning, so that if there’s not enough time to do justice to each one, they can be prioritized and maybe some of them set aside for another visit,” Logan says.
When presenting your list of concerns, questions and needs (including any medication refills or referral requests), recognize that your doctor might have a different idea of what’s most important: “If chest pain is at the bottom of the priority list, I’m going to argue that that should be number one — and that we might need to take longer than you think to understand what’s causing it,” Borad says.
Patient, Don’t Diagnose Thyself
With all the health information now available to patients, many make the mistake of diagnosing themselves in advance and then bringing up only the symptoms that support the case, Borad notes. She recommends that patients avoid jumping to conclusions and instead try to paint a complete picture of what they’re experiencing. Don’t filter out symptoms you think might not be germane: Something you consider irrelevant could help to solve the puzzle.
No Place for Secrets
Are you engaging in unsafe sex, extramarital or otherwise? A closet smoker? Drinking a bit more than you care to admit? As much as you might not want to reveal your transgressions, it’s best to come clean with your doctor — who has heard it many times before and will keep such communications confidential. “Some very intimate things come up in doctors’ offices that many people don’t share even with their own spouse, and these can be of vital importance in how they relate to health,” Logan says. “I’m not here to judge,” Borad adds. “And if you’re not going to tell me these things, I can’t help you with them.”
Both Logan and Borad have found that in addition to avoiding potentially embarrassing topics involving sex, drugs and alcohol, many patients hold back mental health concerns such as anxiety and depression. “People experiencing these problems often feel isolated and alone, and may feel ashamed to bring them up with someone they don’t know that well,” Logan says. “But this is something we can help with, and people can get better with treatment.”
Get it in Writing
Use your newfound communication skills when visiting a doctor at any of UCLA’s primary care locations.
“You’re getting a lot of new information and instruction in a short period of time, and that can be overwhelming,” Borad says. “There’s nothing wrong with asking your doctor to write it out for you.” If you don’t understand something, she says, make sure to ask — and even if you think you understand, it’s not a bad idea to summarize what you’ve heard to make sure there is no misinterpretation. Particularly if your visit is for something likely to produce some anxiety, such as a major diagnosis, you may have trouble taking it all in; consider bringing a family member or close friend as another pair of ears.
Honesty is the Best Policy
Tell your physician the truth about whether you’ve been following the plan you agreed to, or whether a new plan seems feasible.
“Patients will often say what they think we want to hear — that they’ve been exercising and eating right, and taking their medications as instructed,” Logan says. “But if they’re not, maybe something else is going on — the medication has an unpleasant side effect, or they don’t feel safe walking in their neighborhood, or the diet that’s been prescribed is unrealistic. If I know — ideally, from the outset — that the patient has reservations about his or her ability to follow through, maybe I can recommend a different strategy or find ways to address whatever barrier is in the way. I’m never going to be mad at a patient for not being able to stick to the plan.”