I want to dedicate this week’s post to the top 6 things that I recommend you Do and Don’t do at the doctor’s office.  My goal is that by being a Wise Patient, you can get the most out of your doctor’s visit. 

DON’T:

1. Talk while the doctor is listening to your chest with his/her stethoscope. It seems obvious, but we cannot hear anything over your voice when you are talking. 

2. Criticize your doctor for being late. As I discussed in my article “Why Is the Doctor Late?”, there are many things that can cause the doctor to be late for your appointment. While some are in the doctor’s control, there are many that are outside a doctor’s control. When I walk into the exam room, I will apologize for being late, but I want to immediately move forward to accomplishing our goals for the day’s visit. Read more at: Why Is the Doctor Late?

3. Be hostile. While doctors try to treat each patient with respect and equality, we are still human. If a patient is rude to us, we will do our best, but it is harder. In my own practice and in speaking with other doctors, I have realized the truth that kinder patients receive better care. 

4. Gripe about things outside of your doctors control.  We don’t mind a little venting about a bad experience, but I have had patients spend their entire appointment time telling me a story that has nothing to do with why they came in the first place. When you go to the doctor, it’s important to stay focused so that you both achieve the goals that you want to accomplish in a visit. 

5. Interrupt your doctor while he/she is researching your chart. While you may feel like the silence provides a good opportunity to interject another aspect of your issue, or gives you an opening to ask another question, it does not. A lot of the information that we need to make the best decision is located in your chart. We need some time to review the information in your chart and process our decisions. When you interrupt that process, we can easily get sidetracked into answering your question or making note of your comment, but this may distract us from getting the information that we need to make the best decision. I understand that patients are afraid they will forget to mention their point or ask their question, so what I recommend is this: write down your thoughts on a notepad and bring it up again after we are done. 

6. Tell your whole story to the nurse rooming you. They may ask questions, but you have no guarantees that all of your story will be relayed to the doctor. You will have to repeat it all again when the doctor comes in. It’s best to only use a few words about why you are there when talking with the office staff. Also consider this: more time spent with the nurse means less time spent with your doctor.

Do:

1. Arrive early. Though your appointment time is at 10:00, make sure to arrive at 9:40. There are so many things that go on before you see your doctor. You have to check-in. The medical assistant or nurse will have to measure your vital signs and take you back to your room. They will ask you why you are here. Also, they are often required to ask you a lot of standardized questions that have nothing to do with your visit today. They may ask how much alcohol you drink, or if you fall down at home, or if you feel safe at home. They are asking these questions to either meet a legal requirement or to help the clinic meet quality metrics, which we can discuss on a later post. All of these steps have to occur before the doctor comes in. It can take 5-15 minutes depending on the process. So if you arrive at 10:00 for your 10:00 appointment, you may not see the doctor for another 15 minutes. That’s 15 minutes that you could have been talking to your doctor. 

2. Bring the 7 things I mentioned in my article: The 7 Most Important Things to Bring to Your Doctor’s Appointment

3. Set the agenda as I mentioned earlier last month: Agendas, Important For Any Meeting, Especially with Your Doctor

4. Arrive motivated to help yourself. Your doctor will be more enthusiastic to help if you are engaged in the process.  Doctors can make plenty of recommendations, but positive effects are not seen until you enact those recommendations.

5. Do your best to address only one problem per visit.  I had an incredibly fruitful conversation with one of my patients last month.  He came in for a 1 week follow-up appointment and he was rather upset. He told me he was disappointed in our last visit. When I asked him why, he told me that he had lots of other issues that he wanted to discuss with me, but I didn’t allow him the time to discuss them at the previous visit.  I thought back to previous visit, I recalled what we had discussed: he had some leg swelling. This may not be a huge deal in a normal healthy patient, however this guy had had previous blood clots in his legs. I checked labs and got an ultrasound immediately to rule out a new blood clot, which took the entirety of our visit time. At the follow-up, I shared some of my perspective with him. I said: “Look you’re a medically complex guy. We will not be able to address every concern at every visit. In fact, you don’t want me to do that. If I tried to address 10 things at every visit, then you would get 10% of my focus for each problem.  I’ll see you back twice per week, if you need, but let’s try to address only one problem per visit.” He responded quite well to that, and we have a good working relationship now. If you want 100% of your doctors focus on a problem, only address one per visit. 

6. Clarify the question. When you come to the doctor with lots of concerns, sometimes it can be difficult for your doctor to understand exactly why you are there.  I assume that patients want to know how to fix their problems when they come in. However, I have been surprised before. Some patients just want to update me on their status. Some want to make sure they don’t have something life-threatening. And some want to know what diet or lifestyle changes may work best. If you clarify your question at the beginning of the visit, it will help both you and your doctor to focus on reaching the goals of your visit. 

These are just a few recommendations for your doctor’s visit. My goal is that by following these “Do’s and Don’ts” you will have more fruitful encounters with your doctor.