I’m sure we’ve all heard or said these complaints after a visit with our health care provider:
“I had to wait too long. “All my questions were not answered.” “My problem was not solved.” “I felt like he/she didn’t listen.”
Most of the time these are valid complaints, and I have to admit that I have been on both sides of these complaints from time to time. So how do you get your health care problems solved in the fifteen minutes that you have to spend with your provider? As one who has been on both sides of the stethoscope, let me give you the insider’s scoop.
First, realize that most of the time you only have fifteen minutes scheduled for your appointment, so be on time. Offices vary, but in most cases a routine appointment is 15-20 minutes, a recheck appointment is 10-15 minutes, and physicals/annual exams are 30-60 minutes. While this may seem unreasonable, most providers need to see 20-25 (or more) patients per day to cover the costs of running an office. Why the costs are so high is a topic for another time, but suffice it to say that it’s complex. So make the most of the time you have.
Come prepared. Bring an updated list of your medications with the name, dose, frequency and what it’s for. Some offices recommend bringing all your pill bottles, but it’s quite time-consuming to look through all those bottles to read off to the medical assistant what you are taking. An up to date list is better. Don’t be the patient who says “I don’t know what I’m taking, my wife takes care of that.” Know what you’re taking and why – it’s your responsiblity.
Understand who you are talking to throughout the visit and gear your comments appropriately. The person you meet when you first arrive or when you call on the phone is likely a receptionist – a clerical person who collects clerical information. This is not the person who can answer your medical questions. The person who calls you into the exam room is most likely a medical assistant. In some cases it may be an LPN, or RN, but most of the time is not. Medical assistants are trained to do the work of medical offices – they record information, take vital signs, perform procedures such as injections, EKGs, throat cultures, blood draws, etc. While they are very good at what they do, they do not have the same amount of technical training as an LPN or RN, and are not the ones to answer technical questions or give medical advice. Although they usually are somewhat familiar with medication names, they may not know what you are taking them for or the usual dose. To add to the confusion, office personnel will frequently call medical assistants “the nurse.” This generic use of the term “nurse” is convenient for staff to use, but adds to confusion for patients.
Plan on addressing only one problem at each visit. Patients who expect that all their problems will be solved in one visit are the major cause of other patients making the comment “I had to wait too long.” If your appointment takes more time than allotted, you are cutting into someone else’s spot. You don’t like it when you have to wait, so don’t put the other patients in that position.
Come prepared with the story of your illness/problem. Write it out if you have to. Make it concise and leave out extraneous details. Know when your problem began, what things make it better or worse, what things you’ve tried to solve it, what helped and what didn’t . Adding extraneous details just wastes time and causes your provider to have to sort out the useless information from the important information. Things like “My Aunt Hilda had the exact same problem and her doctor told her to take Brewer’s yeast mixed with dishwater and it completely cleared up” don’t help. You’ll actually need two versions of your story – a one sentence one for the medical assistant who asks “why are you here” (i.e. “I’ve had a cough for one month”) and the detailed version for your provider (see example at the end.)
Give your provider your full attention. Put down the magazine when they enter the room and have your cell phone already tuned off. Your provider has reserved this time for you and deserves your courteous attention. I can’t tell you how many times I’ve had patients sit and play with their cell phones while I’m trying to ask them questions or explain their very important MRI results. My response usually is to tell them I’ll come back when they’re not so busy. Remember you are paying for this visit – why would you want to waste it by texting?
Avoid partial self-treatment with other people’s prescriptions. If you take your sister’s two amoxicillin before the visit, it just muddies the water and limits diagnostic options. If a culture is needed, it’s reliability is ruined by the antibiotic you just took. If you get new symptoms, it’s hard to know if they are side effects of your partial self-treatment, or a worsening of your problem.
Avoid raising doorknob issues. You’ve presented your problem, your provider has examined you or reviewed test results, and the two of you have come up with a plan to solve your problem. You’ve been given instructions, told what to do for follow-up. Then, as your provider gets up to leave the room, you decide that everything went so well that you’ll just get one more thing fixed – a door knob issue. “Could you just take a look at this rash” or “I’ve got this pain in my elbow…” those are really new issues that deserve a full work-up, not the doorknob version. Raising doorknob issues usually means your problem will be inadequately treated, and you’ll have to come back for it anyway, or the patient after you, and the next one, and the next one, will wonder why they have to wait so long.
Now, how to tell the story of your illness. First, the wrong way:
“I’ve had a cough for a while. It started when I had a cold around Christmas time because I went out side without a hat. My husband had the same cold but he took vitamin C and got better. The cough is kind of funny. Sometimes I think it’s getting better and sometimes worse. I took some amoxicillin that my sister had but it didn’t help. I don’t know why I’m coughing so long – maybe it’s because I’m not taking enough vitamins.”
Now, the right way:
“I’ve had a cough for one month. It started after I had a cold at Christmas. The cold got better but the cough lingered. The cough is barky and my chest feels tight. It keeps me awake at night. I cough up green mucus in the morning. I don’t have a fever but feel chills sometimes. I’m fatigued by the end of the day and get short of breath easily. My appetite is fair. I took Robitussin cough syrup but it hasn’t helped.”
Don’t work against your health care provider – let them be your partner in helping you meet your health care goals.