Take Charge of Your Health- Prepare for Your Doctor's Appointments

We have developed a culture of medicine in America in which primary care providers don’t have adequate time to truly assess our needs and actually deliver the quality health care that we need.

As a medical provider, I can tell you it’s not easy delivering quality health care, the kind you would want to have for yourself, for your mother or for your favorite aunt. Let’s face it, a proper record review for some of us would take hours, if not days. Not many of us are fortunate enough to have that old-time personal physician that has known us, our medical history, and the history of all of our family members since the day we were born.

The healthcare environment can be intimidating.
The healthcare environment can be intimidating. | Source

Electronic Medical Record


I spent 20 years working in military medicine. The military transitioned to an online electronic record starting about 2003. As a provider it’s great. You have access to patients’ labs, x-rays, prescription history and all medical visits (at least since about 2005 when the system was implimented worldwide). Some civilian providers and facilities are transitioning to some type of computer documentation program. Many however continue with handwritten charts and all of the difficulties that go along with them, not the least of which is reading multitudes of different handwritings. I can’t always read my own writing. There are frequent situations where patients are seen with no form of written history record. Unfortunately there are other situations where providers don’t review an available medical record, for whatever reason.

As an occupational therapist, I had an hour for new patients, and almost always reviewed my daily cases the night before to prepare. I could even review actual x-rays on my computer screen, which was important in orthopedic cases. Didn’t leave much time for a life, but having gotten less than satisfying medical care in so many instances myself, it was something I felt I had to do.


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Lots of Things Need to Happen Associated with Each Doctor Appointment

How long do you usually have face-to-face with your doctor? Fifteen minutes? Ten? Five? How much time do you think your provider spends looking over your chart before they walk in the door? Ten minutes? None? How much time does your doctor then spend writing orders and documenting when you leave the exam room? Does a nurse or medical tech do these things?

Let’s say the total time that a primary care provider spends on all of the above is 15 to 30 minutes. Let’s say we want more time, average being 60 minutes for doctor appointments. Sounds great, but I think we all know this is not likely to happen. What would this do to health care costs? What would this do to doctor availability? I’m a huge fan of Nurse Practitioners and Physicians Assistants, but the same would be true. There just would not be enough providers and the cost would be at least doubled.

As a provider, there is the stress of trying to review clients’ records. There is the stress of trying to do a good job, serve your patient, get your documentation done, enter x-ray and other orders. All this while being behind all day every day. So you see the next patient, in an attempt not to get too far off schedule. Then at the end of the day, or the next day, or never, you complete that documentation for that patient encounter. So assuming you actually heard what the patient was trying to communicate in the first place, do you still remember what was said by the patient, what you concluded and what you recommended? So from a patient perspective, the next time you’re seen, assuming the provider even takes the time to read your record, is it accurate?



Goods and Services

You are paying for a service.  Expect to be well served!
You are paying for a service. Expect to be well served! | Source

Prepare for Doctor Appointments

Lots of things contribute to our rushed, inadequate system of Western Medicine health care. What is the answer? I’m afraid I don’t have a lot of answers to fix our broken way of providing healthcare, but I will offer a few suggestions for patients.

Prepare for doctor appointments with your primary care provider like you are preparing for a class or a test. Spend some time thinking about what you need to say. How can you present your “story” in a logical way, including key points and leaving out the fluff. I know it’s especially difficult when your problems are complex, you’ve not gotten satisfaction thus far, and you don’t frankly know what bit of info might be the “eureka” that turns things around. None-the-less, make an outline of your key points as best you can. Also make a list of your questions. I started taking a day of leave on my appointment days to minimize distractions, and to focus on myself.

Have a copy of your medications, chronic health conditions and brief history of current complaint that your provider can keep.

Be selfish. Yes your provider is likely pressed for time. You have to forget about that other patient that may get cut short if you take three extra minutes of the doctor’s time, but just do it. Press on until you get what you need from your doctor.

Do not be apologetic. You are a customer, and you deserve good customer service. I give great customer service, and when I don’t get it in return, from my doctor or from my Wal-Mart checker, it offends me.

It may not be possible because of your health care plan or because of lack of doctors in your area, but when possible shop around. There are places that realize that they are a business in a competitive market, and their good customer service reflects that.

You Deserve Good Customer Service

Don’t be apologetic if you have questions or if you don’t understand something. If your doctor did not explain things in a way you can understand, that’s on him/her. This is what they do. It is their responsibility to explain things in ways patients can understand. I figure I’m at least as smart as the average bear. If I have a question, it must be a good question.

Hold your ground. You know your body better than anyone. Doesn’t matter how much formal education you have. I don’t know about you, but the less and less young I get, I find that I’m right way more than I’m wrong. Trust yourself.

Do your homework. Take advantage of the internet. You may not have more time than your provider, but who should be more interested in your health than you? Don’t be afraid to take your research in and show it to your doctor.

Finally, if what you’re doing is not working, do something else. Consider seeing an Alternative Medicine provider. It will likely cost you 100% out of pocket, but I can almost guarantee that you will feel listened to, and that you will leave feeling like you have been taken seriously.

 

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Comments 18 comments

pstraubie48 profile image

pstraubie48 4 years ago from sunny Florida

It is so important to know this information, rmcrayne. I was a patient advocate so to speak for both of my parents in their senior years so I learned to be proactive for them. The suggestions you make are well stated and are ones all should know and follow.

I have shared this in a hub I wrote, !2 clues that it is time to find a new doctor.

I am glad I found this. Thank you for sharing.


stillwaters707 profile image

stillwaters707 4 years ago from Texas

Thank you for reminding us that we deserve the best customer service.


rmcrayne profile image

rmcrayne 5 years ago from San Antonio Texas Author

Thanks for your visit and your comment WesternHistory. I usually write a list for my visit. When I was still seeing an MD, and still taking prescription meds, I had all that stuff typed up. Now I see a Naturopath, and always have plenty of time, an hour or so.


WesternHistory profile image

WesternHistory 5 years ago from California

Excellent hub. Many very good points. In the U.S., medicine is a business and profits seem to rule the day. Not only in regards to the doctor but in all aspects of U.S. health care. Most hospitals and all insurance carriers are geared to make a profit. In the case of health insurance companies, the profits in the U.S. are huge. Most doctor want to earn as much as possible and there is absolutely nothing really wrong with that. I do think it needs to be recognized however and because of that there are ways to make the doctors visit more beneficial. Your hub mentions many of these things. I would estimate that face time with my doctor is probably no more than 6-8 minutes. Most of the procedures such as blood pressure and pulse are taken by the medical assistants before the doctor steps in. If there are new issues to bring to your doctors attention,making solid mental notes prior to the visit is a must.You may be paying $125 for a few minutes of seeing your doctor so preparation is essential.


rmcrayne profile image

rmcrayne 6 years ago from San Antonio Texas Author

Thanks for your comments jen. It's pretty mindboggling how broken the system can be, isn't it?


jenblacksheep profile image

jenblacksheep 6 years ago from England

I think this is the case almost everywhere. I went to see the nurse to have some shots before i went away. i had to have a course of 3 for something. so i had the first one and when i went back the following week she had no idea why I was there.

My nan had a similar thing: she was taking aspirin for years and then the doctor took her off it. and then when she went back again recently he told her that she needed some more of it and when she said 'oh but you took me off it' he had no recollection!


rmcrayne profile image

rmcrayne 6 years ago from San Antonio Texas Author

Thanks for reading and commenting Rope.


The Rope profile image

The Rope 6 years ago from SE US

Great hub! You are so right on so many levels. Thanks for sending me the heads up.


rmcrayne profile image

rmcrayne 6 years ago from San Antonio Texas Author

Good story Christy. Doesn't seem the right things are driving practice. (Ever think of writing some hubs?)


Christy8914 6 years ago

I so agree. A few years ago I was taking a prescription that by law, I had to be seen by the doctor, every three months. I did this with the same doctor for several years. I noticed that if I had a 9:30 appointment, I had to undress, get into the hospital gown, and she would start with--open up and say ahhhh--and finish with checking my knee reflexes, hitting everything in between. If I had a 4:30 appointment, they would check my blood pressure and ask maybe 2 or 3 questions, and it was done!!! You are right---it is each persons responsibility to learn all they can about anything they can in addition to trips to the doctor. Another great story, with so much knowledge. Keep writing--Don't sleep! ! !


rmcrayne profile image

rmcrayne 6 years ago from San Antonio Texas Author

What a crazy phenomenon Robert. Reminds me of when I consulted in the NICU. As part of my assessment of the babies, I would of course talk to the nurses. Especially with the senior nurses, they had all the answers, if the docs would have just asked them. How many times I merely related the nurses’ info to the docs on these consults.


robertsloan2 profile image

robertsloan2 7 years ago from San Francisco, CA

Excellent article. It's driven me nuts when just explaining the list of my chronic conditions to the latest primary care physician takes longer than he has for the appointment and then he doesn't listen anyway. I found that having someone else come with who is not sick and declares herself caretaker does get listened to. Kitten started doing that and it helps communication a lot.

You can get a friend to stand there and not have your complaints and explain them to the doc and get listened to easier than doing it yoruself, especially if you are sick or in pain at the time. Because they really don't listen to anyone who's displaying any symptoms of anything.


rmcrayne profile image

rmcrayne 7 years ago from San Antonio Texas Author

Thank you so much for your support of my work freta. I can totally picture your doc with his hand on the doorknob!


fastfreta profile image

fastfreta 7 years ago from Southern California

Such good advice. My last doctor would come in the room and seemingly never took his hand off the door knob, and he pooh, poohed most of my complaints. I agree you know your body better than anyone, and shouldn't be bullied into not speaking up. Thanks rmcrayne, for such wonderful advice.


rmcrayne profile image

rmcrayne 7 years ago from San Antonio Texas Author

Thanks for reading and commenting lyrics. I appreciated your support.


lyricsingray 7 years ago

Really interesting for me learning from a Canadian perspective-great Hub-Thanks!


rmcrayne profile image

rmcrayne 7 years ago from San Antonio Texas Author

Thanks for your support JD!


judydianne profile image

judydianne 7 years ago from Palm Harbor, FL

There is some good advice here! Thanks for sharing with us!

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