Here is a summary which will be further detailed below.
1. Before the appointment: Organize yourself.
2. At the appointment: With the doctor define what you will be addressing.
3. What not to do.
Now that you have found a good doctor, how do you get your needs met during an appointment? Before the appointment, organize yourself. What is it that you want to have addressed at the appointment? Of these, which is the most important? Write all of the above down as it is easier to remember. I as a physician have been flustered at appointments and have forgotten things. Your list should be able to be addressed within 15 minutes. If you have a more complex medical history or have more than 2 complaints you want addressed, ask for an extended appointment time if it is available.
In order to organize your thoughts for the appointment, it is helpful to know how a doctor conducts an appointment and the kind of information the doctor will be asking. Most doctors use the “SOAP” format during an appointment. “S” stands for subjective and is the information you provide about your symptoms. “O” stands for objective or the information the doctor gathers by taking your vital signs and performing a physical examination. “A” stands for assessment which is a summary of the problems. If the diagnosis is not known, then this may simply be a list of your symptoms i.e. Fatigue, headaches etc. “P” stands for plan and outlines what will be done to either treat the condition or further evaluate the symptoms in order to determine a diagnosis. The doctor will want to know the following about your symptoms: When did the symptoms start? When do they occur in the day? How long do they last? How bad are your symptoms in regard to their intensity? What makes the symptoms better if anything? Is there anything that makes your symptoms worse? Have you had the symptoms before? Additionally, the doctor will want to know whether anyone in your family has had similar symptoms. Lastly, your past medical history will be reviewed along with whether you drink alcohol or smoke tobacco amongst other things which is referred to as your social history.
At the beginning of the appointment present your list and define with your doctor what you will address on that given day. This list if presented early allows your doctor to make a mental note of how to divide the appointment time. Sometimes the complaint (i.e. abnormal mole) that a patient is most worried about takes the shortest time to address. While a complaint the patient is least concerned with (i.e. the tightening in their jaw with exercise) can be the most critical and take the longest to address. At the end of the appointment, ask for summary of next steps if you are unclear. With the advent of the medical record, a summary of next steps is easier to provide. Make a follow up appointment if necessary and carry out the plan advised. If laboratory tests or specialized diagnostic tests are ordered, I think it is beneficial to schedule a follow up appointment to review the results. It allows you time to discuss with your doctor next steps whether test results are normal or abnormal.
The last step in getting your needs met are the “don’ts”, the 2 things that could hinder your appointments. The first only applies to when you are scheduled for a complete physical exam. Ten years ago in a popular ladies magazine, an article was published advising women to make a “laundry” list of their problems they wanted addressed at their complete physicals. The 30 minutes that is typically scheduled for a complete physical can be spent obtaining a history, completing the physical examination and then counseling a patient on pertinent screening tests and how to stay healthy. There is usually no time to address additional problems. Yes, it is convenient for some healthy patients to only come in once a year and have everything addressed. But for the majority of patients it is a disservice as it does not allow for adequate evaluation of these additional problems. The second thing to avoid is “Oh, by the way”, a statement made as a doctor walks out the door. There are times a patient forgets or does not feel comfortable bringing up a problem. But, if you have followed the above outline and the prior advice in how to find a good doctor, you will have defined your problem list at the start of the appointment and you will feel comfortable with your doctor. So “Oh by the way” will not be necessary. In summary, organize yourself, define with the doctor what will be addressed and avoid the “don’ts” and you will be on your way to always getting your needs met in the doctor’s office.