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August 23, 2000
The Office Visit: Make the Most of It!
Rhonda B. White, R.N., M.S.N.

illustration: Michael Alto

Do doctor's appointments make you nervous? Does the time with your physician seem to pass too quickly? Do you find yourself leaving the doctor's office with a dozen unanswered questions?

As a critical care nurse working in a hospital, I see many patients struggle with the questions they have -- often patients feel like they don't have time to bring up their concerns, or they simply forget to do so. I try to help them and their families prepare to discuss their concerns with the doctor. During my morning rounds, I ask patients what they would like to cover with the doctor that day, and usually at least four or five issues come up. Yet when the doctor arrives to talk about test results or treatments and then asks if the patient has questions, nine times out of ten the patient says, "No."

The reasons behind this common problem aren't mysterious; while you're busy processing all the information your doctor is giving you, it's easy to forget your own questions. When I can, I jump in and remind patients what some of their concerns were. This is a large part of a nurse's job -- being there as an advocate for patients and their families.

Being hospitalized is very different from seeing a doctor for routine appointments, however. Office nurses will certainly help you prepare for the exam, but in order to get the most from your routine appointments, you need to be an educated consumer of health care. Here are some suggestions to help you prepare for your next appointment:

  • Know your health history. This may be the most important information you can give your health care provider. Sheila Benedict, R.N.C., F.N.P., of Marshfield Clinic Oakwood Center in Eau Claire, Wisconsin, says, "It's really helpful if patients know their family history ... I like to know about immunization status and, in particular, any past medical problems that may not be in our records." If you give your provider a detailed health history, it can alert him or her to potential problems. This is especially important if you have a family history of diseases such as cancer, heart disease, vascular disease, high blood pressure, diabetes, or psychiatric illness. Don't be shy about giving your doctor this information -- it can save your life.
  • Prioritize your problems. During a routine checkup, make sure you spend time on the most important issues. "Often patients come in with a list of things they want to cover at a routine scheduled appointment," reports Benedict. "The problem is, we could never cover what they want to discuss in the time allowed." If you have pressing issues, you should schedule an acute appointment.
  • Be prepared for your appointment. If you're in the office for tests, make sure you've done the correct preparation for the screenings you are having. Your provider will, in most cases, give you written instructions for preparations well in advance of your scheduled appointment. Be sure to follow those instructions to the letter, or you may waste your entire appointment. If you're confused, call your clinic and ask questions. If you're a woman, keep in mind that your annual or biannual Pap smear and routine exam should not coincide with your menstrual cycle, since the bleeding can cause inaccurate test results. Reschedule your appointment if it occurs during your monthly cycle.
  • Understand your illness. People with a chronic condition like high blood pressure or diabetes often have frequent appointments to check the progress of treatments. If you're educated about your disease, it is much easier to understand new treatments your doctor may suggest. It amazes me how many chronically ill patients know very little about their disease. You have to be your own best advocate, and you can do that by learning the basic facts of your condition, researching new treatments, and asking your health care provider questions.
  • Write down your questions on a piece of paper. Bring a list of questions with you to your appointment; it's the best way to ensure that all your concerns get addressed. In some sensitive medical cases, a patient may feel uncomfortable asking the questions aloud. If this is the case, make two identical lists, and just hand one to your doctor.

Preparing for your medical appointments is particularly important these days; managed care companies require that health care providers schedule appointments very tightly in order to see the maximum amount of patients in the minimum amount of time. This can be frustrating for patients and providers alike. The key to getting the best care is knowing your health history, being educated about your conditions, and communicating with your health care provider. By making your needs known and asking the right questions, you can help your provider give you the best care possible.