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Making the Most of a Health Care Visit

by Michael R. Wasserman, MD

Preparing for a health care visit helps people get the most out of time spent with a doctor or another health care practitioner. Preparing ahead also helps people communicate with a practitioner more effectively. Information and questions for the practitioner should be written down before the visit.

First visit

The first time people visit their primary care doctor, they should ask any of the questions that are relevant to choosing a doctor and that they have not asked or need to ask again (see ). In addition, several other questions may be helpful:

  • How are sudden urgent health problems that occur at night or during weekends handled?

  • How are test results obtained? (For example, where to call or e-mail if the person is responsible for asking for these results.)

  • Why should I have an advance directive (such as a living will or a durable power of attorney agreement—see Advance Directives : Durable Power of Attorney for Health Care)? How do I go about preparing one?

If people already have an advance directive, they should bring a copy or the original to be copied for the doctor’s records. They should also collect all drugs they are currently taking, including over-the-counter drugs, medicinal herbs, and vitamins, and bring them to the doctor’s office.

At the first visit, the doctor asks about topics such as past and present health, the health of close relatives, treatments, tests, and lifestyle. Even if the doctor does not ask, people should make sure the doctor has certain information about them:

  • Any personal, spiritual, or cultural considerations that might affect health care decisions

  • Information about past hospitalizations, use of home health services, or care received from any specialists or other health care practitioners (including alternative medicine practitioners), with the names, addresses, and phone numbers of these sources of health care

  • Information about any diagnostic tests and treatments already planned

  • Exercise habits, sleep habits, diet (including consumption of caffeine), sexual practices, and use of tobacco and drugs not prescribed by a health care practitioner (including alcohol, over-the-counter drugs, and medicinal herbs)

Providing this information helps improve the quality of care and ensure that any change in practitioners is smooth. For example, people should give their primary care doctor contact information for other health care practitioners and facilities they have visited. Then, the involved practitioners can communicate with each other more easily. Contact information also helps the primary care doctor obtain copies of pertinent information for the medical record.

Subsequent visits

Each time people see their doctor, they should prepare a list to make sure the doctor knows everything relevant to their health care. The list should include the following:

  • Any health-related questions

  • Any symptoms or medical problems, including mental health problems

  • Any side effects experienced while taking drugs

  • Any diagnostic testing or new treatments recommended by another health care practitioner

  • Any time they are not taking drugs as prescribed and the reason for it (for example, “I seem to get stomach cramps from the drug” or “I cannot afford the drug”)

  • Any changes in personal information, including major life events (such as retirement, change in marital status, a death in the family, or a move to a different home)

Lists should be written down. During a busy office visit, people can easily forget what they want to say. The list should also be prioritized, with the most important items listed first. Symptoms should be described as accurately and precisely as possible, being careful not to minimize or exaggerate them. Reading about or talking with someone who has had a disorder or a recommended diagnostic test or treatment before a visit may enable people to ask more specific, useful questions.

Any forms (such as insurance, school, or preemployment forms) that need to be completed by the doctor or office staff should be brought. People should also bring current insurance cards, any required referrals, and a means of payment for any required fees.

Arriving at the doctor’s office 10 to 15 minutes before the scheduled appointment (particularly for the first visit) gives the office staff time to make sure that insurance information is current and that any required forms are completed.

During the visit, listening carefully to the doctor and responding as honestly and completely as possible, even about sensitive issues (such as bladder control or sexual practices), is essential. If a treatment or an invasive diagnostic test is being considered, people should ask about the following:

  • How effective is the treatment or how accurate is the diagnostic test?

  • How will the test results change treatment?

  • What are the possible side effects?

  • What other choices are available?

  • What are the specific goals for the treatment?

  • How will the response to treatment be followed or monitored?

  • Any other questions they have about the treatment or test

People should request an explanation of anything that is not understood and ask for a patient education sheet or handout on the subject if available. Asking the doctor to write out instructions and reading them back to the doctor at the end of the visit help make sure the instructions are understood. Reading them back gives the doctor the opportunity to correct any miscommunication. Taking notes during a visit may also help. For people who cannot use written materials or who have problems with vision, speech, or hearing, other approaches may be needed to keep track of the information. For example, the instructions may be recorded on tape, or a family member or friend may agree to read the instructions when needed. When people go to the pharmacy for drugs, they can use the same approaches.

Before leaving, people should check their list of questions and symptoms and talk to the doctor about anything that was not covered. If many questions remain, the doctor may have to schedule another appointment or write a referral to another health care practitioner, such as a nurse, pharmacist, or dietitian, for further information and education.

After the visit, any recommended follow-up appointments should be scheduled. Any prescriptions should be filled, and any written materials provided by the doctor or pharmacist should be read. Also, people may want to consider keeping a diary of important aspects of their care. For example, a person with constant headaches may want to record when headaches occur, what triggers them, and how they respond to drugs.