Getting the best medical care possible requires navigating a complex relationship within the few minutes you have during a typical office visit. Some may say these are unrealistic constraints, but they are common.
A lot of people are not satisfied with their doctors. The reasons may range from waiting too long to be seen to what patients deem to be ineffective treatments.
In the age of Dr. Google, oftentimes patients think they know what the problem is. Sometimes they are correct, but very often they are not, Dr. Dyan Hes, medical director of Gramercy Pediatrics, says. You can’t blame them; there is simply too much information out there, and it’s hard to know which sites to trust, she adds.
It will help if you know what primary-care physicians need you to be aware of before you go see them. This will help remove most professional challenges. It will also be useful in getting the most out of your relationship with your own doctors.
A lot of people are suspicious of doctors, Dr. Hes says. Whether it’s because they have bad previous experience or it’s because they’ve read or seen something on the news, some patients come in already predisposed to distrust the doctor. “Keep in mind that we always have your best interest in mind,” Dr. Hes says. The visit will be much smoother.
Patients often confuse the two, Dr. Hes says. “If you come in once a year with a list of 30 symptoms, this is a sick visit.” There are different insurance policies. Sometimes you don’t have a copay with a well visit, but you do with a sick visit. “Don’t wait to see a doctor once a year if there is a myriad of signs you’re not healthy,” she adds. It will cost you more and you will get sicker and sicker.
This has to do with insurance, Dr. Hes says. “If you’re seeing an in-network doctor, he or she is getting paid very little per patient, so they can’t afford to spend a lot of time with only one person,” Hes explains. “No one does it.” If you pay cash, out of pocket, then doctors may be able to see you for longer.
You will save a lot of time if you know beforehand whether your insurance covers whatever you need to get done – vaccines, mammograms, blood test, etc. – in the doctor’s office, Dr. Greg Burke, Internal Medicine Physician at Geisinger. Make things more efficient and call your insurance to ask if you’re covered and whether you have a copay. Doing this at the office will only result, at the very least, in longer waits.
It’s helpful to know some basic principles of medicine, Dr. Burke says. This will save time as doctors won’t have to explain in detail why they can’t give an antibiotic or penicillin for a cold. The flu is an infection caused by a virus. Antibiotics treat infections caused by bacteria. Antiviral medication helps against the cold and flu. They don’t cure the illness but make you feel a little better and less contagious.
If you go to a doctor you’ve never seen before without your medical records, you create a huge problem, Dr. Hes says. There are tons of possible conditions, medications, and medical procedures that may play a role in what’s bringing you to the doctor today. You can’t have doctors try to guess what you’ve been through in the past.
Family history is becoming more and more important today’s precision medicine, Dr. Burke says. Did you have a relative who died of cancer? What kind and at what age? It makes a big difference if, for example, your dad died of colon cancer at 50 or lung cancer at 90 after smoking his whole life, Dr. Burke adds. “Investigate your family medical history better.” Know if anyone in your family has had a stroke, diabetes, or possible hereditary conditions.
Analytical data is very helpful, Dr. Burke says. Did you have a fever? For how many days? What was the highest number? Be as specific as possible, he adds. If you had high blood pressure, for example, keeping track can help identify if it only happens when you have a headache or after certain physical activity. This, as a result, can aid in diagnosing the illness and treating it.
It’s sometimes appropriate to bring a family member, a friend, and even another physician with you, Dr. Burke says. This is especially important if you’re expecting a complex diagnosis. “Oftentimes patients are in shock and don’t ask questions they should.” Having someone else there, for collateral information, can be very useful, he adds.
“Patients should know what medicines they are on,” Dr. Hes says. Vague descriptions such as little blue or yellow pills do not help, he adds. “Take a photo of the bottle so you have it on your phone. This will be helpful if you forget to bring the medication with you to the doctor’s office.”
They may be made of natural ingredients but they may also interact with drugs you are prescribed, Dr. Burke says. You have to be honest about everything you’re taking, he adds. Herbs, supplements and other alternative treatments are not FDA-regulated, which means manufacturers can often get away with making unproven claims about the contents of the pills and their benefits.
This includes any drug allergies, Dr. Hes says. This will help determine whether what you’re experiencing is an abnormal reaction of your immune system to a medication, food, vaccine, bacteria, or virus, to name a few. Also, the doctor needs to know this information before prescribing any medication. A severe allergic reaction can be life-threatening.
It might be helpful to share with your doctor if you’ve had other appointments, Dr. Burke says. Seemingly unrelated symptoms can be very important. For example, your eye doctor may have found evidence of poorly controlled blood pressure, he adds. “A high level of transparency is really necessary.”
Very often patients need to have certain forms filled out – for college, family leave or disability – but don’t bring them to the office, Dr. Hes says. This is not productive at all. “Then you have to email or fax them, which will only slow the process down.” Some of the forms may require additional testing. In that case, you’ll have to go in again, causing even more delays.
It is not uncommon at all for patients, especially the elderly, to not know previous hospitalizations or surgeries, Dr. Hes says. “Parents sometimes don’t even remember if their kids had their tonsils removed, why or when,” she adds.
This is crucial not only if your doctor suspects you may be pregnant, Dr. Hes says. An irregular period can be a symptom of several conditions, including polycystic ovary syndrome (PCOS), thyroid problems, eating disorders, too much stress, and even excessive exercise. It can also be a side effect of certain medications. There are many phone apps you can use to track your period.
The bottom line is that it’s your time, money and health. “It’s on you,” Dr. Hes says. “Go for a second opinion, explore all possible options, but if you don’t trust your doctor, you need to find a new one,” she adds. Why would you want to spend long hours waiting to see a specialist, only to disregard everything he or she tells you?
Come prepared with a list of questions to ask your doctor, Dr. Burke says. Don’t count on remembering everything you wonder about; chances are you will forget. Make the most of the time you have the doctor’s undivided attention.
Chronic pain is not easy to treat. “You can’t cure all pain, and people should know that,” Dr. Hes says. “Some patients go to the ER for pain medication, but this is not the place.” You need to see a pain specialist – a chiropractor or physical therapist, for example – to treat the source of the problem. While you can treat pain at home, know that there is no magic trick or quick fix.
There is no way people won’t look online before they go see a doctor, and you can’t fault them for doing so, Dr. Hes says. “But they have to realize that it’s not artificial intelligence that’s making the diagnosis or doing a physical exam.” Most illnesses have a lot of vague symptoms in common, which makes Dr. Google wrong more times than not.
Depending on who you talk to, what you read, and what you see on social media, you may believe all kinds of myths out there, Dr. Burke says. “Everything can look so convincing, it’s hard to tell good information from bad.” A lot of health questions, especially more common ones, are answered on the Centers for Disease and Control (CDC) website, and most people would agree this is a reputable and reliable source, he adds. “They don’t have a lot of vested interest.”
Ask your doctor what sites he uses to stay up to date with medicines, treatments, illness, etc., Dr. Burke says. This you can avoid unreliable sources and be sure that you can trust what you’re reading. “I once printed a 30-page document about arthritis for a patient, who later came prepared with questions based on it,” Dr. Burke said.
If you only have a runny nose and a mild fever for a day, call the office first, Dr. Burke says. They have nurses who can “screen” your symptoms and tell you if a personal checkup is warranted, Dr. Hes adds. It’s good to always call first, but if you’ve had a high fever for three days straight, go see a doctor right away.
Improving your health involves small steps, Dr. Hes says. Most people can’t quit every bad habit they have cold turkey. This is not a realistic expectation. So start slowly. “Stop smoking after 5 p.m., cut one sweet drink every day, drink alcohol only at social events.” Making small changes is not so overwhelming, and you’re more likely to follow through, which is what matters in the end, she adds.
It’s boring, slow and uncomplicated, but it’s true. Many chronic problems are caused by an unhealthy lifestyle, and you only have yourself to blame. A doctor will try to convince you and explain why you shouldn’t drink soda all the time and why you need to exercise more, Dr. Hes says, but it’s ultimately your responsibility to take care of your body.