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Going to the doctor? Go prepared, expert advises

NEW YORK (Reuters Health) - To make the most of your next visit to the doctor -- be prepared, proactive and “pleasantly assertive,” Dr. Michael Pignone, chief of general internal medicine at University of North Carolina at Chapel Hill advises.

“Have an agenda. Write down the problems that need to be addressed. It helps the doctor a whole lot if you can give him a quick synopsis of your agenda for the visit. The more you can have a plan going in the better,” Pignone noted in a telephone interview with Reuters Health.

It’s also important to know your medical history and medications. “Doctors need to know what tests you’ve had - and when - as well as what medications you’re taking,” Pignone said. “Without that information, they might mistakenly re-order tests or prescribe medication that has a bad interaction with something you’re already taking.”

It’s also important to tell your doctors about your values and lifestyle. It’s not something patients think about, Pignone said, but “it doesn’t make sense to agree to a treatment plan you know you won’t follow.”

Research has shown that patients who prepare for a doctor’s appointment are likely to get better care and come away more satisfied than those who do not.

If you don’t go in prepared, odds are you’ll forget something, Pignone noted, and in the current “fee-for-service” health care model, “you can’t just pick up the phone and ask the doctor.”

“The current system is antiquated and rewards face-to-face visits and especially rewards procedures over the cognitive work, when it turns out that most of the care that needs to happen, especially in the care of older adults, is that cognitive work,” he said.

In the era of chronic disease, Pignone said, only a minority of patients have conditions that require a face-to-face office visit. “Especially if the patient has been appropriately trained in some of the self-monitoring -- like checking their blood sugar or blood pressure or assessing their shortness of breath if they have lung disease -- then much of it can be done over the phone, with various adjustments to medication dose.”

Pignone predicts that 5 years from now, the future doctor’s office might look very different. One health care reform proposal called the “medical home” model would grant reimbursement to doctors for time spent caring for patients by phone or email.

“If I could get paid at the same rate for my time by doing email or talking on the phone as I can for doing exactly the same work in the office, it would allow me to structure my day better and it certainly would be better for patients,” Pignone said.

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