Introduction
The pace of life is getting faster. Everyone is in a rush and nobody wants to wait for anything; patients do not like to wait and physicians do not like to keep patients waiting. Instead of spending time in the waiting room tapping your foot impatiently, you may be able to better use the time by preparing for the doctor visit. Advanced planning can help you get more out of your visit. There are preparations you can make before each doctor visit that can be organized in a personal healthcare book. Doctors are trained to recognize disease states by the pattern of symptoms the diseases create. If you have prepared for your doctor visit by listing your symptoms, you will be better able to answer your doctor's questions, which can benefit your care.
Doctor Visit Preparation: When You Are Sick
When a doctor visit is the result of an illness, people immediately ask, “What do I have?” In preparing for this type of visit, the patient's goal should be to help the physician answer that question. Like a detective, the doctor will want to know all sorts of things about your particular illness, such as how, what, when, and where the symptoms are occurring in the body. Preparing outside the office in a less rushed atmosphere allows for better recall. Sit, think, organize, and write down your thoughts to answer the following types of questions.
- How long has it been going on?
- How has it changed over time?
- What was the first thing you noticed?
- What alarmed you enough to come to the doctor?
- What did it feel like?
- What other symptoms appeared?
- What were you doing at the onset of symptoms?
- What made your symptoms worse?
- What made your symptoms seem to get better?
- When did the symptoms start (day or night, morning or evening, etc.)?
- When did the symptoms start (related to a new medicine, stress, injury)?
- Where in your body was the symptom first located?
- Where did the symptom move?
- Where did new symptoms appear next?
Doctor Visit Preparation: Follow-UpVisit
Follow-up visits exist to help you and your doctor evaluate treatment progress. Common questions at the follow-up visit are: “How am I doing?” “Should I be doing anything else?” and “When will I be able to stop the treatment?” The purpose of the visit is different from the initial visit, and the preparation for the visit is different. Just as there are patterns for the onset of an illness, there are expected patterns for recovery. Your doctor will want to know if you are progressing as expected. Often your condition changes, and you may not notice gradual changes. A review of your previous notes will help you. Sit, think, organize and write down your thoughts. Especially if you have not improved, prepare for your visit using both questions for a sick visit and some of the questions for a follow-up visit listed below. If you have improved, the following type of questions may be used to monitor you progress:
- How did the symptom change since the last visit?
- How did you tolerate the new treatment (any medication side effects)?
- How regularly were you able to take your medicine or treatment?
- What lifestyle changes were you able to make?
- What new symptoms did you notice?
- What continues to make your symptoms worse?
- What now seems to make your symptoms seem to get better?
- Where do you have any residual symptoms?
- When after starting treatment did you notice a difference?
Doctor Visit Preparation: Routine Visit
Sometimes patients see their doctors when they feel well. This is the visit to discuss preventive medicine, ending certain medications that you may be on, health maintenance issues (screening tests), and advanced directives. Advanced directives include making out a living will or designating a healthcare proxy, and making decisions about whether you want to minimize heroic measures in the case of terminal illness, such as shocking of the heart, CPR, mechanical ventilation, tube feeds, etc. These are some of the type of questions to consider:
- How you are feeling on the current treatment?
- Should you make any lifestyle changes?
- Do you have any questions that have arisen from things your friends, neighbors, or spouse have said, or things you have heard from the news media?
- What preventive or screening tests should be done for you?
- When will you be able to decrease your frequency of doctor visits?
- If you take a lot of pills each day, is there a way you would be able to change your medications to decrease the number of pills you take each day?
Creating a Personal Healthcare Book
Health
The healthcare system continues to improve, which generally brings improved care. You can participate in your own healthcare by learning how to get the most out of each visit. Especially if you are seeing more than one doctor, you should organize your records to avoid getting lost. One way to help get yourself organized is to create a personal healthcare book. It can save you time, avoid duplication of tests, and help prevent you from taking medications that failed in the past.
To create a personal healthcare book, use a loose-leaf binder. This “book” should be divided into sections. Each section starts with a table of contents. The table of contents lists the order of the chapters. Because the number of pages will vary for each chapter, using a loose-leaf binder will enable you to add pages and keep things in order. The table of contents also acts as a summary page of your care. The following is a way to create a personal healthcare book using four sections.
Section 1: Doctors
The first page of the section should be the table of contents. It should consist of a list of the names of doctors you see and the dates of your next visits—so leave a few lines between doctor names so you can insert appointment times and dates. Each doctor should represent a different chapter in this section. The first page of a chapter should have the doctor's name, specialty, phone number, and related information. Write down questions or concerns that occur to you between visits and date your questions. When your question is answered by the doctor at a visit, record the information he or she gives you. You may include information from a specialist or another doctor in these doctor chapters. The information will then be handy should any of your other doctors ask about your care.
Before your visit, review your notes in that doctor's chapter and organize your thoughts. Try to consolidate your concerns into one or two questions, then write them down. Doing so before your visit will make it less likely you will forget to ask about something that has been bothering you. When you leave, write your next appointment date next to the doctor's name in the table of contents. This will not only help you keep track of your visits, but will also be handy if one of the other doctors asks the time of your next appointment. You could also use the doctor's chapter section to monitor response to treatment, such as blood pressures, or your progress in health behavior modifications, such as weight loss, or reduction in smoking or alcohol intake.
Section 2: Medications
In this section, a table of contents should also be the first page. Here, you should list your medications. Include the date you started and stopped taking them. List not only prescription medications, but also alternative treatments (herbs, vitamins, acupuncture, etc.). The first page of each chapter in this section should include the following information:
- name of the medication
- the dose
- the doctor who prescribed it
- why you take it
- how often you take it
- any noticeable medication effects (good or bad)
If available, attach the drug information sheet many pharmacists provide. It is also a place to write down any side effects you may want to ask your doctor about. Keeping these types of lists is also helpful when your doctor wants to change your medication. By checking your medications table of contents, you can be sure you have not previously taken that medication. The corresponding chapter will have the details explaining why that medication was stopped.
Section 3: Tests
The table of contents page for tests should consist of a list of names and dates of tests that were performed. The first page of each subsequent chapter should include the following information:
- the name of the test
- the doctor who ordered it
- why it was done
- if there were problems (such as an allergic reaction)
- a copy of the result
If you have tests done frequently, you may want to create a table or graph on the first page of the chapter to better track the results. Whenever a test is done, ask to have a copy of the result sent directly to you. Having these results in your possession is helpful when you are seeing a different doctor who may not have received those particular test results. Many tests are repeated on a regular basis. Having a table listing when those tests were last done will help avoid unnecessary tests. You should also find out what preventive tests need to be done and be sure they are in your table of contents.
Section 4: Advance Directives
This section should have copies of your living will and directions for how to contact your healthcare proxy (also called durable power of attorney for health care). Keeping copies in your book will keep all your medical information together for emergency rooms and out-of-town visits. It will also remind you to periodically review these wishes and keep them up to date.
Summary
Life is getting better. There are more options for work and leisure. The same is true in the field of medicine. But because there are so many choices, it takes more time to sort out what needs to be done. By organizing your thoughts before seeing your doctor, you can simplify the process. You can participate in the process of figuring out what is wrong, and help to determine what needs to be done next.
