How to get the most from your doctor's visit (Q&A)
With a primary care physician (PCP) shortage and the Affordable Care Act adding several million new health care consumers to the market, it's more important than ever to make the most of each visit to your doctor. To find out more about how you can optimize your doctor's visits, we spoke to Dr. Zackary Berger, a primary care doctor, assistant professor at the Johns Hopkins School of Medicine, and author of "Talking to Your Doctor - A Patient's Guide to Communication in the Exam Room and Beyond."
How you can get the most from your doctor's visit
How often should you try to see your doctor?
It's been common to say "once a year," and in some ways that makes sense. But it's also somewhat arbitrary. There's no reason you can't pay a visit sooner or less frequently. If you have more medical issues, see your provider more regularly.
It's useful to think of the patient-doctor relationship as just that -- a relationship. A good one requires care, feeding and maintenance. To see your PCP regularly is useful. How often varies from one person to the next.
What questions should you ask?
When you start to visit a PCP, it's good to ask a variety of procedural questions (such as):
- What's the best way to get in touch with your physician?
- What issues require a personal visit versus over the phone or by email?
- What concerns can be handled by a nurse or physician's assistant?
- Can I have electronic access to my medical records?
Shared decision-making means doctor and patient both contribute to the choice. It's the opposite of the doctor standing on a pedestal and shouting instructions to the patient below. The doctor and nurse are experts in medicine. The patient is the expert in how they feel and what they think is important.
Ideally, making a decision is best done when you and the doctor are involved. But sometimes patients don't want that. They can find shared decision-making to be off-putting. Some like the doctor to make the decisions. If that works for you, that's fine. There's no one "best" way for every doctor-patient relationship.
What are common errors both patients and doctors can make in a routine visit?
Patients and doctors don't always really listen to each other. There needs to be an effort on the part of both in the exam room.
Is there one thing patients can do that will maximize the time with their PCP?
Experience and common sense say you're not going to deal with all your medical concerns in one visit. So one practical and very important thing you can do is come to your appointment with an agenda. Before the appointment, think about what concerns matter most to you. List them and then prioritize them.
Realize that your doctor, too, has an agenda -- things he or she believes are important to take care of. Your doctor needs to prioritize, too. You'll need to meet in the middle. That means negotiation. As in any negotiation, not everyone will be satisfied with all aspects of the outcome.
In your book, you talk about the importance of framing before the visit. What is framing and why is it so important?
Framing is a way to present your concerns to your physician with a story. Framing is a way to present your concerns to your physician with a story. Putting your concerns in story form increases the chances that your doctor will better understand your situation and offer better insights. When putting together a narrative, (here are some) questions to ask yourself:
- When did the symptoms start?
- What part of your body is affected?
- What's made them better or worse?
- What treatments have you used until now?
- What are you worried about?
- What do the symptoms make you think of?