Healthcast 607- Doctor's Appointments-How to Get What You Need

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Many people don't get what they need from their doctor's office appointment in this modern age of 10-minute doctor visits. They complain about it but don't know how fix the problem.

I would like to challenge you to prepare yourself for your doctor's visit before your doctor appointment, because it is the only way you can get the treatment you need.

Doctors are smart and the most intensively trained professionals in our society, but they are often not the best communicators. Your success when trying to get the right treatment is half your responsibility and half your doctor's. Here are a few things you can do to start the office visit for a problem you are having, in a way that helps your doctor come to the right treatment for you.

PATIENT'S ROLE:

DO write down your Chief Complaint (the primary problem you are seeking a solution to) and bring it with you. Think about it before your go to the office, or while you're in the waiting room.

Then write down your symptoms in a list. These symptoms that you have, when they started and how severe they are, become the clues for your doctor to solve the mystery of your medical problem. If your doctor gets distracted, you can hand him the list of symptoms you have written down.

DON'T launch into a long story! Stories are often convoluted and unrelated to what the problem you are seeing him or her for and will confuse the issue for your doctor. The office visit is not long, and you will waste your time talking about what you had for lunch instead of what is bothering you.

Years ago I would accompany my MIL to the doctor and she would tell him everything that occurred since her last visit..what she ate, when she went to bed, trouble with her heating and cooling system…and I could see the doctors eyes glaze over. She never got to the reason she was there, and he doesn't have ESP, so it took multiple office visits to get to the bottom of a simple problem, so that she could receive treatment. Remember, are there either for a health checkup or for a problem. Tell your doctor what you are there for, in a few sentences.

DO give your doctor any lab or radiology reports from your referring doctor at the beginning of a problem visit with a list of your symptoms so she can read them while you talk and get the clinical facts from them as you tell her what is wrong.

Add any related problems that started at the same time as your primary problem.

Remember, some symptoms that occur at the same time as your primary problem may be related to your medical problem and some may not. It is the doctor's job to help you decide what is related.

An example is that sometimes a patient in our office will notice hair loss when they are taking testosterone and immediately think it is the T pellets, however there are many other medical conditions that cause hair loss. The many medical problems that are likely to be the cause include low thyroid, lack of protein in the diet, adrenal oversupply of cortisol, stress, autoimmune diseases, and medications. Your Primary problem may not be for the reason you think it is, but these other medical issues need to be evaluated to find the cause.

On the other hand some medical problems happen secondary to a treatment, or a procedure, and infection or a trauma. You should tell your doctor those things that have happened around the time of your problem starting.

My husband had symptoms of a Pulmonary Embolism on January 6th. He got a J&J vaccine on January 3rd. Was that the cause or was the fact that he had a positive covid test the cause? We will probably never know but now doctors have found that the J&J vaccine can cause PEs (pulmonary embolisms) on the second shot, and that is what might have caused his. His cause is figured out in retrospect with new problems that doctors encounter in their practices. Luckily, they treated the problem, and not the cause and he got better over night!

IT is always better to know the cause of illness, but it is not always essential to treatment.

Sometimes doctors cannot give you a definite diagnosis until they put you through the necessary tests to gather more information (clues). It is necessary to go through the testing to prove or disprove a diagnosis, so please be compliant and get the necessary testing for your doctor to put all the pieces together!

BTW if you have had a test to diagnose a problem, then get the test and wait for the follow up appointment to get the results, unless it is an emergency. However, if the doctor said she would follow up by phone or email and you haven't heard in 7-10 days then call the office to make sure the test reached her and that she will contact you. You can't believe how many medical records; radiology reports and lab tests don't reach the doctor in this age of fax and email reports. However, it is better than waiting for the mail to come in like we used to do!

Sometimes, doctors don't know the answer, or need you to see a specialist to get a particular diagnosis. We can't know everything, and we don't guess about a diagnosis. Sometimes a type of doctor is not able to order a certain test because your insurance won't pay it if she orders it but will pay for it if a specialist orders the same test.

Sometimes in newly diagnosed diseases and rare diseases your doctor won't know the answer until more research is in!

For instance, Covid is now known to cause hair loss in both men and women, but that was not medically proven for the first year of Covid until we formulated the data from patients all over the world.

If you don't have your symptoms relieved by a certain treatment, or medication, but the doctor says you are "cured", tell them that your symptoms aren't gone, and that you would like to try either a higher dose or another medication or treatment. This should be accepted by the doctor, and they should try to treat your symptoms, not just the lab.

Sometimes symptoms are not from what they treated you for, or is a known side effect of the medicine, or they just haven't gotten the treatment right for you. They should tell you that. If your doctor is not willing to adjust or change your treatment, try another doctor who will listen to your symptoms.

Doctors can't know everything and sometimes doctors are not trained on certain areas of medicine, like hormone replacement for men and women, especially testosterone for women. In this case they should send you to someone who does know what they don't…that's called a referral.

Summary:

If you do your thinking and writing your symptoms and have a clear idea of how you would like the office visit with your doctor to turn out, then your doctor should listen, diagnose and treat, test you further, or refer you to another doctor to treat your special condition.