Make the most of the time spent with a doctor to minimize patient frustration

A lot of people express frustration when visiting their doctor’s office.  They don’t feel they are listened to, cared about, or have their issues adequately addressed.  If this sounds familiar, it could be that your doctor is evil, or what’s more likely, he’s trying to practice medicine within a difficult system.

Due to decreasing reimbursement and increasing expenses, many doctors are forced to see more patients just to keep their clinics afloat.  Unfortunately, this leaves the doctor in a really challenging spot:  provide thorough, quality, compassionate care, which is time consuming, and face serious financial consequences, or squeeze in as many patients as possible to pay the bills and do his best with the minimal time he has.

Remember, your doctor has to review your chart, lab results, medications, and vital signs before entering the room.  He then has to interview you about your complaint(s) to get a thorough history and perform an examination.  Next he has to mull over possible diagnoses, devise a treatment plan, order tests, make referrals, and write prescriptions.  If he’s your primary doctor, he also has to check to make sure all other consultations and labs have been followed up on and make sure your screening tests are up to date.  Meanwhile, he has to listen compassionately, reassure you, and educate you about preventive health measures.  In many instances he has less than 15 minutes to complete all of this and document it thoroughly in the chart. (And no, the electronic medical records don’t help.)

So how does this information help you?  Well, given the situation with the American healthcare system is likely to get worse, you’ll need to be more proactive and organized to get the most out of you short doctor’s visit. Most doctors are already stretching as far as they can to make ends meet and still practice good medicine.

Here are some suggestions to help you get the most from a current day doctor’s visit:

  • Write down a list of your most pressing concerns.
  • Do not expect your doctor to address all of them in one or even two visits.  A seemingly simple complaint to you may require complex evaluation on the part of your doctor.
  • Focus in on your top two to three issues to bring to her attention at the start of the visit.
  • Tell your doctor right at the beginning of the visit what your major concern is.  Don’t wait till her hand is on the door to leave to tell her you really came in because you think you have a sexually transmitted disease or you are having suicidal thoughts.
  • Be flexible –your doctor may find something more pressing than your wrist pain she needs to focus on, like a blood pressure reading of 200/110.
  • Once a treatment plan has been designed, keep all follow up appointments, especially if tests were ordered.  Your doctor has a responsibility to contact you if there are worrisome results, but it is your health on the line.  No one should be more concerned about your health than you.
  • Understand that you may need multiple follow up appointments to get all of your concerns addressed.

If you try working with your physician in this way and find that you still are not getting your needs met, find another doctor.  Sometimes two people simply don’t work well together.  Keep in mind that it is not within your doctor’s power to make you healthy or happy, only you can do that.

It is frustrating, and we’re all having to make adjustments to work within our healthcare system, but when we take full responsibility for our health by being organized, proactive, and following up, we are far more likely to get what we need and want from our doctors.

Melanie Lane is a family physician who blogs at The Doctor Weighs In.

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  • Debbie

    AMEN!

  • http://www.MDWhistleblower.blogspot.com Michael Kirsch, MD

    Good advice, Melanie.

  • e-patient

    Perhaps my blood pressure is high because of the stress of having to get off work where my boss is screaming for that report and I can’t find someone to pick up the kids because I have to work late to get that report done because the doctor needs 3 or 4 visits to figure out why my wrist hurts.

    I have several complex health issues that intersect with each other. Dealing with one problem at a time because only 15 minutes is available isn’t an effective way to provide care. When I got sick, my PCP couldn’t see how everything fit together and I suffered for two years with debilitating symptoms while dealing with one symptom at a time. At that point, I became an e-patient. I started coordinating my own care and found specialists that could give me the answers I needed. I researched lifestyle issues that would relieve my symptoms. I no longer bring these issue to my PCP. If further evaluation or a treatment change is needed, I seek out a provider that doesn’t need 3 or 4 appointments to figure it out.

  • MIS Prof

    Dr. Lane’s advice in the post is really good. I’ve spent a lot of time in a lot of doctors’ offices, and Dr. Lane’s points are great for making the most out of each visit.

    But e-patient has some good points, too. If the situation is more complicated, just be careful of expectations about the visit. I’ve had to follow the same trail as e-patient.

    If what I need is complex and needs a more cutting edge treatment, my pcp doesn’t really have time to deal with it. Generally, he is willing to cooperate with and keep up the treatments the specialists set up. If the treatment doesn’t fall into standardized medicine yet, he is likely to discourage me. He doesn’t have the time to update his knowledge by reading all the research articles on the condition and treatment or attending the conferences. Not and stay in business and have a reasonable salary.

    So I don’t expect that more. I just keep my pcp visits to routine things he can handle in 10 minutes. Then I search out the specialists who do keep up on the research, plan for longer office visits (charging more), and work out treatment plans with them. If my pcp disagrees … well, I’m the one who has to live with the outcome of treatment (or non-treatment) anyway. I’ll make the best choice for me. Luckily, I have the financial and intellectual resources to hunt down the specialists and the treatments I need.

    I do make sure my pcp knows what else I’m doing so he can factor it in even if he does disagree. He hasn’t fired me yet as a patient, so we must have established a mutually respectful relationship. Or he needs the business …. ;-)

    Come to think of it, that’s what some of Dr. Lane’s advice is really about … being organized, being mutually respectful of each other’s time, and having reasonable expectations in mind.

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