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How to maximize your dermatology appointment for effective care

Karen Ezenne and Albert Zhou, MD, PhD
Physician
June 17, 2023
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An office visit with a health care professional can seem like a race against time and money. With rising co-pays and shorter appointments, arriving prepared for a health care appointment will maximize the likelihood of addressing as many concerns as possible and developing a personalized treatment plan. Below are the ways you can prepare for your upcoming dermatologist appointment.

Keep track of your scheduled appointments and arrive early.

Know the day and time of your appointment and schedule your day in advance. Offices often send reminders within a week before your appointment. For new appointments, map out the office address and account for traffic. Public transit, rideshare apps (i.e., Uber or Lyft), or having a friend or family member drive are great alternatives for those without reliable transportation. We recommend arriving at your appointment at least 15 minutes before your scheduled time, which provides time to complete any additional paperwork and to collect yourself and your belongings. Important items to bring to the appointment include an insurance card, government-issued identification, a prescription card, and a credit card. Be mindful of the cancellation policies at the office; cancellations or no-shows can be penalized. After five no-shows, a patient may be “fired” from the practice.

Complete paperwork and questionnaires ahead of time.

Most offices have extensive health questionnaires and paperwork to complete. Completing this in advance will allow for a more comprehensive and holistic assessment. Note any allergies (e.g., food allergies, seasonal allergies, medication allergies, etc.), as these can impact daily health and influence what medications are prescribed. Any significant family history of diseases, prior surgeries, hospitalizations, and underlying medical conditions should also be disclosed. Please bring the results of any recent imaging, biopsies, and lab work.

Develop an understanding of insurance, co-pays, and prior authorizations.

Some insurances require a referral in advance of a dermatology appointment. Ensure that the practice accepts your insurance plan. Most insurance policies require a co-pay after the appointment. To prevent surprise bills, it may be advisable to call the insurance company ahead of time to inquire about the deductible, reimbursements, and medication/pharmacy coverages. Certain qualified medical expenses may be paid via a HSA (health savings account), a popular tax-exempt retirement savings vehicle where funds can roll over year-to-year. Cosmetic procedures such as laser therapy, Botox, and CoolSculpting are not usually covered by insurance and thus can have exorbitant out-of-pocket fees. Certain offices may offer payment plans.

Make a list of any past or current medications.

Organize a list of medications you are taking or have previously taken, including any over-the-counter (OTC) medications and herbal supplements. Keep track of dosage and frequency, the last fill date, side effects, and general adherence to the medication. Bring the bottles (even if expired or empty), though a clear cell phone picture of each may be ideal. Doing so will allow physicians to better evaluate for any potential adjustments and are more likely to offer refills. Importantly, note which medications have been helpful or unhelpful.

Document any symptoms, reactions, and issues you may have.

Take notes and pictures of any abnormal signs and symptoms experienced! We suggest using an easily accessible smartphone app (i.e., notes, photos) or a written journal to record triggers, pictures, surrounding events, and timelines of symptoms. The OPQRST method is a great guide: onset of symptoms, provocation (what may have started it), quality of pain/symptoms, radiation (does the pain/symptoms travel anywhere?), severity of pain/ symptoms, and timing.

These notes are crucial for discerning patterns or associations and serve as an accurate and unbiased assessment of the healing process. Organized, high-quality cell phone pictures are appreciated. For instance, pictures should be taken in set intervals when recovering from a surgical procedure and saved to an album/folder. This also applies to any incidental rashes and or skin lesions. On the day of your appointment, we recommend performing a full-body self-exam and determining whether this is a “good” or “bad day.”

We also appreciate when patients take notes during an appointment. With the introduction of the CARES Act, physician notes and lab results should be more accessible, though medical terminology is often difficult to comprehend. As such, personal notes can be important to reflect on after a visit, especially when discussing recommended OTC products.

Compile a list of prioritized questions along with any other concerns to discuss.

Since appointment times are limited, organize questions in order of importance and priority. Asking questions promote patient advocacy, engagement, and understanding. However, while questions can foster informative conversations, be mindful of the allotted appointment time as all questions may be difficult to address.

Good questions include:

  • What preventive care services are right for me?
  • Where can I find reliable and trustworthy medical information online?
  • How many patients with my condition have you treated?
  • Will your treatment address what matters most to me?
  • My real fear is “XYZ.” How concerned should I be?

Some questions and refill requests can be submitted via the electronic medical record, such as the EPIC MyChart platform. Try to include as much information as possible in a single message and include pictures. Physicians are busy and may be unable to respond immediately. However, be aware that certain institutions can bill for these messages.

Wear loose clothing and remove makeup and any nail polish.

For dermatologists, it is critical to assess the skin at its baseline to identify the best treatment. Makeup or applied moisturizers can detract from the physical exam. Wear loose and comfortable clothing that can be quickly changed out of. While often overlooked, the condition of fingernails offers significant insight into general skin health. Many forms of fungal infections, skin cancer, and autoimmune disease can have presenting signs in nail beds.

Be honest.

An important part of a patient-physician relationship is honesty. We aim to help and protect your health and well-being, so let us know how you are feeling. Although difficult, your vulnerability will allow us to settle upon a personalized treatment plan and deepen our working partnership.

In-person vs. telehealth appointments

Busy schedules and poor health care access can cause delays in care and may be a deterrent for routine follow-up. Fortunately, telehealth’s incorporation and expanding role allow the convenience of meeting with a dermatologist virtually. In-person and telehealth appointments are equally effective for both patients and providers and could save costs for those in difficult financial situations. A telehealth appointment may be ideal depending on availability, skin condition, individual needs, circumstances, and comfortability.

Have a loved one join your visit.

Having a trusted friend or family member at the appointment can be beneficial. Discussion points are better remembered, and they can serve as patient advocates. Setting boundaries and expectations with a companion may be necessary, especially regarding private matters. If you are handicapped or have a disability, a loved one can better help navigate the appointment’s physical and emotional parts.

Karen Ezenne is an undergraduate student. Albert Zhou is a dermatology resident.

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