June 12, 2012

Making the Most Out of Your Doctor Appointments

Okay, I do miss some of my doctor appointments. Why does this happen? To be honest, I am not sure if it is my subconscious kicking in and telling me to ignore it or whether I am having memory problems. I do know that when the weather is bad, I will not travel the thirty plus miles one way, and I know that one got canceled (I actually called) because of the price of gas and trying to stretch the budget.

My appointments have become too routine and my lab results have been very consistent (boring comes to mind). What puzzles me even more is how difficult it is to schedule several doctor appointments in one day. In nine years of trying to do this, I have only succeeded getting two doctor's appointments in one day once – repeat one time. I thought I had done it three other times, but one doctor always had to reschedule for some legitimate reason. I do not like this, but things do mess with doctors schedules that cannot be prevented.

I am discussing this because of a blog in diabetesselfmanagement.com that brings up some excellent pointers that we should follow to get the most out of our doctor appointments. It is written for diabetes appointments, but I am covering all doctor appointments. Read the blog and see how you compare and if you are planning for a successful healthcare visit. I will cover each point as well to show how I compare. First, I must state that I have no problems with keeping my diabetes appointments. It is my other doctors I have my problems in forgetting my appointments.

1. Make time for it (the appointment). As a retired person, I seldom have any conflicts for my time – unless it is during the winter months and the weather is bad. As suggested I do turn off my cell phone and if I forget, most offices have reminders to do just that. I have heard people talking on their cell phones during office visits and I can understand doctors becoming very annoyed by this.
2. Plan ahead. Since we cannot remember everything to ask the doctor, I do make a list of questions that I need covered. Then a day or two before the appointment I try to prioritize them in order of their importance to me. I print them out so that if time runs out, I can hand it to the doctor and most of the time I will receive something in the mail with answers, or some doctors will call and give me the answer. Always record any activity out of the usual, like job changes, travel, or other changes. For me this is not a problem, but I do make mention of applicable health problems that concern me. I have them written down and also have blank paper to record instructions. I do repeat what I have written to make sure I have understood what the doctor has said.
3. Bring your meter and logbook. Although many people will not let their doctor have access to their meter, I think I get much more out of my appointments as the doctor does download my meter and reviews the readings and a couple of graphs with me. I always have my logbook for food and insulin injections if it is needed.
4. Facing the scale. Get over it, the number is what it is and you can only remove heavy clothing like a heavy winter coat. I know this is the procedure for most of my office visits, so I have an interest, but I do not obsess about it. I do get a few wry comments, but I just say it is what it is and the topic usually is dropped. I did have one doctor ask if I would consider bariatric procedure. My instantaneous no response stopped him cold. He did ask why and I carefully told him why explaining several of the things I would not be told and the problems this could cause for me. He commented I must have researched this and I hauled out a printout and he looked at it and when he saw the source, handed it back. He said that he had read it and agreed with it, but that the hospital was pushing all doctors to try to see what could be done. He did say he would not bring it up again with me, if I could hold my current weight or reduce it, as he was looking at my weight chart and said I have been up and down but that I was under what my highest had been. I told him to look for possible alternatives, but to forget people that insisted on the ADA way. He agreed and said I did not need the calories or carbohydrates.
5. Discuss your medicines. This is important and is something doctors are mostly requiring. Although the blog suggests a list or the bottles, I normally use the list method, but I do have two doctors that are now demanding the bottles before giving out any new prescriptions or renewals. They are not requiring this at every appointment, only when something is to be renewed. Some use e-prescribing and a few still are not. This blog does what should be done but few blogs do. It tells you to list all over-the-counter or herbal products

Many people insist they do not have to tell their doctor what supplements or other non-prescription medications they are taking. I will say I record everything, even prescriptions that are for short periods and I have not taken for some time since the last appointment. I do list the period that they were taken.

6. Take off your shoes and socks. For appointments with your diabetes doctor and your podiatrist this is a must. You may not have both, but you should consider this. Yes, it is a requirement for your podiatrist, but may not be for your diabetes doctor or endocrinologist if they know you see a podiatrist regularly. Either way, you should consider this as being important for the health of your feet. Even my neurologist surprises me once in a while when checking my neuropathy.

Especially for your podiatrist be prepared to discuss any foot-related concerns you may have. If you have problems with trimming your toenails or finding shoes that fit, and you don't have a podiatrist, ask for a referral to one.

7. Discuss your goals. Always be prepared for this, especially for your diabetes and have questions at the ready for your doctor as to how best achieve these. Be prepared as some doctors are only interesting in the A1c readings and you may need to ask some specific questions to convince the doctor you are serious. With all candor, if your doctor is unwilling to listen and discuss your goals, consider the need to find another doctor that will work with you to achieve goals for both of you.
8. Bring your calendar. Always bring your appointment book, or calendar (digital or paper) with you to schedule future visits. Make sure that you allow sufficient time between lab tests and your appointment to prevent conflicts or obtaining lab results. Always ask for a copy of lab results to assist you in tracking your own health.
9. Get the most from your minutes. This may seem difficult as the 10 to 15 minutes go by fast. Accept that the doctor may feel as rushed as you and you may have more questions than he has time to answer. I admit this is often the case for me. So I prioritize my questions to get the most important ones answered first. I am fortunate that a few of my doctors realize that I have a list and they do ask that I put my name, address, and telephone number on it. I always do this and they generally take the list of questions and answer them after hours or mail me the answers. One doctor does use email to answer them. I have had one doctor then call if he has a no-show to answer questions. Another doctor does answer the questions and gives me my sheet with his answers at the next appointment. This has let me know that I should be detailed in my questions and a couple of the doctors have thanked me for doing this.

Not every appointment will go as planned, so the better you have prepared yourself, the easier it can be for both of you. Although this seldom happens, I did have one appointment terminated as the doctor was called away on an emergency. I did hear him instruct his nurse to get my list of questions and give me my copy of the lab report as he hustled off. The nurse did say that it way one of his family in the emergency room, but that was all she said. Two days later, he called to ask if I understood the lab reports and if I had paper and pen available. He answered my questions after saying it was his wife that had been in a vehicle accident.

This was totally appreciated and explained why he had rushed off and I was very appreciative of his time in answering my questions. In the appointments since, no further mention was made of what happened and things were normal for the appointments. This is just one more reason to have a list of questions ready with your information included. I have found out over time that most doctors will appreciate the questions printed out in case they are short of time and the good ones will evaluate the questions and respond to the important ones. Depending on the number of questions, some do mail back the answers.

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