PRODUCTIVE DR. VISITS
By "DocNurse" Norma Stephens Hannigan
Going to see your health care provider (HCP), for many people, is a nerve-wracking experience. There is a variety of reasons why this is so. You may not know the provider at all, or at least not very well, you may not particularly like the provider but think you are stuck with him/her because of your insurance situation, or you might just be one of those folks who gets nervous being asked all kinds of nosy questions we in health care are asking these days.
This article is designed to make health care visits a less painful experience for you. I am a nurse practitioner but, even as a health care provider, I am also a patient from time to time, so I have many of your same concerns. As an HCP, however, I can look at the situation from both sides, so this will be a bit of “true confessions” for me. It might help you to understand a bit more of what the expectations of the visit are from the health care provider’s perspective. If both the patient and the HCP are on the same page, the visit can be much easier for each party.
One of the currently popular terms being used in health care is “shared decision making” (which refers to the way that decisions are made about your health care). For some patients, their idea of the best possible visit is that the HCP tells them exactly what to do and they do it (or not). For most patients, though, there is a desire to be part of the decision making process. After all, it’s your body and you will ultimately decide how you want to treat it. If an HCP is giving you advice about treatments you can’t afford, it makes it that much more difficult to follow the advice, even if you want to. If you’re an assertive person, you may want to ask your HCP directly where he/she stands on shared decision making. If you are not quite so bold, you may just want to wait and see how the visit and decisions about it – what medications you will take, what x-rays and blood work you will have, etc. – play out.
Okay, here comes the “true confessions” part – I find it really difficult when a patient I am seeing doesn’t tell me the whole story, or tells it to me piecemeal. I’m pretty smart and I have years of experience, but I am not a mind reader. Some people go to see a health care provider and almost try to “trick” them into a diagnosis just to see how good the HCP really is. I’m not really sure what the motivation is, but it is not in your best interest to play guessing games. An accurate diagnosis is based on the complete, bona-fide information a patient gives me, not half-truths.
Sure, sometimes the truth is embarrassing. If you lost your prescription, or engaged in some behavior that is less than perfect, or have been eating or drinking too much, you may as well spill the beans. Perhaps your HCP is someone who can help you with those issues. Maybe he/she is one who yells at you. Don’t go back to that person if you feel worse after your visit (unless you find that it motivates you). If your HCP is worth her/his salt, you won’t walk away feeling ashamed, but rather glad that you explained the whole situation.
I recommend to my patients that they write down their questions. American health care has turned into such a profit-driven mess that many HCPs feel like they have to limit their visits to 15 minutes (and, in some cases, less). If you are just beginning to think about what your concerns and questions are when you get into the exam room, the interaction may be unpleasant for both you and your HCP because, just as the HCP thinks the visit is wrapping up, you are thinking of another question to ask or another problem you have that demands a lot more time to deal with. The tendency is for the health care provider to say, “Come back for another visit.” This is usually not the response you want to hear when you have places to go and people to see. You can start by telling your HCP, “I have a couple of things I want to discuss with you.” That lets your HCP know that you are focused on some certain concerns and that he/she can also focus and, thereby, assist you better.
Bring your medications with you! There is nothing so frustrating for the HCP as trying to guess what it is you are taking. Do you know how many “tiny little white pills” there are? If there are too many bottles for you to carry, write a list, copying exactly what each label says. There are a couple reasons to do this: first, the HCP can see that the label reflects what she/he wrote in the original prescription. Secondly, you should carry a list of medicines you are on routinely in the event of a hospitalization. If you are in pain or unconscious, that is not the time to be trying to figure out what medicines you take. Medicines can mix with each other causing bad reactions. Whatever is wrong with you might be related to the dose of a medicine you are taking, an allergic reaction or a side effect. Also, using the example of a medicine that is causing you problems, if you don’t know what medicine you already take, how is the HCP going to know not to give you the same medicine again? These health care issues are far too serious, and potentially dangerous, to be guessing about.
It’s a new year – take the opportunity to think in some new ways. Next time you have a health care visit, be prepared to work with your health care provider. After all, ultimately, you are in the driver’s seat in regards to not only your occupation, but your health as well!
~ Dr. Norma Stephens Hannigan, who recently graduated with a Doctor of Nursing Practice degree, teaches at Columbia University in New York and has treated many truck drivers at the various clinics she has worked over the years. She currently writes from her home in Newburgh, New York.