In our busy health-care system, patients and doctors face a lot of pressures. Stress, time constraints and communication barriers can hinder the problem-solving that needs to happen during a doctor's visit.
There are lots of medical conditions that are not only painful and frustrating, but difficult to describe. This becomes even more challenging when you have only a brief window of time with your doctor to figure things out.
Your doctor really wants to help you get to the bottom of things and to find a solution.
By sharing some information from a doctor's perspective, I hope to help you better understand and get the most out of your next visit.
Understanding your doctor's approach
Did you ever wonder why your doctor asks you the questions they do? Do you feel like sometimes your doctor answers a question with even more questions?
Family doctors are trained to use a specific structure to deal with a patient's concern. A nice way to explain the structure is to tell you how we record your visit in your chart. Most of us use a "SOAP note".
- S is for Subjective — information on your symptoms provided by you.
- O for Objective — exam findings or test results.
- A for Assessment — what are the possible diagnoses, also known as the differential.
- P for the all-important Plan — what to do next.
Notice this whole process begins with your description of your symptoms, known as the history in medical terms. You are telling your doctor a story. The details of this story can really make a difference in the accuracy of your diagnosis.
It's tempting to think that tests always hold the key to a diagnosis, but in a large number of cases the information that helps to make the diagnosis comes from your own reporting. You hold the key!
Preparing for your visit
When so much depends on your story, it can help to prepare a bit before your doctor's visit. Especially if your issue has been going on for a while, you may want to review the details so they're fresh in your mind for the interview.
Timeline is an important feature. Your doctor will have very different ideas of what the cause may be if your pain has been going on for three weeks, three months or three years.
Reflect on the nature of your symptoms. For example, if you have a headache, is it sharp, dull, throbbing, more on the right side?
Think about the pattern of your symptoms. Do they happen once a month? Every day? Do they last for minutes at a time or hours?
On another note, if your problem involves something visual, like a rash, think about taking along some photos to the appointment. I really appreciate when my patients do this, especially when it's a symptom that comes and goes.
What if I don't have a family doctor?
If you are seeing a doctor who doesn't know you, remember that they may not have access to any of your records. The doctor will try to ask all of the relevant questions, but you may want to offer any extra information that you think may matter.
For example if you're being seen for a cough, mention if you have a family history of lung disease, whether or not you're a smoker, or whether anyone around you is sick with a cough.
This will help the doctor not miss anything important and to make the right diagnosis.
When I see a new patient, I find it so helpful when they bring along an up-to-date list of their medications and a summary of their past medical issues and surgeries. Once your list is started it's easy to keep updating it. Think of it as a resume of your health.
Only one problem per visit?
Sometimes doctor's offices will specify the number of problems that can be dealt with at a given visit. From a patient's perspective, this can seem very inconvenient.
My office doesn't have a set limit on the number of problems that can be dealt with at one time. But if a patient comes in with multiple concerns, I will often ask them to book a separate appointment to deal with some of it. Why?
Think of a car appointment. When I drop off my car to have the tires changed, but the mechanic notices another issue, I am booked back later to have the second issue addressed. My mechanic just hasn't allotted time in the day to do the extra work, and other customers are waiting.
A doctor's appointment is similar — it takes time to do our job properly.
As I mentioned, a lot of information has to be discussed and reviewed to come to a diagnosis and plan. Most of my visits are booked for 10 or 20 minutes.
For every additional problem brought up, that 10 or 20 minutes gets divided into smaller and smaller parts.
Think carefully about how many things you want to address in one clinic visit. Some issues are truly quick and can be added without taking much time away from the main problem. But, especially if you have an issue you've never discussed with your doctor before, think about dedicating one visit just for that. That way you'll get your doctor's full brain power on the case.
If you do have several issues, review the list with your doctor at the start of the visit, then the two of you can decide what can be dealt with that day based on importance, severity and convenience. Another approach is to inform the receptionist or nurse of the list of problems you are hoping to address, and they can book the appropriate amount of time or more than one visit if needed.
Making the best of it
While we have to seek and provide care in an imperfect system, I believe that good communication can help remedy some of our system challenges.
I hope this information from a doctor's perspective will help out with your next medical encounter.
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