It’s Monday at 11 a.m., and you have a visit set for 3 p.m. with your primary physician. You plan to ask your doctor about a recent knee injury and intermittent headaches, but you only mentioned knee pain when you made the appointment. You’ve put a reminder note in your cellphone to also mention the headaches, but that’s as far as you’ve gotten.
What’s wrong here? For one, you’ve only given your doctor part of the picture, and that means you’ll spend the first few minutes of the visit filling in the details before you and your doctor can start discussing a diagnosis and care plan. Second, the office is likely preparing for a single-issue visit and has allotted your doctor’s time accordingly.
Whether you’re making an appointment for your annual wellness check or a new health issue, preparing yourself—and the practice staff—in advance can help make the difference between a satisfying, productive medical visit and a frustrating one. Below, you’ll find some guidance for making the most of your doctor’s visit—whether it’s in person or virtual.
1. Think big picture about your health, not just your immediate needs.
Preparing a list of your health concerns for an annual visit or writing down details about a bothersome new symptom are good starting points. It can also be helpful to perform a brief health self-assessment to prioritize your medical concerns, says John Wasson, M.D., emeritus professor of community and family medicine and longtime researcher with the Dartmouth Institute for Health Policy and Clinical Practice in Lebanon, New Hampshire. Dr. Wasson helped to create the What Matters Index at How’s Your Health, a brief confidential questionnaire meant to help people identify various potential issues to discuss with their doctors.
Thinking through your overall health prior to your appointment in addition to your specific concerns can help increase your health-confidence level, which Dr. Wasson points to as an important aspect of navigating medical care. Health confidence is an indicator of how capable patients feel at managing their health conditions. Research has shown that higher health-confidence levels improve the engagement of patients in their care and the communication between doctor and patient during visits. Health confidence doesn’t exist in a vacuum—many factors can impact it, including your socioeconomic status and the quality of the care you receive. But spending time thinking about your health before your appointment may help you increase your health confidence and better advocate for your needs.
2. Brief the medical staff on your needs so they can allot enough time for your visit.
Most physician practices set aside an amount of time for your appointment that reflects the visit’s expected “complexity,” in health care terminology. An annual or preventive visit might be scheduled for 30 to 45 minutes, for instance, and a problem recheck—to see how a wound is healing or whether antibiotics knocked out an infection—for 10 to 15 minutes, Dr. Wasson explains. A new-problem visit, when the patient has requested an appointment for perhaps a skin rash or a possible urinary tract infection, might be allocated 15 or 20 minutes. A third type of visit is transactional—you’re going in for a test or procedure—and its length varies depending on the test or procedure in question. “If you use the What Matters Index, and you know how much time is allotted for your visit, then you might be able to detect and remedy a mismatch before you get there,” Dr. Wasson says.
It’s helpful to have some sense of what goes on behind the scenes in your doctor’s office if possible so that you can request the right type of visit. “Some organizations place constraints on the amount of time providers are given with each patient,” Matthew Goldman, M.D., a family medicine specialist at the Cleveland Clinic in Ohio, tells SELF. “Ideally, the more time the better. But because a lot of people are often seeking care from a single provider at a time, constraints must be placed to avoid long wait times.”
To avoid a mismatch between the practice’s expectations and your own, Dr. Goldman suggests preparing a list of concerns, prioritized by what’s most pressing, that you want your doctor to address. Ideally, you would share that information in advance with the scheduler or in a secure message via the online portal, if you have access to one. That helps ensure that you get the attention you need and deserve, Dr. Goldman says, by making the encounter as efficient as possible.
Even if you’re not able to share your list of concerns with the practice staff in advance, make sure you know how long your visit is supposed to be. “It’s helpful for the patient to ask, how long is this visit?” Mathew Devine, D.O., associate medicine professor at the University of Rochester Medical Center in Rochester, New York, and medical director of Highland Family Medicine, tells SELF. “They know they’re supposed to arrive at 11:45, but does that mean the visit is 15 minutes or 20 or 45 minutes? Patients should be aware of that.”
3. If possible, be extremely detailed when you brief the practice staff.
At a typical doctor’s office, the front-desk staff, nurses, and medical assistants are all key players in queueing up your visit. So let the staff help you by providing them as much detail as possible.
“By letting the schedulers, medical assistant, and nurses know what’s going on ahead of the visit, the physician has time to review the chart and focus on potential causes—medications or previous medical history, for example—that might be contributing to the patient’s concerns,” Dr. Goldman tells SELF. “I suggest that patients dedicate time to writing out their concerns and then, if possible, elaborate on each concern. Create a timeline or big picture of when the issue started and the treatments you’ve tried.”
The better informed the doctor is, the better the visit may go. Dr. Devine describes an “A+” experience involving a patient who’d been in an accident. The patient was managing several different health care providers and services, and the day before her visit, she sent, through the portal, an update on how she was doing and what she wanted to talk about in the visit. “I have the update and the agenda, so once we get in the room, I’m cooking,” Dr. Devine says. “It’s amazing when patients are prepared like that.” But it’s also unusual; in his experience, only 10% of patients prepare and bring a list to the visit. There are many valid reasons why it might not be possible for you to provide that kind of detailed update beforehand, such as a lack of time. But if you’re able to do this, it can be really helpful.
If the visit will be virtual, preparation is especially crucial. Try to make sure you have all pertinent information on hand and available to the doctor in advance. This includes not only your medications and a timeline of your concerns but also images of the area you’re having an issue with—if that’s applicable and doable. Ideally, it helps if you also access the virtual platform before the scheduled visit start time to make sure it’s working smoothly, Dr. Goldman tells SELF. “Technical glitches can be a challenge, so ensuring a working connection, camera, and access to the application before the visit starts can help prevent issues when it is time for the visit,” he says.
4. Understand that your visit agenda and the doctor’s might differ.
If you show up with an eight-item list, the doctor might not be able to address all your concerns in one visit. Also, keep in mind that the doctor will want to focus on any potentially serious issue first. “Sometimes, my patient’s number one problem they want to talk about is different than mine,” Dr. Devine says. The patient might be worried about a spot on her skin that he can tell isn’t cancerous, he explains, but he wants to start with the unintended weight loss that the patient mentioned in the portal before the visit. “I want to make sure the patient gets to talk about their agenda items, but there are some things where we have to meet in the middle,” he says.
If the patient has 12 things on their list, Dr. Devine resets expectations. “I say, ‘I see that you have a lot of things you want to talk about, but we can probably only talk about three to five in this visit. Which things are really important to you that you want to make sure we talk about today?’” he says. “Then I pick a few things that are important to me to address, and we go from there.” If you’re not able to fit it all into one visit, ask your doctor if you can address the remaining issues in a subsequent one.
5. Be prepared to share everything that concerns you upfront.
There’s a phenomenon in physician-patient encounters, the “hand on the doorknob.” That’s when the doctor thinks the visit has concluded and is getting ready to leave the room, but the patient raises an issue they haven’t previously divulged. When that happens, it’s problematic for both parties. The “by the way” problem might be an important health issue that should have been addressed early in the visit. Or the doctor may simply be out of time. Either way, the situation can make for a less than satisfying visit.
Dr. Devine has developed a method for preventing that dilemma. At the start of the visit, he acknowledges the patient’s list, but then asks: Is there anything else? “If I don’t do that, I risk the hand on the doorknob,” he tells SELF. Even if your doctor doesn’t ask that type of question, try to remember how helpful it can be to bring up all of your concerns at the start of the visit instead of saving some for the end.
To ensure that your doctor’s visit is comprehensive, it’s also important to be prepared to discuss anything that’s concerning you—even something sensitive like possible exposure to sexually transmitted infections, Dr. Goldman advises. “These topics can be difficult to discuss for many potential reasons. I encourage patients to gather information on the topic to gain insight on potential causes, testing, and treatment options,” he says. “Oftentimes the office can provide this kind of information beforehand. Having a better understanding often helps reduce anxiety and stress.” If you want to do some online research into a health issue you’re having before you go to the doctor’s office, make sure you only use reliable sources such as the Mayo Clinic Symptom Checker, Dr. Wasson advises. (Or that you rely only on resources that draw from those kinds of sources.) It’s also worth asking if the practice can provide or direct you to information to review.
Finally, if you leave the office (or sign off from your appointment) and realize you’ve forgotten to ask about an issue, that’s okay. Get back in touch with your doctor’s office by calling or sending a message online. “That’s a great use for the portal. If you’re awake at 3 a.m. thinking about something you forgot, and you’re not having the worst chest pain of your life, send a note—and the nurse or doctor will get back to you,” Dr. Devine says. “Just remember that the portal isn’t for emergencies.”
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