My clinic day starts at 8:30 am. I usually arrive at the office 15 minutes early, which allows me to review my patient list for the day and prepare to see the first patient. Sometimes, I have to review dozens of pages of my patients’ medical records from other healthcare systems one or two days in advance. A little bit of preparation can make a huge difference, improving my efficiency and giving me more time to listen to my patients.
Now, would you do any preparation before you visit a doctor? This question may seem nonsensical. It’s the doctor’s job to diagnose and create a treatment plan. Why should a patient prepare?
Let’s consider another scenario. You’re going to meet with your accountant to prepare your tax return. Would you go without any preparation? Probably not. You would bring your W2 or 1099 forms and gather all your receipts to maximize your deductions. You want to ensure that your accountant doesn’t miss any details, so you can save as much money as possible on taxes.
Similarly, seeing a doctor can be expensive and time-consuming. You wouldn’t want any delays or mismanagement. In fact, for a doctor to make a diagnosis, they need to gather information first, including subjective and objective data. The symptoms you describe, the course of the disease you’ve experienced, and your response to prior medical treatments fall into the category of subjective history. Your blood test results, imaging reports, or physical examination findings belong to the objective data category. Generally, your doctor should have access to all your medical records, which are either already available in the computer system or can be obtained upon request. Therefore, you don’t need to remember all your test results. Your primary responsibility is to provide a detailed description of your symptoms or concerns. While your doctor usually leads the conversation, you are the primary source of information. Ideally, you should keep your story concise, accurate, and include essential details. Avoid exaggerating or sugar-coating the severity of your symptoms, as this could lead to misunderstandings with your doctor. Consequently, unnecessary tests may be ordered, or the diagnosis might be delayed.
Moreover, remember that your time is limited. If your appointment is only 30 minutes (for details on why it’s limited, please see “What Is in Your Medical Bill”), you probably have no more than 15 minutes to provide this information, as your doctor needs the remainder of the time to answer your questions and explain the treatment plan. As you can see, being a patient is not always easy.
Here are some general rules I would recommend following. They will make your appointment more efficient and productive.
- Take notes about your concerns. Sometimes, you may have to wait for weeks or even months to see a doctor. Even though a medical condition may have been bothering you for some time, you won’t remember every single detail. This has nothing to do with your memory; it’s a part of human nature. Humans tend to have a better memory of what they want to believe. If the symptoms are improving, people tend to understate the duration or severity of the initial symptoms. On the other hand, exaggeration is not uncommon. To ensure an accurate description, you should start documenting your symptoms when you decide to see a doctor.
- Document ‘3W and RICE’. ‘3W’ stands for ‘When’, ‘Where’, and ‘What’.
‘WHEN’: When diagnosing a disease, it’s crucial to know when the symptom started and how long it has lasted. For the same symptom, an acute onset can be vastly different from a symptom with a subtle onset, and intermittent symptoms may suggest less severe health conditions compared to persistent symptoms.
‘WHERE’: Location is crucial. In most cases, the symptom’s location can provide valuable clues about the underlying problem. For instance, when you experience chest pain, doctors may order tests to examine your heart, lungs, esophagus, blood vessels in your chest, and ribs. However, there are exceptions. During a heart attack, you might first notice pain in your left arm, jaw, or upper abdomen due to cross-talk between the nerves regulating your heart and other structures. Additionally, symptoms can occur at different locations, so it’s essential to record the timing of these events. Migrating symptoms could be a characteristic feature of certain diseases, such as acute appendicitis, which features migratory abdominal pain.
‘WHAT’: This is the key part of your story, providing vital information to your doctor as they formulate a plan to investigate. Ideally, you want to keep your story focused and avoid fixating on trivial details.
I recommend using ‘RICE,’ which stands for ‘Reliever, Intensity, Change, Enhancer,’ to guide your description. Do your best to identify and record potential factors triggering or relieving your symptoms, and how your symptoms have changed over time. Sometimes, it may be challenging to pinpoint exactly what contributes to your symptoms, especially when they occur randomly. In such cases, keeping a diary recording all relevant events can be helpful. Once you’ve collected enough information, sorting through it will help you find correlations between your symptoms and external factors. Additionally, describing intensity with a numeric rating scale, such as 0-10, where 10 represents the worst, makes your description more accurate and facilitates comparison.
- Don’t Google your symptoms, and don’t trust ChatGPT. Many people search for information about their health conditions online, which is understandable. When you search for a single symptom, you can receive hundreds or even thousands of search results. The real question is which sources you can trust. Some provide educational information, while others may simply be trying to sell you something. Additionally, conflicting opinions on the same question are common, and it can be difficult to discern which one is correct, especially when you don’t have much knowledge in medicine.
You might think ChatGPT does a better job, but I have to say you may be too naive. ChatGPT often provides a mixture of facts and imagination. Without a background in that specific field, it’s easy to be misled by ChatGPT because it is an excellent writer and can present false claims that are often very convincing.
- Make sure your medical records are available to your doctor. Whenever your primary care provider refers you to see a specialist, the office note will be sent to that specialist. If the specialist and your primary care provider work in the same network, they may share the same electronic medical record system and have direct access to all the data, including images. If they don’t belong to the same network, there is a chance that the specialist doesn’t have all your medical records. So, it’s a good practice to call the provider’s office at least two weeks before your appointment to confirm that they have received the medical records, especially if you’ve already undergone numerous tests or imaging. The last thing you want is for the doctor not to have your medical records when you sit in their office. This could lead to either unnecessary tests or the need to schedule another follow-up appointment once they review your medical records. Both scenarios waste your time and money.
These suggestions may seem like a lot of effort, but they will help you be well-prepared for your doctor’s appointment, making it more efficient and productive. In the end, they will save you time and money, and, more importantly, help avoid any delays in your treatment.
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