Wednesday 11 September 2013

Getting What You Need From A Doctor Appointment

Consider this:  an appointment with a doctor is similar to an important business meeting.  The better prepared you are, the more profitable the results of the meeting will be.  On the 'bad' end of the scale, the meeting will have no agenda.  Recent events will be only partially remembered and poorly communicated.  At the end of the allotted appointment time, the Doctor will say, "I'm sorry, but my next patient is waiting.  I'll see you again in six months."  You have barely begun to tell your story and you are forced to leave, angry and without a treatment plan.

To get the best results for you or your loved one, you need to set the agenda and ensure that you get everything you need in the allotted appointment time.

Below you'll find my version of a template for a doctor appointment working document.  Fill in all the pertinent information about you or your loved one and make copies for everyone in attendance.  If the appointment is very important and likely to be emotional, bring a friend who will act as a notetaker or scribe.  Make sure that the person taking notes has plenty of paper and an extra pen.  

For complex cases or chronic illness, a separate document with the history will be really useful for every healthcare-related appointment or visit to a clinic or the emergency room.  Major events, diagnoses, hospitalisations, procedures or surgeries should be listed in point form with approximate dates and name of hospital/institution.  Doctors will still ask for historical information, but using the prepared document will save valuable time.  Ensure that you don't forget any important facts.  

Presenting an appointment document shows that you have already invested time and energy into your relationship with the physician.  Doctors appreciate not having to dig for vital information and more time can be spent on getting straight to the diagnosis or treatment plan.  It pays to BE PREPARED!

Appointment with Dr. _________

Appointment Date:  
Appointment Location: 

Name of Patient 
Date of Birth
Address of Patient
INSURANCE information (or National/Provincial Health Card # if applicable)
Home tel:
Cell Number:
Emergency Contact:  Name and Telephone

Current Medications
List all medications in milligrams including those prescribed on an as-needed basis (eg.  Domperidone 10mg 4x/day)

Current Professionals Involved:
List GP and all specialists including contact information for each

MEDICAL HISTORY (example of a fictional patient's medical history since diagnosis of MME)
·      Healthy and normal until Mononucleosis in October, 2009
·     Since  November, 2009  Extreme fatigue and poor stamina
2   2011 Diagnosis of MME-Epstein Barr (Chronic Fatigue) at Mount Sinai Hospital 
    April, 2012 Admission to Mount Sinai Hospital for pneumonia

RECENT HISTORY AND CURRENT SYMPTOMS (List symptoms since last appointment or, if this is the first appointment with a specialist, list symptoms within the last month.  Note any symptoms within the last week if this is an emergency appointment)
·    Periodic weakness in legs (unable to walk)
    Numbness/tingling in right hand
    Ringing in ears
    Extreme fatigue
QUESTIONS:  (questions for doctor)

Do you agree with the diagnosis of MME - Chronic Fatigue syndrome?
·      Given the current research and my constellation of symptoms, what is my prognosis?
·      Are there treatments that I haven’t tried that you could suggest?
·      Are there strategies I could try myself to improve my quality of life?
·      What are the actions patient and family should take between calling 911 and doing nothing?  How often will you be seeing me?  When should we call you? Is there a nurse practitioner in your practice?  Who can I call for advice if I am not doing well?  Is there a local support group?  How can I apply for disability or unemployment benefits?

REQUESTS: (action items for doctor)
-  Share test results, reports and relevant research with GP
 -  Social work consult for questions about disability or unemployment benefits

PERSONAL STATEMENT:  (the effect of the illness on patient's whole life)
My symptoms and extreme fatigue have forced me to abandon my job for the time being.  I am discouraged and sick of being sick.  I am concerned about the long-term effects of my illness, including on my sister who is my principle caregiver.  I remain optimistic that you, working together with my other specialists, will help me recover my health and my life.