In my career as a patient, I’ll admit I’ve been lucky. Blessed with a good constitution and healthy lifestyle, I haven’t spent any time in the hospital or suffered from chronic conditions. Raised in Canada, I remember informative check-ups with my general practictioner, sometimes lasting an hour or more, which included a lesson on preventative care. It isn’t so surprising then, that for our family doctor here in Southern California, we chose K. Mitchell Naficy. Dr. Naficy is patient, answers all questions and has an excellent bedside manner. He runs a busy office, but always appears relaxed and ready to hear out our concerns, and sits down to problem-solve alternative remedies with us, without simply handing over a prescription and moving on. However, like most people, we’ve had the frustration of walking out of our doctor’s office and realizing that we hadn’t addressed all the problems that led to the visit–primarily because we weren’t organized enough.
In some cases, even the most well-meaning doctors struggle to provide the care they wish to give. More and more, it is due to tightening budgets–not only on the patient’s side, but times have changed for the medical profession. Dr. Margaret Lewin, Medical Director of Cinergy Health, says, “Financially, we’d like to get our healthcare with doctors who participate with our health plan, so that we need part with only a relatively small co-pay for the visit. However, your healthplan doctor has discounted his fees in order to participate in the plan and has had to add staff and equipment in order to handle the paperwork and phonecalls generated by the insurance companies. When you consider the increasing cycle of skyrocketing costs and decreasing reimbursements, you can see that participating doctors must see more and more patients daily – spending less and less time with each.”
Dr. Lewin suggests that if you’re lucky enough to have a policy which covers out of network healthcare, and you want more time with the doctor, then choose a physician who does not accept insurance. Do check to see how long the doctor spends for a complete exam and for a short office visit, to see if that scheduling better suits your needs than an in-network doctor. You’ll probably have to pay up-front, submitting the claims to your insurance company and waiting to be reimbursed.
Make sure to maximize your time with your doctor:
· On your first visit, give the doctor a detailed medical history – preferably typed, and including your allergies, past surgeries and serious illnesses, family medical history and a list of all your medications, including dietary supplements and other over-the-counter products – even if you don’t use them regularly (in fact, you should always carry that list of medications in your wallet, along with your doctor’s business card, in case of emergency); on subsequent visits, always give the doctor an updated list of those medications
· Take with you a careful list of all your issues, placing first the most important ones – try not to get distracted from that list. If you need prescription refills, be sure to give the doctor a list of those needs at the beginning of the visit. Make sure preventative care is on your list.
· Studies show that when a doctor makes the simple gesture of sitting down, it immediatrely gives the patient more confidence that he is listening. Politely request this. Most doctors spend a lot of time on their feet, so don’t be shy.
· For many doctors, discussing complementary alternative medicine (CAM) with a patient can prove as delicate a topic as religion or politics. Don’t wait for your doctor to bring up CAM methods–Ask.
· When the doctor explains the diagnosis and recommendations, make sure you understand by repeating back in your own words.
· When given prescriptions, check that the new medications don’t interact unfavorably with your usual regimen, and ask for expected side effects and what to do should they occur.
Before leaving the office, check with the staff to find out to handle problems that come up between visits:
· What to do in an emergency, including finding out which hospital emergency department to go to if necessary
· Is the doctor available for emergencies outside of regular office hours – and if not, what arrangements have been set up?
· Is there a nurse practitioner or physician’s assistant to call? Does the doctor have regular times set aside for telephone calls? Can you email in your questions – and if so, what’s the expected turn-around time?
· What’s the procedure for getting prescription refills?
Being super-organized will help you get the most out of your doctor visits. If, however, you find that even this doesn’t give you the time you need to fulfill your medical needs, it’s time to consider changing doctors!