Together Patient Advocates Blog

Doctor appointments are very brief--according to Medscape’s Physician Compensation Report, the average appointment time across all specialties is 13-16 minutes. There’s a lot to accomplish during that short time, and it’s easy for important information to be rushed, or skipped altogether. Through my experiences first as a physician, and later as a patient, I've compiled a list of ten ways in which you can better advocate for yourself at the doctor’s office:

1. Prepare for your appointment ahead of time: Know the main reason you’re going to this appointment and take a list of current concerns and questions with you. If seeing your doctor for a specific complaint, think about how when it started, what makes it better or worse, any associated symptoms, and what you've tried for it. If you're seeing a specialist, make sure they have access to relevant test results - or bring a copy with you. Bring an updated medication list, or carry all medications in a ziplock bag. Don't forget supplements and over-the-counter medications.
2. Arrive 15 minutes prior to your visit. These 15 minutes will be spent checking in, filling out paperwork, and having vital signs taken. Being early allows the entire visit to be spent on your concerns. Patients who arrive late are either rescheduled, asked to wait until the end of the half-day, or allotted less time for their appointment. If you must be late, call ahead and discuss with the receptionist.
3. Make a list of your concerns.  If you have a long list of concerns, let your doctor know at the beginning of the appointment. It's helpful if you can acknowledge that there may not be time to address all of your concerns at this appointment. A list ensures you don't forget something important, and may allow your physician to focus on the issue most critical to your health. Case in point, I had a patient who regularly presented with numerous different concerns. I asked her to write them out - when she did her priority was her toenail fungus, but my priority was last (#20!) on her list: chest pain.
4. Take notes and take a friend with you if possible. If you're considering recording your appointment, ask your physician first. No one likes to be recorded without permission - and it's illegal in some states. Studies show patients forget 40-80% of the information communicated during a doctor's appointment immediately and that the information remembered is incorrect 50% of the time.
5. Be ready to have the areas that are bothering you examined. It’s a simple thing, but saves time for more important issues. Ask for a gown if the area is covered. Take off your shoes and socks if your feet need to be examined. I saw a patient with musculoskeletal sounding back pain once. Thankfully, I had him gown and could see the classic shingle's rash across his back.
6. Ask “What else could this be?” when a diagnosis is made. This simple question helps your physician avoid the most common error: fixing on a diagnosis and failing to consider alternative ones. Dr. Jerome Groopman explores this and other cognitive errors made by physicians in his book How Doctor's Think.
7. If a new drug is prescribed, ask questions! Watch for a future blog post on this topic.  
8. If you don’t understand something, ask for clarification. Medical jargon is often hard to understand. Your doctor won’t know you don’t understand unless you say something.
9. Know the follow-up plan: How soon should you follow-up if symptoms don’t resolve? If they do resolve? If a referral was made to a specialist, how soon should you be seen? When should you hear from the office about the referral? When should you let your doctor know if you haven’t heard from the specialist’s office? I was referred to a specialist by my primary. I knew she wanted me seen within two weeks and knew to call to follow-up on the appointment if I hadn't been contacted within the week. The referral had been dropped by the computer system and without this information, I could have waited weeks before knowing there was a problem.
10. Hire an independent patient advocate. An independent patient advocate will help you prepare for your appointment, will help you understand what happened, and can educate you on your disease. Most importantly, an independent patient advocate will advocate with you during your visit if your concerns aren’t being addressed, or if there’s reason to think that an error is being made. Physicians generally appreciate having an advocate present as they know that their patient will be more likely to understand the appointment and will have additional resources for education about their illness. Patients who have advocates are better prepared to follow the treatment plan and to make all necessary follow-up visits. 

These simple steps will help you to be a better advocate for yourself and thus, improve your healthcare and your health outcomes.