Frustrations of Doctor Appointments- Take Charge!

We have developed a culture of medicine in America in which primary care providers don’t have adequate time to truly assess our needs and actually deliver the quality health care that we need.

As a medical provider, I can tell you it’s not easy delivering quality health care, the kind you would want to have for yourself, for your mother or for your favorite aunt. Let’s face it, a proper record review for some of us would take hours, if not days. Not many of us are fortunate enough to have that old-time personal physician that has known us, our medical history, and the history of all of our family members since the day we were born.

I spent the last 20 years working in military medicine. The military transitioned to an online electronic record starting about 2003. As a provider it’s great. You have access to patients’ labs, x-rays, prescription history and all medical visits (at least since about 2005 when the system was implimented worldwide). Some civilian providers and facilities are transitioning to some type of computer documentation program. Many, if not most however continue with handwritten charts and all of the difficulties that go along with them, not the least of which is reading multitudes of different handwritings. I can’t always read my own writing. There are frequent situations where patients are seen with no form of written history record. Unfortunately there are other situations where providers don’t review an available medical record, for whatever reason.

As an occupational therapist, I had an hour for new patients, and almost always reviewed my daily cases the night before to prepare. I could even review actual x-rays on my computer screen, which was important in orthopedic cases. Didn’t leave much time for a life, but having gotten less than satisfying medical care in so many instances myself, it was something I felt I had to do.

How long do you usually have face-to-face with your doctor? Fifteen minutes? Ten? Five? How much time do you think your provider spends looking over your chart before they walk in the door? Ten minutes? None? How much time does your doctor then spend writing orders and documenting when you leave the exam room? Does a nurse or medical tech do these things?

Let’s say the total time that a primary care provider spends on all of the above is 15 to 30 minutes. Let’s say we want more time, average being 60 minutes for doctor appointments. Sounds great, but I think we all know this is not likely to happen. What would this do to health care costs? What would this do to doctor availability? I’m a huge fan of Nurse Practitioners and Physicians Assistants, but the same would be true. There just would not be enough providers and the cost would be at least doubled.

As a provier, there is the stress of trying to review clients’ records. There is the stress of trying to do a good job, serve your patient, get your documentation done, enter x-ray and other orders. All this while being behind all day every day. So you see the next patient, in an attempt not to get too far off schedule. Then at the end of the day, or the next day, or never, you complete that documentation for that patient encounter. So assuming you actually heard what the patient was trying to communicate in the first place, do you still remember what was said by the patient, what you concluded and what you recommended? So from a patient perspective, the next time you’re seen, assuming the provider even takes the time to read your record, is it accurate?

Lots of things contribute to our rushed, inadequate system of Western Medicine health care. What is the answer? I’m afraid I don’t have a lot of answers to fix our broken way of providing healthcare, but I will offer a few suggestions for patients.

Prepare for doctor appointments with your primary care provider like you are preparing for a class or a test. Spend some time thinking about what you need to say. How can you present your “story” in a logical way, including key points and leaving out the fluff. I know it’s especially difficult when your problems are complex, you’ve not gotten satisfaction thus far, and you don’t frankly know what bit of info might be the “eureka” that turns things around. None-the-less, make an outline of your key points as best you can. Also make a list of your questions. I started taking a day of leave on my appointment days to minimize distractions, and to focus on myself.

Have a copy of your medications, chronic health conditions and brief history of current complaint that your provider can keep.

Be selfish. Yes your provider is likely pressed for time. You have to forget about that other patient that may get cut short if you take three extra minutes of the doctor’s time, but just do it. Press on until you get what you need from your doctor.

Do not be apologetic. You are a customer, and you deserve good customer service. I give great customer service, and when I don’t get it in return, from my doctor or from my Wal-Mart checker, it offends me.

It may not be possible because of your health care plan or because of lack of doctors in your area, but when possible shop around. There are places that realize that they are a business in a competitive market, and their good customer service reflects that.

Don’t be apologetic if you have questions or if you don’t understand something. If your doctor did not explain things in a way you can understand, that’s on him/her. This is what they do. It is their responsibility to explain things in ways patients can understand. I figure I’m at least as smart as the average bear. If I have a question, it must be a good question.

Hold your ground. You know your body better than anyone. Doesn’t matter how much formal education you have. I don’t know about you, but the less and less young I get, I find that I’m right way more than I’m wrong. Trust yourself.

Do your homework. Take advantage of the internet. You may not have more time than your provider, but who should be more interested in your health than you? Don’t be afraid to take your research in and show it to your doctor.

Finally, if what you’re doing is not working, do something else. Consider seeing an Alternative Medicine provider. It will likely cost you 100% out of pocket, but I can almost guarantee that you will feel listened to, and that you will leave feeling like you have been taken seriously.

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