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As delivery of healthcare continues to change, your relationship with your doctor may no longer be like talking to Marcus Welby. No matter what you heard, Dr. Welby was an actor not a doctor.

Managed care, restrictions and reimbursement reductions imposed by Medicare and private insurance have forced doctors to see more patients just to keep their practices afloat. This means less time for each patient.

Even the most confident big wigs may feel intimidated as they wait barefoot in an exam room in a open-backed hospital gown. To complicate matters, all the restrictions, paperwork and limits on reimbursements contribute to a shortage of front line doctors like internists and general practitioners. In addition, a movement to empower the patient to become more involved in their own care has shifted relationship focus from primary care doctor to specialist, who typically have even less time to foster a long-term patient-doctor relationship.

So how do you handle a doctor appointment, get answers to your questions and understand what the doctor tells you? Here are a few tips to help you make your doctor visit a success:

  • Start with a pencil and paper. If you are experiencing a symptom that has prompted you to consider an appointment, keep a diary of what is happening, what activities bring on your symptoms and when you experience them so you can give your doctor the most accurate information. If you are experiencing pain rank it in the diary from 1 to 10. If the symptoms or pain are aggravated or relieved by medication you are taking, note that too.
  • Learn how to communicate effectively with the office staff.  Making an appointment with a doctor can be a challenge in itself. If a health issue is potentially embarrassing, asking the doctor to call you may not be the best course to take without giving them an inkling to the why you are calling. If a script is helpful when you call and talk to the receptionist or scheduler, write one. Regardless of the issue, give the receptionist at least some idea of why you are calling. Don’t worry – he or she has heard worse. One trick that works well for me is to fax the doctor. I give a brief, written explanation, and I always get a quick call from the nurse or physicians assistance. If the office will give you an e-mail address, that’s even better. You can e-mail your notes or symptom diary.
  • Bring someone that will keep you occupied and not aggravated in the waiting room. If you feel you may benefit by someone being there with you, then bring a friend, family member or caregiver. Another set of ears and someone who is slightly detached from your symptoms may make the visit even more beneficial. Of course, this is your appointment and you should be communicating directly with the doctor.  Your support person should be there just to support you and should not be having the primary conversation with the doctor.
  • Remember your doctor is here to help you. You should clearly communicate all information, issues and concerns with your doctor.  Your doctor can then more thoroughly evaluate you and then offer a clear explanation or solution that you can understand.
  • Take notes. If necessary, ask the doctor to repeat what he or she told you so you can make notes. If your doctor is giving you too much information too quickly, speak up and let him or her know to slow down. A small tape recorder could come in very handy for playback later.
  • If you feel that good bedside manner is lacking in your relationship with your doctor, a change may be in order. Not all doctors have good bedside or exam table manners. While they may be great technicians or mechanics, they may lack in the personality arena. More and more, medical schools are focusing on this intra-personal area of medicine. Many are adopting role playing scenarios to allow doctors to understand how their mannerisms can affect their patients. You should expect your doctor to treat you with respect.
  • Being open and honest with your doctor is in your best interest. If you have a concern about what you are being told, tell him or her. If there is some underlying issue that may affect when, where or how you may be able to comply with recommendations, tell your doctor. The more your doctor knows about you, the better he or she can help you.

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