Wednesday 23 May 2018

15 ways to get the most out of your doctor's appointment

Your appointment is short, but there's lots you want to ask. With a little preparation, you can ensure your GP visit is productive

Preparation will help to make the most of your visit to your doctor
Preparation will help to make the most of your visit to your doctor

Ailin Quinlan

Amid reports of a fall-off in the number of family doctors in parts of the country, many GP clinics are busier, and more time-pressured than ever before - so how do you make the most of your consultation? We've talked to experienced GPs and the Irish Patients' Association to get some useful tips.

1 Know why you're there

Be clear about why you're seeing your doctor, says Dr Andrew Jordan, chairman of the National Association of GPs and a practising GP based in Dublin.

Patient don't always express clearly why they've come to see the doctor, he says, adding that GPs can often spend valuable time trying to tease out what exactly the problem is.

"Time is the currency of general practise," says Dr Jordan, who advises patients to "clearly identify what's wrong and provide a good outline of your symptoms." Dr Jordan adds that it's also helpful to discuss issues in order of priority and to be ready with necessary information, such as how long you have been experiencing symptoms.

2 Don't Be a Heart-Sink Patient

Remember your doctor is only human so don't arrive at your consultation with a lengthy list of ailments that you want to discuss.

"Sometimes, a patient could have nine or 10 things on their list," says Dr Mark Rowe, GP, author of A Prescription for Happiness and expert in lifestyle medicine.

Like many doctors, he says, he's had experience of the "heart-sink" consultation where someone has come in with a long 'shopping-list' of ailments.

"Understand that the doctor is only human and can cover only about two or three things in a 15-minute consultation," he says, advising that patients should generally stick to a maximum of three issues, which they consider carefully and write down in advance.

"Explain at the beginning of the consultation that there are two things you want to consult the doctor about," he suggests.

3 Don't Be Embarrassed by Taboo Illnesses

If for example, you suffer from depression or have a sexually transmitted infection, don't let embarrassment get in the way of a helpful consultation, says Stephen McMahon of the Irish Patients' Association.

"Understand that the GP has seen it all before and it is not something to hold back on. Be open about your complaint," he says.

There's absolutely no point, he observes, in making an appointment with your GP and then not telling him or her about a serious health issue, because of embarrassment.

And don't be afraid to discuss issues such as suspected addiction to alcohol or gambling, adds Dr Rowe - your doctor is there specifically to help you.

4 Understand medication

Be sure you understand the context of any medicine that you are being prescribed, says Stephen McMahon. "If you're being prescribed a medication for depression or cholesterol, ensure that you establish what blood tests are needed in the future to monitor the effect of a drug, for example, lithium, in the case of depression. A lot of people may not even be aware that regular blood tests may be required to check the effect of medication they are taking.

5 Don't expect a pill for every ill

"A doctor does not have a magic wand, and many health conditions now are chronic, such as chronic pain, chronic obesity or mental health issues," says Dr Rowe.

"View the doctor-patient relationship as a partnership approach towards positive lifestyle improvement because very often, positive lifestyle changes can be the best medicine," he observes.

6 Dress Appropriately

Loose-fitting clothing is most appropriate for any visit which may involve a physical examination, says Dr Jordan.

"If you have a complaint in a particular part of the body, wear clothing that makes it easier to access and examine that area," he says, adding that sometimes patients arrive at the surgery in a number of layers of tight-fitting clothing.

7 Don't Be Rushed

Remember, you, the patient, are at the centre of your particular health crisis.

Don't feel your consultation should have to be rushed because there are other people sitting outside waiting to be seen by the doctor, says Stephen McMahon

"If you feel rushed, it's important to say to the doctor that, while you recognise that he or she is under pressure time-wise, you feel that you're being rushed and that you're not getting the time to explain your symptoms," he says. "This can be an issue with older patients whose GP has retired, for example and who are now meeting with a different GP, in a situation where there may be more pressure on the practise and the clock is running so they may not have the social engagement that they would have had in the past.

8 Honesty is the best policy

"Don't try to hoodwink your doctor about your alcohol consumption, how much your smoke, your diet or your exercise habits, urges Dr Rowe.

Be honest about your lifestyle as this will help your doctor help you, he emphasises.

"Your doctor is there to help and support you and there is no judgement, so don't be afraid to ask for the help you need."

9 Be sure you're seeing the relevant health professional

Be sure that you are seeing the right person, Dr Jordan advises.

"Some practices have a practice nurse, who will carry out functions such as administering travel or baby vaccines. The practice nurse will have different functions to the GP."

There have also been instances, he recalls, where people in the throes of a heart attack have turned up at their GP's surgery instead of going straight to a hospital emergency department.

"People often go to the A&E inappropriately, but occasionally some people come to the GP inappropriately," he adds.

Also consider that other health professionals besides the GP ­- such as physiotherapists, dietitians or therapists may be more relevant to certain issues like back pain, overweight or sleep problems, suggests Dr Rowe.

10 Know What Happens Next

At the end of your consultation, always ensure that you're clear about your treatment plan and how you will access any test results, Dr Jordan advises.

"Patients need to be clear about the follow-up plan for after the consultation - for example, that it is he or she who must ring the clinic for the results of a blood test.

"It's very important that you know if it is your responsibility to ring back for results.

"Different practises have different methods for dealing with this issue.

"For example, in our practise, we ask patients to either phone or email for their results. Is the GP going to contact them or will the GP practice make contact with the patient?"

11 Know What You're Taking

If you're taking any over-the-counter products or medication of any kind other than what the GP is prescribing for you, write down the details on a piece of paper to give to your doctor, or even bring the product with you in a zip-lock bag, so that if the doctor asks, you can give him or her a well-informed answer, advises Dr Jordan.

12 Urine Sample

Bring a fresh sample of urine in a sterile container to every consultation, preferably from your first urination of the day.

"This can be very useful," emphasises Dr Jordan, adding that if you don't have a suitable container at home, request one from the clinic reception desk when you arrive, and fill it in the toilet while you are waiting to see your doctor.

"A dipstick test can be done there and then. This can clearly identify a number of issues, for example, high levels of sugar or protein in the urine which are an indication of diabetes or kidney disease."

13 Get a Second Opinion

If you've made a number of visits to your GP about a health problem over an extended period of time, and you feel your condition is not improving, you're entitled to seek a second opinion, either from within the practice or outside it, says Stephen McMahon.

Alternatively, he suggests, highlight the lack of progress in resolving the problem to your doctor, and request that he or she treat you as a "new" patient by taking a fresh approach to the health condition and giving you a root-and-branch MOT.

14 
Think about Accessing the Cross Border Health Directive

If you're on a waiting list for an operation such as a hip replacement, or to get a first appointment with a consultant for further investigation of a health issue, take the opportunity on your next visit to your GP to ask whether your condition has deteriorated since you first went on the waiting list:

"If your condition has deteriorated, it might be worth asking about the Cross Border Health Directive, which offers more timely access to health care in another member state," says Mr McMahon. For information on the Directive, visit hse.ie

15 Take Responsibility

Be an active leader in your health rather than a passive consumer of healthcare advises Dr Rowe, who emphasises that it is very important for patients to be well-informed about their health and to take an active responsibility for it.

"Know about your own medical history and any screenings - breast check, colonoscopies or cholesterol checks - that you may need to have regularly," he says.

Ask yourself - 'What is my heath IQ?' he suggests. "Do you have the information in order to make the best choices for your long-term health?"

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