Making the Most of Your Doctor Visit

Whether you avoid the doctor's office like the plague or visit often enough to earn your own parking space, it's important to remember the best healthcare is rarely obtained by chance. So if you're moving to a new community, switching insurance plans, or dissatisfied with your current healthcare provider and are thinking about making a change, here are some guidelines to help you find a doctor you're comfortable with—and to make that doctor visit more productive.

Choosing Your Primary-Care Physician

Consider the following in selecting a doctor:

Decide what type of medical office you prefer as "home base." Even if you have a complex medical history, it's wise to have a primary-care physician who knows your "whole story" and can deal with day-to-day problems. For many, this is a family physician who can treat multiple generations living under the same roof. Others prefer having a pediatrician for the kids and a general internist for themselves. For many women the gynecologist/obstetrician serves as the primary provider, handling a variety of acute problems along with routine checkups and Pap smears.

Ask around. Take an informal poll in your church, neighborhood, or at work to see which doctors or clinics are mentioned most often. If you already know someone in the medical community—for example, a neighbor who's a nurse at a local hospital—ask for some recommendations. Women with prolife convictions usually prefer to see gynecologists who don't perform abortions, and local crisis pregnancy centers or other prolife organizations usually maintain a list of abortionists.

Consider having a "get acquainted" session. If you've narrowed your list but aren't sure of your choice, set up a "meet-the-doctor" visit. Among other things, you will want to:

1. See how you're treated on the phone. Does the person at the other end of the line sound friendly and pleasant, or harried and hostile?
   
   
2. Check out the office. Do you feel welcome? Does it feel like Grand Central Station, a funeral parlor, or a place that will help you stay calm in a crisis?
   
   
3. Briefly talk with the doctor. If you make it clear you just want to look around, you typically won't be charged (but don't expect a half-hour consultation). If you have lots of questions about the practice, someone on the office staff may be able to answer them for you.
   
   

Once You've Picked the Practice …

Here's how to get the most out of your contacts with the doctor and office staff.

Let the appointment person know what you need to talk about. The time allotted to you may well depend on the number and type of concerns you have. It takes more time to deal with chronic fatigue than a sore throat, and three complaints probably take longer than one. (If the topic's sensitive, you can say you want to discuss a personal problem.)

Don't insist you'll "speak only to the doctor, and no one else." Except for highly complex or confidential problems, this usually delays getting your problem solved. Nearly every doctor relies heavily on a nurse to screen medical calls, and she'll usually be able to deal with your need more quickly; the doctor may not be able to get to "physician only" calls until the end of the day. Also, if the office utilizes nurse practitioners or physician's assistants, don't be afraid to see one, especially for an acute problem. These well-trained caregivers work under the direct supervision of the physician, and on a busy day may actually be able to give you more time than the doctor.

Let the doctor know what's on your agenda. If you have more than one item to talk about, make a list and note what's most important to you. If you give this to the caregiver at the beginning of your visit, your time together will be spent more effectively.

Avoid using the three most dreaded words in medicine: "By the way … " The "By the way … " problem (or its cousin, the "While I'm here … " complaint) may need more time than the original reason for the visit, and you won't want a half-baked, "shoot from the hip" response.

Don't bring a "surprise guest." This is a "By the way … " question with two legs: "While we're here, would you look in Jennie's ear?" The doctor will need Jennie's chart and probably a little more time to provide the proper care (even if the problem is simple), so advance notice is appropriate.

Make friends with the office staff. On any given day the receptionist, nurses, and other employees in most medical offices deal with a number of unhappy and occasionally hostile people. If you're particularly friendly, cooperative, and even complimentary, you'll make their day—and probably get better service.

Don't push the wrong friendship buttons. If you know the doctor outside the office setting, don't try to use this to bypass normal office procedures. Saying "I'm a friend of Dr. Jones—he'll see me without an appointment"—is a sure way to alienate the people who work with him every day. Even worse, if you announce you attend the same church as your physician, then regularly hassle or browbeat the office staff, this will reflect poorly on Christ and on your church as a whole.

Respect your doctor's off-duty boundaries. The supermarket, the mall, and especially the church aren't extensions of his or her office. One physician who was repeatedly approached at church for medical advice finally ended these intrusions by suggesting, "Why don't you take off your clothes and lie down here on the pew so we can check it out?"

Don't be afraid to ask questions. It's always appropriate to understand what your doctor recommends, and what the risks and benefits of any proposed treatment are. If you feel the information you've received during a visit needs to be translated into plain English, don't hesitate to ask for clarification. Elderly patients who have difficulty hearing or comprehending may misunderstand the physician's recommendations, so a family member at the visit may help prevent a potentially hazardous consequence.

Paul Reisser, M.D., is a family physician in Southern California and the author of What You Need to Know about Menopause (Servant Books). He serves on the Physician's Advisory Council for Focus on the Family.

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