Transcript Document

How to Talk To Your Doctor
Marj Bernstein & Cathie Duncan
Bridges Program
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Goals
• What is a primary care doctor?
• How can I make the most out of my doctor visit?
• Decision making with your doctor
• What is your responsibility?
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Who are Primary Care Doctors?
• Family Practice
• Internal Medicine
• Ob/Gyn
• Pediatricians
• Physician Assistants
• Nurse Practitioners
• Not a specialist
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What Does Your PCP Need to Know?
• Your medical history
• Your surgical history
• Your medications
• Your home and family situation
• Your values, religion and beliefs
• Your end of life wishes
• Any barriers that prevent you from
affording or accessing care
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How Can You Get the Most Out of
Your Doctor Visit?
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Things to Do
• Prepare
• Prioritize
• Be Clear
• Be Honest
• Ask Questions
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Prepare
• Time is limited
• Most appointment slots are 10-20 minutes long
• Providers have more pressures on them than ever before
• Insurance companies have decreased reimbursements
• They must see more patients
• Overhead is increasing
• Electronic medical records are slowing some down and
changing the nature of the patient-physician relationship
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Prepare
• Take information with you to include:
• Prior medical records
• Insurance card
• Test results
• Medication list or medications in bottle
• Everything you are taking including herbal
supplements
• Contact information for other doctors
• Make a list of your questions or symptoms
• Bring glasses or hearing devices so you can hear and
see
• Consider bringing a friend or family member
• Ask for an interpreter if necessary
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Sample Questions
• Why is this test necessary? What will it tell us that we don't
already know?
• Will the results significantly alter any treatment plans?
• When will the results be ready? Should I call you for them, or
will you call me?
• What is my exact diagnosis? What's the cause of my problem?
• How long will I be sick?
• How long before I'll see improvement?
• What treatments are used for my condition? Which is best for
me, and why?
• What does the research show about this treatment?
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Sample Questions
• Is there any research on the horizon about treatments for my
condition?
• What can I expect from this treatment, based on your
experience?
• What are the side effects of this medication? Will it interact with
alcohol, caffeine, or other drugs or supplements I take?
• Are there any alternative treatments appropriate for me to try,
either before or along with conventional treatment?
• How will these changes help my disorder? How soon should I
expect to see an effect?
• How drastic do the changes have to be to produce real results?
• Do you have any tips that would make these changes easier?
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Prioritize
• List your concerns
• What is the most important to you?
• What is the point of your visit?
• List 3-4 significant issues that you
want to discuss
• Chronic medical problems?
• Medications?
• Test results?
• Concerns about health?
• Visit for routine screening?
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Be Clear
Describe your symptoms:
“A departure from normal function or feeling
that is noticed by a patient, indicating the
presence of disease or abnormality”
Everything is relative…
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Symptoms
• Bodily Location
Where does it hurt?
• Quality
What kind of pain? Sharp/dull
• Quantity
How often, how much?
• Timing
When did it start?
Does it come and go?
• Settings
What brings it on?
• Changes
What makes it better or worse?
• Other symptoms
What else happens when you
have this pain?
Consider keeping a symptom diary to help you remember these details
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Be Honest
• It is important for you to answer your doctor’s
questions honestly
• Although some things may be uncomfortable
to talk about, it helps the doctor understand
your problems better
• Don’t tell them what you think they want to
hear
• Voice your concerns
• What do you think is happening?
• What are you concerned about?
• Do you have problems paying for medicine, copays or getting to specialist appointments?
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Ask Questions When…
• You don’t understand the meaning of a word or phrase
• Instructions aren’t clear
• You aren’t sure why is test is being ordered
• You don’t understand what needs to be done to do the test
correctly
• You aren’t sure how to take a medication, what it is for and what
side effects you might have
• Ask questions during the visit, not at the end
prior to the physician leaving the room
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Helping you Understand and
Remember
• Asking questions helps you understand and
remember instructions
• Take notes
• Repeat back what you understand
• Ask for instructions in writing if necessary
• Talk to other members of the team, like
nurses
• Call or e-mail the office if you find later that
you don’t understand what was discussed,
or what to do
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Making Decisions
• Discuss choices, this is a partnership
• Discuss risks and benefits of surgery or medications
• Discuss how your values and beliefs impact your decisions
• Be honest
• It is ok to ask for a second opinion
• It is ok to discuss decisions with your family or friends at a later
time
• It is ok to challenge your physician
• It is ok to do research before or after
a visit to help you make a decision, with
caution
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Does This Have Anything to do with
Health Literacy?
• Ask yourself these questions:
• Are you having trouble reading the information given?
• Do you understand the terms and instructions?
• Is there a language barrier?
• Is there an information or base knowledge deficit?
• Are you able to communicate with your provider?
Basically, are you getting what you need from the visit in a way that
makes sense to you.
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What To Do If You Don’t Have a PCP?
• For urgent or emergency problems only, use Immediate Care
or the Emergency Room
• Attend free screenings or clinics
• Mission of Mercy (non-profits)
• Maryland Health Insurance Exchange:
https://www.marylandhealthconnection.gov/
• Federal Health Insurance Exchange:
https://www.healthcare.gov/
• Frederick County Health Department: 301-600-1029
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Summary
• Prepare for each visit
• Bring all medications and
supplements
• Keep a list but prioritize your 34 major concerns
• Consider a symptom diary
• Make sure that you can see,
hear and understand
• Make sure you can be
understood
• Bring a family member or
friend if necessary
• At the visit
• Start with your top concerns
• Clearly describe your
symptoms
• Be honest and open with your
symptoms and concerns
• Let the doctor know if you
cannot access or afford items
for your health
• Make sure you know what to
do before you leave the office
• Ask questions
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QUESTIONS?
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