Maximizing Your Doctor Visit
By James Beauchamp, D.C.
A trip to the doctor is one of life’s more stressful events, particularly after accident or injury. You are suddenly thrust into the role of being a patient, which implies a certain sense of passivity. You should never be passive when it comes to your health! I want active patients, people who will participate with me in solving their health problems. So I am going to explain to you, from a background of 27 years of practice, how to get the most out of your doctors visit by being an active participant in the process.
Your initial visit with your physician begins and ends with paperwork. Believe me, none of us are happy with that, but there are ways to minimize the burden. Many practices have websites from which you can print out the initial visit paperwork; others will email it to you. This allows you to complete the forms at your leisure in the comfort of your own home. An added benefit is that you are more likely to have all of the information at hand.
Other things that you will want to bring with you are the exact medicines you are taking, in particular those for your current problem, plus the names and if possible the addresses of any doctors that you have seen, including where any x-rays were obtained.
Make a list of the pains that you are experiencing, in order of importance to you, along with any questions that you want to make sure are answered. Even I forget some things when the shoe is on the other foot and I am the patient.
All successful social encounters go best with good communication. All of that preparation I mentioned is designed to give your doctor the information he needs in order to help you. Part of good communication is making sure that you have the correct appointment time and the address of the office and know how to get there. Be on time, many offices will not see you if you are more than a few minutes late. It is important for your care that you tell the story of your illness. Like all stories, it is best to tell it in order. Start at the beginning and work your way, if possible, to the present. I say ‘if possible’ only because most doctors will interrupt you within about 20 seconds. Many people find this to be off-putting or even downright rude, depending upon the doctor’s manner.
There are a few things to keep in mind when your physician interrupts. One is that most conversations are punctuated by interruptions and comments, so expect some give and take. Another is that asking a question shows engagement and interest on the part of the listener. Most importantly, doctors need information and so we will be actively directing the conversation according to this acronym: OPQRSST.
- Onset: When did this start?
- Provocative/Palliative: What makes it worse or better?
- Quality: What does it feel like?
- Radiation: Is the pain starting in one location and traveling to another?
- Site: Where is the pain?
- Severity: Just how intense is the pain?
- Timing: How often does it occur, and when?
When it comes to asking how intense the pain is (“Severity”, see above), we like to ask for a number between 1 and 10. It’s a widely used convention, and it is fairly accurate as long as you are on the same page as us about what constitutes a 10. A ten is the worst pain imaginable, one so bad that it literally stops you from doing something. I see few 10’s in my practice. If you have a sprained lower back from an accident and can drive to see me, it is unlikely that you are experiencing a 10, unless your 10 is something that occurs occasionally or with motions that you can avoid. If numbers are not your thing, think of your pain as a beverage: is it a small, medium, large or supersized feeling?
Don’t respond to our questions based on what you think is going on with your injury, what you think is the “right” answer, what Dr. Google says, or whatever horror story someone tells you about their own experience. Your injury is yours alone and no one else but you and your doctor will know the particulars without clear and direct communication.
This is where the rubber (glove) meets the road. We will poke and prod you (we call it “palpation”) and bend and twist you (range of motion and orthopedic tests), among other things. Pay attention to how the maneuvers feel and give the doctor feedback. Do not try and figure out what we are looking for, because we may be examining a foot when you have a back problem. However, if the doctor neglects to look at an area that you told him hurts, please remind us. This is most likely to happen when you have multiple complaints, remember the list that you made.
When I ask for you to move a body part, I want to see a reasonable effort rather than an extreme effort which may make you worse later. Doing so would give us an unrealistic view of what activities you can actually tolerate on a daily basis. At the same time, we do want to see an effort!
The Long Goodbye
When your doctor is finished, he should explain your injuries and make treatment recommendations, plus orders for further testing if indicated. The initial injury description is called a working diagnosis. Ask for clarification if you are unsure what tour condition is or if the doctor uses terms that you are unfamiliar with. It can be hard for us to break the habit of using medical jargon at times.
Under no circumstances should you let the doctor escape the room before you have your concerns and questions addressed. He may be in a bit of a hurry to get to his next patient, but if you let him get away you may have to wait until your next visit for more face to face time. Most doctors, having left the room, are immediately with another person, so they are loath to stop and start over with you. And you probably wouldn’t like your physician interrupted once you got started, either.
Doctors are a resource for you by virtue of their training and experience. But people are people, so all parties must make the effort to be as clear in their communication and proactive in their actions as possible.
Dr. James Beauchamp is a Multi-Specialty HealthCare provider specializing in Chiropractic Care. He is certified in spinal trauma, manipulation under anesthesia, and as an automobile accident reconstructionist. He is also a member of the advisory board for Operation Backbone.
References available by request. Copyright James W. Beauchamp, DC