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Dr. Krauthammer's Excellent Doctor's Visit Tips

category_bug_journal2.gif My friend John Brandt sent me the excellent list below. It is the advice of retired cardiologist, Martin Krauthammer, that will help us get more out of office visits with our doctors.

Some items seem obvious, but we don't always follow our best instincts and it's easy to forget. You might want to print out this list for yourself and keep it somewhere that you'll be sure to consult before your next physician visit.

  1. Keep an up-to-date list of all your medications on your computer, including drug name, dosage and frequency. Print several copies and carry one with you to the doctor and have one in your pocket at all times, just in case.

  2. Call the doctor’s office before your visit to ensure that your test results are in. No need to see the doctor if he doesn’t have your results.

  3. If you have more than one physician, make sure they all have your full, current medical profile.

  4. Write down your questions for the doctor before an office visit and remember to take the list with you.

  5. At your office visit, if you have questions or new symptoms, volunteer them first. The doctor can address them before appointment time gets short at the end.

  6. On the list of questions, leave room for the answers and write them down, particularly instructions on medications. Who can read doctors’ prescriptions?

  7. Because writing answers to your questions during an office visit isn’t always easy, bring a significant other or a trusted friend to be another pair of ears so you don’t forget important instructions. You might even record the answers.

  8. If you’re treated while traveling or away from home, get copies of all pertinent records for your home doctor. It’s more efficient to extract them from a medical practice in Athens face-to-face than to request them by email, fax or carrier pigeon later.

  9. The night before your office visit, put all your information and questions for the doctor in the car. That way, in the morning, when who knows what happens to distract you, you won’t leave the important stuff on the kitchen table.

  10. Establish rapport with the doctor’s office staff. You always want to be known as the person you are rather than your disease or your chart number.

Are there others you would add to the list?

Dr. Krauthammer gave his list during a talk at the Y's Men of Westport/Weston Club in Connecticut and it was posted on the ctnews.com blog.


At The Elder Storytelling Place today, Barbara Sloan: Snow Birds

Comments

These are all good suggestions. I have implemented several of them already since becoming full-time caregiver to a family member with dementia. I can't tell you how important number 9 has been for me. I try to get doctor visits in the afternoon, and often trying to get my mother-in-law all prepared earlier in the day consumes all my energy, so it's good to have this detail work done ahead of time. Another tip that I have found helpful, and maybe useful for anhyone else who is caring for someone with dementia, is to write a note for the doctor, highlighting any new developments, incidents, concerns, etc. and give it to the nurse before the doctor comes in, asking that the doctor reads it before coming into the exam room. Helps to save time, make sure these items are communicated and addressed, and avoid some confusing three-way conversation between doctor, patient and caregiver otherwise.

Ronni, I know you have strict rules about including links in comments, but I think your readers would appreciate this one. It links to a page offering a free downloadable Senior Health Info Kit. The Kit is a series of forms that are designed to help seniors keep their health information updated and accessible so they can get the most out of doctor visits. The forms are available as PDFs or Word docs that can be updated as needed. By way of disclosure, I confess that I do work for the non-profit company that created this Kit. We offer it as a free resource because we recognize how helpful it can be for seniors and their family members who are caregivers. The Kit is downloadable from http://www.seniorhealthinfokit.com

If reports,scans or copies of studies are to be reviewed by the doctor on the day of your visit, be sure to call the office the day before to be sure that they have received them. If not, they can be sometimes faxed or if local, you can pick them up. This can save a lot of frustration.

Good advice, but you gave me one hell of a scare: when I first saw the headline I thought, "Oh no, Ronni's gone over to the dark side!" Then I read the first paragraph and realized to my relief you were not talking about the "Dr. Krauthammer" I feared you were.

1.Re Item #2: The worthy Dr K is presumably male but not all doctors are. Suggest amending 'he' to 's/he.'

2. It is all good advice. However I would add a preamble to the effect that it behooves us to empower ourselves by learning - from books, the Internet etc - as much as we possibly can about any medical conditions we might have (that includes learning the possible meaning of any new symptoms that appear), before making the appointment. In my experience, doctors respect well-informed patients and treat them in a more collegial manner. And it means you get better value out of the visit by asking informed questions rather than wasting appointment time learning the basics.

3. Be sure to ask about all possible side effects before accepting any new drug (and look it up yourself as well, before you take it). Doctors can be a bit too susceptible to hype from Big Pharma.

4. Always ask 'Is this really necessary?' I've heard many doctors say that their patients get upset if they don't write a prescription. e.g. for antibiotics that really are not necessary, so they tend to reach for the prescription pad rather too readily sometimes.

5. And ask if there are natural alternatives and/or recommended lifestyle changes that might obviate the need for a drug.

My doctor suggested I also 1nclude a list of the medications that I can no longer take, why not, and what happens when I take it/them. I update my meds list yearly and take a copy with me every year at my physical time. Make sure your dentist has a copy of your meds list too.

Many doctors now provide an After Visit Summary (they call it an AVS). The instructions they want you to take home with you are printed on the AVS. This means you don't have to take notes during the visit, but it does require that you stick around for a few minutes after the visit while she types it up for you. Ask ahead of time if an AVS will be provided, and if it is do not leave the office until you have it in your hand. It will include information about new meds, necessary tests ordered, lifestyle recommendations, and anything else she covered in the visit.

I've written about this recently at my own blog -- the level of individual responsibility most of us have for managing our interactions with a difficult medical system is an artifact of the system's dysfunction.

Why aren't our medical records computerized and simplified so both we and the docs can see our histories at a glance? Why do we have to adopt all these precautions to avoid being given drugs that interact badly with other drugs from other doctors?

The fee for service payment model, sustained happily by private insurance companies, results in lousy healthcare in which sick people are required to defend themselves as consumers instead of looking to doctors for help.

There are better ways to deliver medical care. Through incredible luck, I enjoy one. We all should. No system is perfect, but the level of wariness required of us should be unacceptable!

Excellent advice. You should also note any OTC drugs, vitamins, herbal substances and recreational drugs you use. bkj

From my years of experience as an emergency department nurse, I would add carrying a copy of your most recent EKG if you have heart disease. The EKG can be reduced to an 8 x 11 sheet. This can help to determine if any changes to the EKG are old or new.

For Smart Phone or epad (any brand of either) users: carry your health history in a file. I carry an Excel file - which can be beamed to my physician's epad - which includes several worksheets. Worksheets include: history of medical events (including dental, eyes) current medications/supplements info, historical blood workup records (I always have a copy of my blood workups mailed to me), and contact info for all health care providers that I use.
In addition, I have a "notes" file on which I have kept a record of any questions that I have thought of since my last annual physical. Dr S goes down the list with me, after transferring it to my erecord on her computer. I make notes of her answers or any other info that she tells me that I wish not to forget.

"That way, in the morning, when who knows what happens to distract you, you won’t leave the important stuff on the kitchen table."

Guilty

These are great tips. Also the web site that Melanie linked to has an excellent record system that can be saved to your computer as a word document, which can be filled in on your computer and saved.

Also on that site, I would like to point out the link to the 5 wishes document at the bottom on the left hand side. My doctor gave it to me and it is the best advanced directive I have seen. It should be filed with your significant others and your PCP when you have filled it out.

Thank you for this post. Very helpful! At the risk of sounding like a neurotic who is always obsessing about her health, I've decided to jot down in my little black Neurotic Notebook WHEN and how frequently my latest pain, throb, lump, bump, "what is that?" crops up. This list grows with each passing year. I will spare everyone the gory details, but we all know what I mean. Stuff that wasn't there before. The doc always asks, "How long have you had this?" and I can't ever answer. Because time is a big blur, what with all the other details of life to keep track of. The other thing is to keep a list of all supplements and over the counter stuff that I take. Even the ones a doc recommended. And tell that to everyone who will iisten: the dentist; the gyno; eye doc; the butcher, the baker, the candlestick maker--anyone. You never know what kind of interaction might occur. I actually won't take any supplement without my doc's okay, but despite the doctor's file folder (aka computer screen), he or she doesn't always seem to know all the things they should know about me or that I've told them.

P.S. I'm sorry, but I can't resist telling you the HORROR I felt when I saw the words "Krauthammer" and "excellent" in your headline. I immediately thought, "Oh, god, surely she doesn't mean that horrid Charles Krauthammer from Faux News!" I thought I was having a bad dream....

Two...

1. Be succinct.

2. If you think you're a border-line hypochondriac, limit any comments to the facts.

You seem to be fond of Obama. I think Obama and Ben Bernanke are the most destructive leaders toward seniors of any politicians in my lifetime. This Administration's financial policies--especially zero interest rates for savers--is literally destroying the finances of millions of older Americans. Obama needs to sing: "The Party's Over__," then leave.

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