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How to Talk To Your Doctor

Marj Bernstein & Cathie DuncanBridges 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 ClearDescribe 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, co-pays 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 3-4 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?