How to make the most of a doctor visit

Dr. Victor Sierpina

Dr. Victor Sierpina

If you have an ear infection, a laceration, broken bone or other acute problem, the answer to this question is easy. You expect and likely will receive immediate, competent and focused care of your condition.

However, in the primary care arena in which I work, these kinds of visit are a relatively minor, simple part of our daily work. Much more time and effort is dedicated to the management of chronic diseases, doing annual physicals and attending to preventive and screening issues. Trying to manage these larger issues is not usually possible during an acute care visit so another appointment generally needs to be scheduled.

So how do you make best use of these more complicated visits? In the words of the Boy Scout motto, “Be prepared.”

  • Come with a list of questions and concerns you wish to discuss with your doctor, physician assistant or nurse practitioner.
  • Bring all your medications and over the counter supplements in a bag so we can be sure to attend to refills, address interactions and make recommendations.
  • Bring readings of blood pressure, blood sugar, pulmonary functions like peak flow or oxygen levels, diet diaries and any outside testing and medical records.
  • Have some idea of what lab work you might need, any referrals, shots, screening tests. Come fasting after midnight if you can so you won’t need another trip for lab work later. A good idea is to contact your doctor to order labs in advance so results are back to discuss at your visit.
  • Be sure to get an after visit summary that reviews your problem list, medications, referrals, labs, X-rays, refills, patient instructions and follow-up appointments.

That advice might be called “Being a Patient 101.” I would like to offer you some additional possibilities, call it “Being a Well Person — the Graduate Course.”

Let’s face it, the amount of time you spend in the doctor’s office is just a few hours per year. Considering that there are 8,760 hours in a year, what you do in between office visits is going to be much more important to your wellness and longevity than what actually happens at the doctor’s office in a few minutes or even a few hours.

An important issue that I try to bring up with my patients when they come in for a new or annual physical is to ask, “What are your health-related goals for today’s visit and long-term?”

This requires you to consider in advance some important questions such as what you want to be healthy for? Some key questions to ask yourself might be: “What brings me joy? What are my hopes? Where does my strength come from?”

Answers to these questions provide a compass on the direction you want your life to go. They also help inform your health professional team how they might best assist you.

Still, a compass can give directions but still isn’t a map.

See the “Wheel of Health” model for a sample map, www.dukeintegrativemedicine.org/about-us/wheel-of-health.

Start with a mindful awareness of who you are. Reflect on the various domains of your health and wellness: spirituality; mind-body connection; movement, exercise, and rest; nutrition; personal and professional development; physical environment; relations and communication.

A map is still not a journey. To move forward, honestly ask yourself which path or paths you are ready, willing and able to pursue and change just now. Remember the proverb that the journey of a thousand miles begins with one step. Start walking by picking something on the map that you feel enthused about and that you can likely accomplish relatively easily. Success breeds success. Even the smallest change in our life takes effort, commitment and perseverance. You can do it.

If you let your health care provider know what you wish to work on at the time of your visit he or she can link you to appropriate resources: a health coach, trainer, dietitian, psychologist, spiritual mentor, class, yoga or tai chi instructor, chiropractor, acupuncturist, massage therapist, financial counselor or support group.

Any of them can become part of your team to promote improved well-being in the thousands of hours of your life between office visits. Always remember that except for serious emergencies, your health and longevity are much more dependent on your daily lifestyle choices than even the best modern medicine can offer.

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