Written by Steven Burns
From his column To Your Health
“My doctor won’t listen to anything I say. He just wants to get out of the room as fast as possible.”
Have you ever heard anyone say something like that? Maybe you’ve said it yourself—or something like: “I go early for my appointment, but the doctor keeps me waiting for an hour.”
I’ve heard comments like these my entire career, and it’s likely some have been made about me. But today, instead of debating the efficiency of a medical practice, I’d prefer to share guidelines that might make the next visit to your doctor a better experience.
A 2017 study of millions of electronic medical records showed primary care physicians spent an average of 18 minutes with each patient, even though the scheduled time was for 10 or 15 minutes. So, by the end of a day, a physician would be at least an hour behind (3 minutes per patient x 20 patients).
Let’s say I’m a family physician, and I have 28 patients on my schedule for an 8-hour day. This means I have 17 minutes to walk to the room, greet my patient, discuss the problem, examine the patient, and plan treatment—such as medications, physical therapy, imaging, lab work, exercise, diet, and consultations with specialists. Then, I have to explain all this to the patient so they will understand and follow through. In between appointments, I need to evaluate results from tests, return calls to patients or doctors, and handle administrative duties.
Now, I’m not griping about the career I’ve chosen. I’m just explaining the challenges faced in a primary care office. Because of the payment system in the U.S., I do not have the ability to see fewer patients and charge each one more. Insurers decide how much my services are worth. If I decide to see fewer patients, I cannot pay my staff or office overhead. Again, not griping—just stating reality.
So, how can you plan medical visits to take best advantage of the limited time with your physician? I recommend the following:
- Make a list of the topics you want to cover and hand it to your doctor at the beginning of your appointment. Most of the time, a physician can group 8 complaints into 3 or 4 problem areas, and deal with them more efficiently.
- When you make an appointment, let the staff know if you’ll need extra time. For example, a visit for an upper respiratory infection is simpler than one for abdominal pain. And, if you have more than one problem, make sure the appointment person knows this.
- Bring your medicines or an accurate list. Patients frequently stop taking a med, or another doctor adds or subtracts from the list, so your records may not be up to date.
- Start with your most significant problem. More often than you would believe, patients mention their sore toe, heartburn, or skin rash, and then, just as the doctor is ready to leave the room, add: “By the way, I have chest pain every time I exercise.” Make the most serious problem the first item on your list. Its evaluation and treatment could save your life!
- Don’t over-explain. When you start with, “I’ve had this headache for years, and three, maybe four months ago, it got worse, about the time my family came to town. You know how stressful it is to have company for 2 weeks...” the visit can go off the rails right away. Stick with the problem and state it briefly: “I’ve had a headache for years, and lately it has worsened.” This gives your doctor more time to ask questions, such as, “Is your vision affected?” “Are you nauseated when you have a headache?” “Does light affect you during the headache?” For any problem, there are questions your physician has been trained to ask that can get to the heart of the matter faster and more accurately.
- Remember, Google Search does not convey upon readers a medical degree. Doctors don’t mind when patients research their conditions, but try to understand if we seem impatient when patients self-diagnose their condition based on what they’ve read online. Most primary care doctors have at least seven years of post-college training, and we’ve seen thousands of patients, so let us make the diagnosis.
- Don’t argue about treatment. If your doctor recommends something you prefer not to do, say so. This allows the doctor to explain why the treatment makes sense, or offer an alternative.
Finally, keep in mind you and your physician are partners, not adversaries. An open, honest discussion is possible even within the constraints of a modern medical practice. I hope these ideas will help you to have better visits with your doctor, and receive the best care possible.
Dr. Steven Burns, M.D., is board-certified in family medicine and has been in practice for more than 30 years. Opinions are his own.