Communicating During Subsequent Visits

Once a person has settled into a routine with a primary care doctor, communication is easy to take for granted. The person may assume that responsibility for effective communication falls on the doctor's shoulders. However, with a little planning, a person can form habits that will make him an equal partner in sharing information and thus enhance communication during future visits.

Before a Visit

Preparing a brief list of concerns or problems can prove very helpful. If more than a few items make their way onto the list, some priorities must be set. Keeping in mind the brevity of a typical visit, important items should be brought up first. Writing down questions for the doctor is also useful. Insurance information and payment for the office visit should be brought as well.

Letting the doctor know what has happened since the last visit is helpful. The person should bring information about any health care that has taken place elsewhere, including where it took place, who was involved, and a telephone number or address where additional details can be obtained. Records of measurements taken at home, such as blood pressure or blood sugar levels, should be brought as well. The doctor should also be told of any changes in drugs or of any major life changes, such as retirement, a move into a different home, or the death of a loved one.

During a Visit

Being honest is a basic guiding principle of effective communication with a doctor. Unless a person is honest, the doctor cannot give the best care possible. For example, a person who under-reports or over-reports the pain he is experiencing greatly hinders the doctor's ability to help. A smoker who denies smoking or inaccurately describes his smoking habit undermines the doctor's efforts to assist. A person who has not been taking drugs as prescribed needs to tell the doctor and provide an explanation (for example, "I seem to get stomach cramps from the medicine" or "I can't afford the medicine").

Besides being forthcoming about symptoms and health habits, a person needs to express when he is unhappy with something the doctor has said or done. The doctor can acknowledge the person's feelings and take steps to resolve differences, but only if the person's viewpoint is known.

Usually, more is said or more takes place than is likely to be recalled after the visit. A person who brings a specific concern or problem to a visit may be told what tests are needed to gather additional information. The person may be given an explanation and a diagnosis for his concern or problem and the typical outlook for people with that particular problem. The doctor is also likely to describe detailed plans for treating the problem. Ways to prevent health problems may be discussed during some visits. The person should request an explanation of anything that is not understood.

A person may have to rely on more than memory to retain information. The doctor may offer to write down important information or provide handouts or other materials. However, the person may also wish to take notes or ask the doctor's permission to use a recording device during a visit. Such strategies help reduce the need for continually repeating questions and answers.

Toward the End of a Visit

The last portion of a visit is critical in determining the effectiveness of communication with the doctor. This is not the best time to bring up something completely new, because the doctor usually will not be able to take more time to address a last-minute item. Most doctors dread hearing the words, "Doctor, there is one more thing I would like to speak with you about today."

Rather, the end of a visit is an opportunity to have the most important information reviewed and summarized. A person can briefly repeat instructions and directions while the doctor listens, so that the doctor can verify that key points have been heard and understood. If certain issues were not addressed because of limited time, arrangements can be made to discuss those issues at the next visit. A longer visit can be scheduled for the next appointment, if necessary.

See the table Questions that Generate More Questions During A Visit.