Getting the Most Out of Your Medical Visit

Have you ever walked out of a medical appointment feeling like your provider (doctor, nurse practitioner, physician assistant) didn’t really understand what you were trying to say? Unfortunately, it’s quite possible that they didn’t. And while I am not excusing providers from being better active listeners, I also believe that there are many reasons for this miscommunication.

Your provider’s chances of getting as close as possible to the correct diagnosis depends, in large part, on your ability to provide as much pertinent information as clearly as possible. Each data point steers them towards or away from the source of the problem. It is not much unlike the game 20 questions. Except in medicine, neither of the players knows the answer, and only you, the patient, know the clues. Your provider starts with an infinite list of possible answers and chisels away at this list with each data point you provide.

Here are some things you, as the patient, can think about beforehand to get the most out of your appointment.

Patterns or Interruptions in the Pattern:

Activities, positions, timing, duration, and locations that are associated with your symptoms can be important clues to the cause of your ailment. If you’ve been suffering for even a few weeks, you have likely noticed patterns. Maybe going down the stairs is worse than going up. Has it been waking you up in the middle of the night? Or perhaps it only hurts when you’ve been sitting for more than an hour, like on a long car ride.

Attempted Interventions:

Tell your provider what you’ve tried to alleviate your symptoms and if it worked. Whether or not an intervention works is an important diagnostic clue. If a certain intervention did not work, it may knock several working diagnoses off of the list. It will also guide your treatment. You don’t want your provider to prescribe a medication or exercise that you’ve already tried and failed.

Now that you have valuable data, you want to present it in an efficient and meaningful way.

Know Your Timeline:

If nothing else, tell your story chronologically. It is one of the most powerful ways to convey a clear medical story. The way a symptom appears and evolves over time is sometimes what defines it and can help your provider hone in on a diagnosis. Start with the first time you ever experienced the symptom. Then tell your story as though reading through a timeline. “I started having left knee pain after a 10k race I ran 3 months ago. I rested for 2 weeks but the pain didn’t go away. I saw my Primary Care Provider then. She did an xray. It was normal so I did physical therapy for the next 4 weeks.”

Be Specific:

Words like “sometimes,” “a lot,” or “a while ago” mean different things to different people. Your provider won’t know what those things mean to you. Instead, be very specific. Here is an example:

— “My leg hurts sometimes.” (vague)

— “The front of my left knee hurts every time I put weight on it.” (specific)

The former could mean almost anything and the latter tells the provider which specific body parts may be injured, what testing may be indicated, and how to start formulating a treatment plan.

Write it Down!

Like keeping a food diary, keeping a journal of your symptoms can give you some clarity over what’s going on. You may not otherwise have realized how many snacks you’re eating through your workday; and you may not have realized you get especially nauseous and have abdominal pain after eating fatty meals. Rather than showing up to your appointment without this realization, you could be showing up with a clue that brings that list of potential answers down from 500 to 15. You may not know which details are relevant so include everything connected to your symptoms. Organize your findings chronologically and bring them with you to your visit.

The written timeline of events, symptoms, and patterns can transform a jumble of symptoms that started (you think) after you had the flu several months ago (or was it before?) into an accurate, focused presentation that is well understood by your provider. Armed with this tool, your provider has the best chances of quickly knowing what may be the cause of your symptoms and how best to treat them.