subject: Planning On Seeing Your Doctor? Think Twice Before Making That List! [print this page] Many experts and well-intentioned advocates recommend taking a list of concerns and questions with you the next time you visit your doctor. What they don't tell you is that list can be dangerous to your health. It can even be deadly.
Faltering memories, diagnoses which can be too horrible to contemplate, and symptoms that confuse and frighten; there are good reasons to be armed with a list when seeing a physician. There has never been a time when communication between patients and their doctors has been more important. Unfortunately, that list can make it harder.
There is a gentleman whom I have followed in my practice for over a decade. He's quite a worrier and always comes to the office with a list. It's not unusual for him to get out of bed in the middle of a sleepless night to add a new fear to the list that awaits his next office visit. On one such visit his list numbered thirteen. Fortunately he's one of my healthiest patients, but the possibility that something sinister could be hiding among the clutter of worry often haunts me.
Such is the danger in the list taken to the doctor's office; precious time may be squandered on needs that may be less urgent than others. I'm amazed at the number of times a patient places their greatest concern at the bottom of their list and I often wonder how many people leave their doctors offices without it being addressed. Perhaps it reflects lessons from childhood, to save the best and most important for last, but it does not serve us well in health care.
I vividly remember a gentleman who sat in my office one summer's day. He had brought a list with him. It took time to work through his list of seasonal allergy concerns, which vitamins I recommended, how to manage dry skin, and whether generic medications were really as good as the name brand ones. It was obvious that there was something still on his mind when he stood leave, but we had spent so much time together that he was simply too embarrassed to ask another question.
When I pressed my patient about my observation, he reluctantly admitted that there was something else that he had intended to ask me about, but that he was fairly certain it was only his summer allergies. Whenever he cut his grass and pushed his mower up an incline in his backyard he felt nauseous and tightness in his throat.
The following morning my patient was on a treadmill in the cardiac department of the hospital and by that night had had emergency bypass surgery. The thought still brings me a shiver; how close I had come to missing something profoundly important. My patient's list was almost the death of him. Now when confronted with a list in the examination room, I always ask my patient to start with the most important problem first. And just for good measure, I always ask what's last on their list.
So what about that advice to take a list with you to the doctor? By all means you should, particularly if you have ever felt rushed by your doctor or have left wanting more. The list can be a powerful tool in medicine, and like the surgeon's scalpel it can be a dangerous tool. There are a few simple tips to remember when making that list for your next appointment with your doctor.
Keep it short. It's unrealistic to expect to cover more than two or three items on a list in a 15-minute appointment. It's better to cover two issues in depth than six issues superficially. Medicine is often about the details and you can't concentrate on the details if you have to rush.
Put your most important issue at the top of the list. Assume that you will only have time to discuss one of your concerns. Don't waste the opportunity.
Tell your physician what you would like to accomplish during your visit and how many things are on your list. Knowing your expectations will help your doctor focus on what is important to you and be better able to help you meet those expectations.
Respect your physician's time as much as you would like your time to be respected. Be sensitive to the crushing demands that can weigh on a doctor's schedule. Take a hard look at each item on your list. Does everything need to be there? Is everything truly important to you? If time grows short, offer to discuss the concerns on your list over two office
appointments.
Keep the importance of your list in perspective. It is merely a tool to help you communicate better with your doctor. It's the talking, the listening, and the sharing of time together that are important. It's through these things that healing becomes possible.
by: William E. Hablitzel, M.D.
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