Too many sick people stagger to their doctor, then endure the waiting room paperwork and the cold examining couch only to blow it at crunch time.
Local physicians estimate they must see and diagnose between 24 and 30 patients daily, so doctor-patient face time is limited to a few precious minutes. A fumbled, rambling reply to "What’s wrong?" can result in a dismissive doctor and an underserved patient.
Health advocates recommend the following phrases to get your doctor’s attention in this era of managed care.
"This is why I’m here today . . ." (Translation: "Let’s cut to the chase"). "Begin the conversation with the issue of priority," said health care expert Rojann Alpers, an associate professor at Arizona State University. "What’s the No. 1 issue that brought you here today?" B. Drew Peterson, a Scottsdale physician, said prioritized problems give him a clear set of marching orders. "If you start with your most important concern, we can give that proper attention."
Peterson said. "Don’t lead off with toe fungus, then say, ‘By the way, I have chest pains.’ "
"This is what it feels like . . ."
("Diagnose this"). The most crucial part of the encounter. "You are the expert on what your problem feels like. So use descriptive phrases," Alpers said. "Describe the sensations as clearly as you can: ‘It’s a tingling.’ ‘It’s a sharp pain.’ ‘It feels like my heart is beating in my ear.’ "
"It goes from here to here . . ."
("Focus here"). Establish the physical boundaries of your problem. "Patients will say, ‘Oh, it hurts all over,’ " Peterson explained. "Then, on follow-up, they’ll indicate a certain area. A specific location tells me a lot more." If pain is episodic, describe when it comes and goes: "Do certain times or habits make it better? Or worse?" he said. "Knowing these details helps me narrow down the cause."
"I first noticed this on . . ."
("This is its history"). "I once asked a patient when his pain started," Peterson recalled. "He said, ‘When I got back from Chicago.’ Precise dates and times help us isolate the problem." Alpern agreed: "Give the doctor a clean timeline." You may have ideas on what caused it. But don’t clutter your initial description. "Give your doctor the facts first. You can fill in the gaps during follow-up questions."
"I’m using these medications . . ." ("Prescribe around these"). Current medications affect both the problem and solution. "Saying ‘I’m taking something for my heart’ doesn’t help," Alpers says. "Write down the name, dosage and frequency of any medications you’re on — or bring them with you."
"So, le t me get this straight. . ." ("NOT so fast!"). Alpers advised concluding encounters by restating your treatment options. "Then you and your doctor will share a clear understanding of the next step," she said.
Peterson agreed: "The old days of ‘Take these and call me in the morning’ are over.
Patients are partners in their health care now. They need to observe that responsibility."