The following is a guest post from William J. Hall, MD, AARP Board Member. Bill Hall is a geriatrician with a special interest in strategies for successful aging.
Last time, I described some of the reasons why both patients and physicians sometimes feel that the office visit is not as satisfying as either would like. Based on many years of caring for older adults, here are a few simple strategies:
- Make a List. No matter what your age, the most effective strategy you can employ is to make a list of the issues that are important to you for any particular visit. Remember, it is your health, so raise any issues of concern. Within reason, there is no issue too silly or too trivial. Do not prejudge what is important or not. Before you finalize the list, consider the personal priorities. Often, the last item on your list will have the most importance to you and the one most likely to be overlooked in a busy office encounter. Give a copy of your list to your doctor.
- Mention any limitation that might interfere with communication. Don't assume that your provider will necessarily recall that you have some barriers to communication. Perhaps the most common barrier is hearing loss followed by visual impairment (Most of us as we age rely on verbal clues from watching the face of the person with whom we are communicating). Valuable time is lost if the provider is not aware of these barriers. It is a courtesy to remind your doctor of these potential barriers right away.
- Know Your Medicines. One of the most challenging aspect of interaction is to be sure that both of you agree on your lists of both prescription and non-prescription medicines. Yes, we use electronic medical records increasingly, but ultimately each of us is responsible for managing our medications. Keep a list of all your medicines by name, dose and how often you are taking them. In later postings we will go into specific pointers for keeping medicines straight, but for now, bring that list to your visit. An alternative approach, sometimes referred to as "the shopping bag test" to simply sweep your medicine cabinet into a shopping and bring the whole thing to your visit. In most cases, you will return with half the medicines discarded. More on that later.
- Don't mislead Your Doctor. Most of us are reluctant or embarrassed to bring up certain things with our doctors or to mention that we really have not been doing all that was recommended at the last visit. Such omissions can literally be deadly. Besides your doctor has heard it all many times before, and is usually guilty of the same tendencies.
- Explain your values. Each of us has unique cultural and religious values regarding medical matters and end-of-life issues. Make sure these values are well understood by those responsible for your medical care. At a minimum, this means making sure you have documents that include advanced directives - written instructions on the type and extent of care you wish to receive in the case of serious illness. You should also designate a health care proxy who is empowered to make key decisions about extent of care if you can no longer make those decisions.
These simple guidelines will go a long way at improving the quality of your office visits and allow you and your doctor to evolve a partnership benefitting both parties.
Photo credit: glennwilliamspdx on Flickr.