I have been practicing medicine for what seems like centuries. I also have a lot of friends who are doctors. These are some random thoughts about things we would appreciate our patients doing or not doing before they come to our offices.
1. Don’t start antibiotics, and then go in for a bladder infection. If we try to do a culture, we may not be able to find out which bacteria is causing your problem. Some staff members (nurses or medical assistants) who didn’t know that you were taking an antibiotic may tell you to stop your medications before the infection is cleared up. When you get a rebound infection, you will be miserable and blame the office.
2. If you are on medications for a particular problem (like blood pressure) it is best to keep taking them before you go in for your visit. Or take your lipid pills before having it checked. If you stop the medications, we don’t know if they are working or not. You have wasted the money you spent for the visit.
3. If your blood pressure is always up at the doctor’s office, you might invest in a blood pressure cuff and take it at home. The machines can be purchased at a pharmacy or retail store for less than $50, and will take your blood pressure at the push of a button. Bring those readings in to the doctor’s office. Your doctor will be able to treat your real blood pressure, not the one that we get in the office. We call that “white coat hypertension”.
4. If you have a blood sugar problem and are supposed to be checking your sugar, bring your readings with you to the office. We do have a test called a hemoglobin A1C – also known as glycosolated hemoglobin – that will check the long term control of your sugar, but day to day control is important. Keeping your sugar in control helps keep the small vessels in your organs in good shape. Important organs like your eyes, your kidneys, your heart….. and the little vessels in your fingers and toes, too. Those are important parts to keep in good health!
5. Don’t go to your GYN visit for your annual exam if you are on your period. If you are having bleeding problems, you might have to go ahead and keep a visit that was scheduled, even though the bleeding was unexpected. You won’t be able to have a pap at that time, though. Did I say don’t douche? And no intercourse for two or three days so we don’t get sperm on the samples.
6. It does help if you stick with the reason for why you are being seen. I have some patients who need to tell me about their family, their pets, their neighbors, their car and everything else before we finally get around to what they are actually being seen for. While a little “social history” is important, especially when working out a treatment plan, it can be quite excessive and unnecessary and have nothing to do with your current problem. I might need to know about children in the household for your schedule of medications or exercise, for example, but your neighbor’s cat’s last delivery generally has nothing to do with your period problem. Remember that your time is limited with most doctors.
7. Please take a bath and clean “all over”. This includes behind your ears, between your toes and the area covered by your undergarments. Put on clean clothing including socks and underwear. Except in an emergency. Then we understand.
8. We can’t talk to your family or friends without written permission. It’s the law. If you want us to talk to your Mom or your husband about your care, please let us know so that we can get the appropriate papers signed. If they call us on the phone, they are going to hear this, too.
9. Many patients assume that, because they don’t have much money, they can get their care at reduced fees or free. If you go to a federally funded clinic, there may be programs for this. In a private practitioner’s office, you need to talk to the front office BEFORE you make your appointment about what you are expected to pay. If you need to make payment arrangements, you should have discussed this before you get up to the desk on the day that you arrive.
10. Please allow enough time for your office visits. Remember that most offices don’t run exactly on time. We have people oriented practices. Someone might have had an emergency or someone earlier in the day might have been late or run over. Be prepared to wait a little while and bring something to keep yourself occupied. I have crocheted some nice scarves in my kid’s pediatrician’s office. But do try to be on time, so that the rest of our day doesn’t run late.
11. The difference between a reaction and an allergy is the kind of reaction that you have. A true allergy to a medication or other substance will cause itching, shortness of breath, heart irregularities, and sometimes a visit to the emergency room. A reaction to medication is when it makes you sick to your stomach, causes diarrhea, or gives you a yeast infection. Both of these are important to tell your doctor, but it is important to be able to tell the difference.
12. We don’t have the time or the staff to babysit your children if you are coming in for an appointment for an adult visit. Please bring in someone to watch them. Or, preferably, leave them with someone you trust at another location. Pediatricians will tell you to only bring the child who has the visit if possible.
13. If we go to the trouble to make you an appointment with another doctor or schedule a test, please keep the appointment. If you can’t make it for some reason, either reschedule it yourself or call our office for assistance rescheduling. As a courtesy to the other office, notify them as soon as possible, so that they can use that time for someone else. There is not much any of us hate more than “no shows”. If you don’t come for your first visit and don’t call, you may not be given another chance. You may also be charged a fee.
14. I am willing to discuss what you have read or what your neighbor said about your problem. Briefly. But they didn’t go to medical school and don’t keep up with medical journals. If you want to take grandma’s advice, fine. Don’t come back asking me for something else because you didn’t do what I suggested. I had a patient who I put on hormones for hot flashes. We discussed this for about 45 minutes. She went home and her Mom told her that they were “dangerous”. She refused to take them. She had tried all my other remedies. They didn’t work. She kept calling wanting to know what to do. What I wanted to say wasn’t printable. I suggested she find another doctor.
15. Just because it is the latest fad in Hollywood or some TV program said that this might be your problem or might fix your problem doesn’t mean that this is the case. The vaccine – autism connection that certain celebrities have espoused has made life miserable for many pediatricians. They now say that you can get things done on an “altered schedule”, which requires multiple visits, different vaccines than are usually stocked at the doctor’s office and costs significantly more to the patient. The doctor that did the original research has recently lost his license in England for irregularities in the research. And most gynecologists will roll their eyes or sigh if you bring up the “bio-identical hormones” controversy. We also aren’t fond of hearing about every theory from talk shows. Many of the medications and treatments they talk about are experimental. Every TV program is meant as general advice and doesn’t necessarily pertain to you.
You and your doctor should be forming a partnership for your health. I hope the tips above help you get ready for your visits with your doctor.