Dr Liza Macdonald FRCR MA

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Practical advice about your consultation

  Getting The Best out of Your Doctor

Practical advice about your consultation

1. Be on time for your appointment.
2. Give yourself time to register, if necessary, before your appointment.
3. Check that the receptionist has your up-to-date address and phone number
4. Check the doctor's name and use it.
5. If delayed always ring and tell the receptionist how long you are likely to be.
6. Prepare a list or some notes of issues you wish to cover.
7. Dress simply with ease of undressing.
8. Take someone with you.
9. Come to the point immediately.
10. Keep your descriptions short, but have the confidence to express yourself.
11. Listen carefully and jot down some notes to help you remember details. Check on spelling if necessary.
12. Ask for a diagram or written diagnosis.
13. Check you have understood correctly.
14. Make sure you agree the next event.
15. Check how to contact the doctor again and in what circumstances.
16. Thank the doctor and leave promptly.
17. Report next plans to the receptionist or secretary.

Let's expand a little on this practical advice.
Doctors unfortunately do frequently run late. This may be because they are trying to pack too much into their day or it may be that they have been unavoidably delayed by an urgent medical situation or a distressed patient or relative. You however should always be on time.

It is wise to arrive a few moments early to register if necessary and to see the lie of the land and how the clinic works. For example, will you meet a medical student first who will take a short history or will a nurse do some preliminary tests like taking your blood pressure and checking your urine?

Find out the name of the doctor and familiarize yourself with it.
When you go in check that you are seeing the person you expected.

If you are unavoidably delayed for your appointment ring and explain to the receptionist how long you are likely to be. If the clinic is running late then you will feel more comfortable. However, if the clinic is on time the receptionist may be able to move other patients forward slightly and slot you in at a slightly later time. Alternatively, if you are severely delayed you may need to rebook your appointment.
Check that the receptionist and therefore your notes have an up-to-date address and phone number. If you do need an appointment or have some sort of test it is essential that results get to you efficiently. If you have for example a Cervical Smear test it can be helpful to take a stamped addressed envelope and ask that a copy of the result be sent on to you.

Do prepare a short list or at least some notes of issues you want to cover. It is very easy in the fluster of a consultation, being well aware that the doctor is short of time, to forget one or two of the important points. Bringing a check list helps to ensure that you are not frustrated later at having omitted something vital. Doctors do have different attitudes to lists. Some doctors encourage them for the reasons I have just explained, while others tend to regard them as complications likely to waste too much time. A list does however need to be short and to the point. No ten minute consultation can be expected to cover twenty different issues. One or two are quite enough and if more time is needed then it is important either to book a longer consultation or to be prepared to come back on another occasion.

The doctor is not interested in a fashion statement. It is wise to dress simply and in clothes which are comfortable and easy to slip out of for an examination.

If there is any serious matter which you wish to discuss with a doctor it is always wise to take with you a friend or relative. Firstly, a companion gives moral support. Secondly your companion can act as an advocate to speak up for you and is more likely to have the presence of mind to remember the points you wanted to make and to refer to your list. If you receive bad news then a companion is more likely to remain objective and keep their wits about them. They are likely to register more of the information given in the later part of the consultation. It is extremely helpful if they make notes on your behalf. However, choose your companion wisely. You need a supportive person with the presence of mind to keep up with the consultation, someone who is confident, but not over-assertive and who will not interrupt, but on the other hand has the confidence to ask about practical issues which you may have overlooked. Family members are often the best companions, but there are some awkward situations such as discussions about sexually transmitted disease or inherited disorders which may have unexpected implications for someone else in the family. In these circumstances a trusted friend is probably a wiser choice.

When you meet the doctor do use the professional address. Although you may know the doctor quite well if you meet them regularly on the golf course, this is a different and a professional situation and it is usually better to address Dr John Smith as Dr Smith rather than just John. Some patients do prefer to be on first name terms with their doctors as this levels up the "power distribution" and this is a personal decision.

When the doctor throws you an open question come to the point immediately, keep your description short, consult your check list, but have the confidence to express yourself in some detail if necessary.

Listen carefully to the doctor's response and either make some notes yourself or ask your companion to do so. If the doctor has a working diagnosis, or a range of options, make a note of these and check the spelling if necessary.

When the doctor has examined you it can be helpful firstly to ask what he or she found and secondly to ask for a diagram to explain the findings. A diagram can be very useful.... often much more helpful than a wordy description.
Check carefully that you have understood correctly. If necessary, repeat the doctor's words in order to agree the findings.

Once there is a working diagnosis, make sure that you agree a plan of action.
Once there is an agreed plan of action thank the doctor and leave promptly.

Go to the reception or to the doctor's secretary and report what has been decided. Show them the forms or the prescription and make the appropriate follow-up appointment.
Make sure you are clear what to expect next and how to contact the doctor again and in what circumstances. Ensure you have the correct request form for a blood test, scan or x-ray and that you know how to make an appointment. Check what you should do if no appointment is forthcoming.... ring the department, contact the GP's receptionist or the nurse?
The receptionist is a key person in the system. She is often very experienced in managing the practical aspects of how things work. She may well know other receptionists personally and may for example be able to say.... "try this clinic because the waiting list is less", or "go to that clinic because it is easier to park". "This secretary is very efficient....that office needs reminders" and so on....invaluable advice to help you move through the system. Show the receptionist the forms or the prescription and make the appropriate follow-up appointment.

Some receptionists can however be very unhelpful. Some seem to feel that their duty is to protect the doctors from too many demands by delaying appointments or being generally unhelpful. Occasionally patients are made to feel distinctly unwelcome and it takes courage and commitment to stick to your guns and insist on making the arrangements which suit you.
If necessary you may have to resort to a quiet word with the practice manager. Don't give up. Other patients will also benefit from your tenacity.

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