Monday, April 18, 2011

How to be prepared for a doctor or Nurse Practitioner appointment

I have written a post about how to review websites for accuracy. I have written previously about checking your internet sources. This is part of the Internet Safety workshops I used to deliver when I was teaching. 

Assessing web-based healthcare content

 E.g., Diana E. Lee is a chronic migraine patient who blogs at Somebody Heal Me
Now, she is a blogger we assume is collecting information on migraines, but since she has ads for products, I wonder if she IS simply a blogger, or someone marketing products. She seems credible, but we cannot know for sure.  Now, one of my pet peeves are Canadian experts writing about medical issues, and basing their information on American data, or referring to US websites. Our medical systems have different mandates and differ greatly. 
One site, KevinMD, I think is a real doctor, but how do we know? He seems to have used up all of his topics and has been posting guest items. 
One such, just appalled me. 'How to sabotage a doctor's appointment'. Written by an American, purportedly a chronic migraine patient, I read this sarcastic post about today's topic. 

I was quite disappointed. How easy it is for doctors to complain about patients, and vice versa. How much we must advocate for ourselves.

Ignorance IS an excuse. Patients don't know how to self-advocate, and they should. With physicians carrying heavy patient loads, and people having complex issues, how can we help our physicians and ourselves? Here are my reflections.

How to be prepared for a doctor or Nurse Practitioner appointment

  1. Be there on time. Yes, sometimes our physicians are late, but I noticed at my previous physician's office that there was a large, 2  x 3" card, attached to my file. It stated the time of my appointment. He would always apologize, even if he was 5 minutes late. I really respected that. 
  2. Stay on topic. Normally, having an appointment later than scheduled isn't the physician's fault. It's the fault of people asking the doctor a question just as s/he is leaving, that takes up another 10 minutes of time. One of those 'Oh, by the way' issues (sexual dysfunction, or other embarrassing issues), which were the real reason for the appointment! 
  3. Visit your pharmacist for Medscheck. In Ontario the government pays for a pharmacist to check in with you and your medications. Polypharmacy is a terrible issue with some seniors. In Ontario, you can get a printed list of your medications, if you visit just one pharmacy. They need to know. The pharmacist will sit down, in privacy, and ensure that your medications are the right ones, that you are taking them correctly. 
  4. Come prepared. Write down a list of questions. 
  5. Take a pen and paper. Write down exactly what your doctor tells you.
  6. Take someone with you to the appointment. In some cases, adult children may need to be involved. If you are caring for someone with any illness, chronic or otherwise, you know that often information overwhelms the patient, and they forget what has been said. My mother hid her illness from me. Refused to let me attend. The chemotherapy she took killed her. She and her doctor decided to 'try it'. She never told the oncologist how weak she was. I burned out caring for her. She was in charge of my late father's care plan, but she was ill herself and didn't always make good decisions. She didn't know the questions to ask the doctors. See: Questions to ask your physician
  7. Bring a list of your medications. If you've been into emergency, or travelled, seen a physician in cottage country, or while visiting your children, and visited a doctor elsewhere, this tells the doctor/nurse what is going on. My late father was on eight different medications. It was crazy.
  8. Choose a Family Health Team, if you can. My physician is part of a Family Health Team (FHT). His nurse screens me. She asks me the reasons for my appointment. She records them on the computer. The doctor walks in, ready to get to business. Patient-centred healthcare is a fabulous system in Ontario. The myth is Canada's health system is 'broken'. I think not. In a FHT I can see my Nurse Practitioner in a week or two. The team has nurses, dietitians, run after hours clinics, a nurse to do lab work. 
  9. Turn off your cell phone. The other patients will appreciate it. Don't yell into the phone in the waiting room. No one else really cares how important you think you are!
  10. Take something to read. Yes, be prepared to wait. Things happen. I am grateful to have universal healthcare. With everyone complaining about our system, there are many satisfied patients who are healing well at home, many finding their way through the system unscathed. 

Sep 12, 2010
I have been pleased with my Family Health Team. The Nurse Practitioner I have been working with has been brilliant. I very much enjoyed working with her.

 - Public Information - MOHLTC

 MedsCheck is a program that allows you to schedule a 20 to 30 minute one-to-one meeting with your community pharmacist to ensure that you...

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