1 How to Talk To Your Doctor Marj Bernstein & Cathie Duncan Bridges Program

2 Goals What is a primary care doctor? How can I make the most out of my doctor visit? Decision making with your doctor What is your responsibility?

3 Who are Primary Care Doctors? Family Practice Internal Medicine Ob/Gyn Pediatricians Physician Assistants Nurse Practitioners Not a specialist

4 What Does Your PCP Need to Know? Your medical history Your surgical history Your medications Your home and family situation Your values, religion and beliefs Your end of life wishes Any barriers that prevent you from affording or accessing care

5 How Can You Get the Most Out of Your Doctor Visit?

6 Things to Do Prepare Prioritize Be Clear Be Honest Ask Questions

7 Prepare Time is limited Most appointment slots are minutes long Providers have more pressures on them than ever before Insurance companies have decreased reimbursements They must see more patients Overhead is increasing Electronic medical records are slowing some down and changing the nature of the patient-physician relationship

8 Prepare Take information with you to include: Prior medical records Insurance card Test results Medication list or medications in bottle Everything you are taking including herbal supplements Contact information for other doctors Make a list of your questions or symptoms Bring glasses or hearing devices so you can hear and see Consider bringing a friend or family member Ask for an interpreter if necessary

9 Sample Questions Why is this test necessary? What will it tell us that we don't already know? Will the results significantly alter any treatment plans? When will the results be ready? Should I call you for them, or will you call me? What is my exact diagnosis? What's the cause of my problem? How long will I be sick? How long before I'll see improvement? What treatments are used for my condition? Which is best for me, and why? What does the research show about this treatment?

10 Sample Questions Is there any research on the horizon about treatments for my condition? What can I expect from this treatment, based on your experience? What are the side effects of this medication? Will it interact with alcohol, caffeine, or other drugs or supplements I take? Are there any alternative treatments appropriate for me to try, either before or along with conventional treatment? How will these changes help my disorder? How soon should I expect to see an effect? How drastic do the changes have to be to produce real results? Do you have any tips that would make these changes easier?

11 Prioritize List your concerns What is the most important to you? What is the point of your visit? List 3-4 significant issues that you want to discuss Chronic medical problems? Medications? Test results? Concerns about health? Visit for routine screening?

12 Be Clear Describe your symptoms: “A departure from normal function or feeling that is noticed by a patient, indicating the presence of disease or abnormality” Everything is relative…

13 Symptoms Bodily LocationWhere does it hurt? QualityWhat kind of pain? Sharp/dull QuantityHow often, how much? TimingWhen did it start? Does it come and go? SettingsWhat brings it on? ChangesWhat makes it better or worse? Other symptomsWhat else happens when you have this pain? Consider keeping a symptom diary to help you remember these details

14 Be Honest It is important for you to answer your doctor’s questions honestly Although some things may be uncomfortable to talk about, it helps the doctor understand your problems better Don’t tell them what you think they want to hear Voice your concerns What do you think is happening? What are you concerned about? Do you have problems paying for medicine, co- pays or getting to specialist appointments?

15 Ask Questions When… You don’t understand the meaning of a word or phrase Instructions aren’t clear You aren’t sure why is test is being ordered You don’t understand what needs to be done to do the test correctly You aren’t sure how to take a medication, what it is for and what side effects you might have Ask questions during the visit, not at the end prior to the physician leaving the room

16 Helping you Understand and Remember Asking questions helps you understand and remember instructions Take notes Repeat back what you understand Ask for instructions in writing if necessary Talk to other members of the team, like nurses Call or the office if you find later that you don’t understand what was discussed, or what to do

17 Making Decisions Discuss choices, this is a partnership Discuss risks and benefits of surgery or medications Discuss how your values and beliefs impact your decisions Be honest It is ok to ask for a second opinion It is ok to discuss decisions with your family or friends at a later time It is ok to challenge your physician It is ok to do research before or after a visit to help you make a decision, with caution

18 Does This Have Anything to do with Health Literacy? Ask yourself these questions: Are you having trouble reading the information given? Do you understand the terms and instructions? Is there a language barrier? Is there an information or base knowledge deficit? Are you able to communicate with your provider? Basically, are you getting what you need from the visit in a way that makes sense to you.

19 What To Do If You Don’t Have a PCP? For urgent or emergency problems only, use Immediate Care or the Emergency Room Attend free screenings or clinics Mission of Mercy (non-profits) Maryland Health Insurance Exchange: Federal Health Insurance Exchange: Frederick County Health Department:

20 Summary Prepare for each visit Bring all medications and supplements Keep a list but prioritize your 3- 4 major concerns Consider a symptom diary Make sure that you can see, hear and understand Make sure you can be understood Bring a family member or friend if necessary At the visit Start with your top concerns Clearly describe your symptoms Be honest and open with your symptoms and concerns Let the doctor know if you cannot access or afford items for your health Make sure you know what to do before you leave the office Ask questions

21 QUESTIONS?