What Your Doctor Is Really Thinking
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Fitness

What Your Doctor Is Really Thinking

How can you get the appointment time you want? Can you see a nurse instead of a doctor? Do you need to wax before you go? We tell you what you need to know before you visit your doctor.

Get the Most out of Your Next Checkup

Want to know the scoop on getting the most out of your medical checkups? FITNESS asked top MDs for tips on how to save time, money, and your health.

Q. What can I do to get an appointment quickly -- and be seen on time once I'm there?

A. Fully describe the severity of your symptoms when you make an appointment, says Marie Savard, MD, a Philadelphia-based general practitioner. "For example, if you say 'I have a bad cold' or 'I have poison ivy,' that won't speed things up." (And, honestly, it shouldn't.) But if you have a pressing situation -- you felt like your eardrums were going to rupture on the plane last weekend, or you have a rash that's inching closer to your eye -- say so. Try to snag the first appointment in the morning or the one right after lunch, when docs are least likely to be backed up, and if you're booking a well visit for your child, do your best to avoid August, when families return from vacation and pediatricians' offices are packed, says Jamie Roach, MD, a pediatrician in private practice in Darien, Connecticut. P.S.: Though holiday gifts and sweet-talking are appreciated, they won't expedite your visit, says Sandra Fryhofer, MD, a general internist in Atlanta and a FITNESS advisory board member.

Q. Does skipping my appointment hurt my chances of getting seen quickly next time?

A. While most doctors say they won't blackball a patient for one ditched visit, receptionists do take note when a patient is a chronic canceler, says Dr. Savard. Try not to miss appointments without advance notice, and think twice before rescheduling -- it may affect your ability to be seen stat when booking a follow-up exam.

Q. How much of doctors' time is taken up by insurance red tape -- and how is my healthcare affected?

A. Our experts agree that insurance companies can make even basic coverage requests a hassle. For every four-hour block of appointments, Alice Chuang, MD, a North Carolina-based ob-gyn, spends about an hour filling out forms that require her evaluation. Dr. Roach says she's been asked to write three-page explanations when simply referring a patient to another physician. "I'm frequently on the phone with an insurer asking why they won't approve something for a patient," she adds. While doctors we spoke to say they do their best to take care of these matters before or after patient hours, some insurance negotiations can cut into office time -- something to consider when you're steaming over a 10-minute delay.

Who Should You See?

Q. How likely is it that my doctor -- versus a trainee -- will perform my surgery?

A. If your operation is taking place in a teaching hospital, it's possible a resident, who's between medical school and practice, will handle minor parts of it, such as closing an incision. But doctors are legally and ethically bound to ask for a patient's consent before letting anyone else perform a surgery they've been hired to do. If you want your doctor to handle every aspect of your operation, make that clear in advance -- or right before the procedure, if necessary. And remember to smile when you ask (that is, if you're not having gum surgery).

Q. In what situations should I ask to speak to a nurse rather than to a doctor?

A. Nurse practitioners (nurses who receive extra training in diagnosing conditions and who often dispense medication to patients) can be more competent than MDs when giving advice about wound care and postoperative healing, says Julie Karen, MD, a New York City dermatologist. Also, an experienced NP will be able to answer any questions you might have about your medical history, since she's spent more time taking down notes in your chart and calling in your prescriptions, says Dr. Savard. "Your doctor will be the one to notice unusual symptoms and make a final diagnosis, but a nurse practitioner will be aware of how you respond to therapies and drugs, in case you need to make an adjustment in your treatment," she explains.

Taking Medication

Q. How does a doctor choose the brand of medication that she suggests?

A. Studies have shown that doctors' drug choices can be influenced by biotech or pharmaceutical reps, who send them free samples or even treat them to meals (although medical institutions are limiting this practice). Sometimes, the bias can simply be chalked up to exposure; with multiple similarly effective drugs on the market for the same ailment, a doctor might be more inclined to prescribe something that's been presented to him in person, says Dr. Karen. But most MDs do their best to remain objective. "Some physicians don't allow pharmaceutical representatives to visit their practices at all," says Dr. Chuang. The doctors that FITNESS editors spoke to say they often suggest a medication based on what's in their office and what will be least costly -- but not to the exclusion of what they feel is best. "We're aware of the newest things on the market, but that doesn't mean we forget about what we've previously used successfully," says Dr. Fryhofer.

Q. Can I take a medication I already have rather than waiting to see my doctor?

A. Our experts agree that self-medicating is appropriate only in the short term. "If a woman recognizes her symptoms and it's a familiar pattern -- for example, she gets a UTI after sex -- taking a single course of a prescription medication she already has is acceptable," says Dr. Savard. (Be sure to check the expiration date.) "But if you have frequent flare-ups of a condition, you should get a culture or other test to make sure you don't have something more serious."

How to Be the Perfect Patient

Q. Do doctors care how well groomed I am?

A. Putting off an appointment because you're due for a waxing is unnecessary. "This isn't a beauty contest; we're trying to take care of your health," Dr. Fryhofer says. "Patients will say, 'I forgot to shave my legs,' and I laugh to myself, because I'd never notice that," adds Dr. Savard.

Q. What do doctors wish patients would do more often?

A. They simply want patients to be prepared. For a visit to a new doctor, this includes arriving with a detailed list of the medications you're taking and knowledge of your family medical history. And mention your most pressing concern at the start. "It's terrible when you've spent the entire time evaluating a hemorrhoid only to find out, as you're walking out the door, that what's really bothering the patient is chest pain," says Dr. Savard.

Q. What do you think of patients who bring in information from the Internet?

A. Printouts are welcome -- provided you're getting them from a reputable source, such as medlineplus.gov or uptodate.com. That said, "It can take a big chunk of an appointment to dispel inaccurate notions a patient has learned from an Internet story," says Dr. Karen. Adds Dr. Roach, "It's tough when I hear 'Someone told me about this online, and I think you should order the following tests.'" A better bet: Bring in a solid research study or a newspaper article and ask how the findings relate to your particular case.

Q. Will requesting a second opinion burn bridges with my original doc?

A. No, our experts say, but they share a distaste for being made to feel like they need to fight to keep patients. "You might tell your MD, 'I'd like to see someone else to make sure we're not missing anything,'" says Dr. Savard. Don't dump a trusted doc solely over a diagnosis disagreement. Medical matters are rarely black and white, so multiple perspectives can help.

Originally published in FITNESS magazine, July 2008.

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