“I’m sitting in my paper gown, alone, realizing that I never even asked half my questions and have no idea if I’m supposed to get any more tests done.”
“OK, great! See you in 6 months!” the doctor says, gliding out of the exam room. The door clicks shut. I’m sitting in my paper gown, alone, realizing that I never even asked half my questions and have no idea if I’m supposed to get any more tests done.
If you’ve been there, you know that today’s 15- to 30-minute medical appointments are no match for the complex conditions many of us are living with.
We often walk into the exam room with the best of intentions to lay out our symptoms in detail and ask everything we need to ask. But faced with an authoritative professional who’s clearly trying to get out of there ASAP, it’s easy to break down and revert to passivity: “Oh, no, that’s all I needed, thanks so much! See you next time!”
Doctors don’t always realize how their rushed demeanor affects their patients’ comfort level, not to mention their medical outcomes. Even when they do get it, the restrictions and requirements that insurance companies and managed care organizations place on doctors often leave them powerless to give us more face time with them.
Learning how to make the most of short appointments is one of the most important medical self-advocacy skills you’ll ever learn — even though it really sucks it’s one we have to use.
Here are some ways to get started.
If you frequently see doctors (#CancerSurvivorProblems), it’s a good idea to create a designated space for medical notes, whether that’s a notebook or a folder in your Notes app.
Before each appointment, prepare an agenda as if you’re going to an important business meeting (which, let’s be real, you kind of are).
Some key points to cover:
- symptoms or side effects you’re dealing with
- how these problems are affecting your daily functioning, like your ability to take care of yourself, work, care for others if needed, and enjoy life (that’s important even if — especially if — you have a chronic illness!)
- what you’ve already tried to cope with these problems
- previous medical care you’ve had
- what you’d like to accomplish in this appointment
That last one is particularly important to think about ahead of time, because it’s not always clear to doctors what we’re hoping for, and it’s not always clear to us that it’s not clear to them.
Are you looking for a medication change? Strategies (including, but not limited to, medications) to cope with symptoms? A diagnosis? Including this in your notes can help you stay on track during the appointment.
Besides just making notes about what you want to talk about, it’s useful to spend some time thinking about what questions you might want to ask your doctor.
One way to maximize a short appointment is to take this one step further: Predict what you might want to ask depending on what your doctor tells you.
Here are some suggestions to get you started:
If your doctor suggests medication:
- How should I expect to feel on the medication?
- What are the potential side effects?
- How long does it take to start working?
- What should I do if insurance won’t cover it?
- What should I do if I can’t tolerate the side effects?
- Should I schedule an earlier follow-up appointment if it’s not working?
If your doctor suggests further testing:
- What can the tests show? What can’t they show?
- When will the results be available?
- What will you do if the tests don’t show anything?
- How will you make sure insurance covers the tests?
If your doctor makes a referral to another provider:
- Should I call them, or will they call me? When should I expect to hear from them, and what should I do if I don’t?
- Who should I see if this provider doesn’t work out?
- What does this type of doctor do?
If your doctor makes a diagnosis:
- How can I learn more about this diagnosis?
- Which other diagnoses did you rule out, and how did you rule them out?
- Is this progressive? What’s my outlook?
- How certain are you about this diagnosis? Is there anything else it could be?
If your doctor says everything looks fine, or they don’t know what’s wrong:
- Who else should I see?
- How do I manage these symptoms?
- What will you do to help me?
Prioritize your concerns
If you have several medical issues to address in your appointment, be prepared for the possibility that you won’t have time to talk about all of them. It may help to prioritize them.
Pick one issue that’s most bothersome or concerning, or that’s affecting your life the most.
Ask yourself, “If I could choose one of my issues to magically disappear, which would make the biggest difference?” That’s your first-priority issue. Then pick another you’d like to get to if time allows, and (if needed) a third if things go really quickly.
At the beginning of your appointment, be clear with your doctor: “I have three issues to discuss today if we have time. The most important is X, followed by Y and then Z.” This gives your doctor a way to structure the appointment so it’s as helpful as possible.
If you don’t get to everything in the allotted time, end the appointment by reminding your doctor of the other issue(s) you mentioned and asking for a plan to address those, whether that’s by scheduling a follow-up appointment or seeing a nurse practitioner or some other provider in the clinic.
Provide documentation for your chart
Although you’ll be spending part of your appointment discussing your symptoms or medical history, it’s not always necessary to cover everything right away — especially if you’re dealing with a complex, chronic issue.
If your doctor doesn’t already have electronic access to your previous medical records, bring hard copies to the appointment and ask to have them scanned into your chart.
It can also be extremely helpful to type up your own notes about symptoms, lifestyle changes you’ve tried, and other important info and have that put in your chart as well.
Although your doctor may not have time to read all of it, they might — and their nurses and assistants even more so. Most of us can read much faster than anyone can speak or listen.
When you have complex symptoms and histories but not very much time, providing written material can help make up for a short appointment.
Schedule your next visit
Unless your issue was resolved in this appointment, or you’re unsure of your schedule, it’s always a good idea to schedule your next visit while you’re still at the doctor’s office.
If you don’t know when your next visit should be, just ask the person at the front desk. In my experience, doctors usually mention this at the end of the appointment, but sometimes they forget.
Because doctors’ schedules can fill up so quickly, it’s best not to wait until something comes up to schedule an appointment.
If you’re seeking a diagnosis or managing a chronic condition, regularly scheduling appointments means you don’t have to wait as long to discuss an ineffective medication or worsening of symptoms.
Follow up with your medical team by phone or online
Sometimes you don’t even have to wait for your next appointment to discuss an issue. If something comes up, or if you realize you didn’t have enough time in the appointment to mention something important, it’s always OK to call your doctor’s office and speak with a nurse or ask for your doctor to call you.
Most medical systems nowadays also use electronic medical records like MyChart, which allows you to send secure messages to your medical providers.
While they may not be able to address serious or new issues, it’s a great way to ask questions you didn’t get to in the appointment or to get help with routine issues.
And really, it’s a challenge for anyone who wants to be careful about their health and get all their questions answered.
Preparing well, using your time efficiently, and following up when you need to can help you really make those 15 to 30 minutes count.
Since short appointments seem to be here to stay — at least for now — the best way to care for ourselves is to get flexible about how we utilize that precious time.
Miri Mogilevsky is a writer, teacher, and practicing therapist in Columbus, Ohio. They hold a BA in psychology from Northwestern University and a master’s in social work from Columbia University. They were diagnosed with stage 2a breast cancer in October 2017 and completed treatment in spring 2018. Miri owns about 25 different wigs from their chemo days and enjoys deploying them strategically. Besides cancer, they also write about mental health, queer identity, safer sex and consent, and gardening.