The Orthopedic Posterous

Graphic from thisisindexed.com...

A few months ago I had a blog post that dealt with the issue this graphic brings to light. Until health care reform enables more physicians to spend more time with their patients--- or until Hello Health takes over health care ... the following post should prove quite useful.

For those interested in my previous post on this topic, please refer to: http://hjluks.posterous.com/new-patients-are-you-prepared-for-your-visit

The unfortunate reality today is that most physicians; primary care and *specialists* alike are pressed for time. Many feel the need to put many (perhaps too many) patients on their schedule and few physicians are sympathetic to the plight of the patients in the waiting room.

Physicians were taught how to interview their patients... but somebody forgot to teach the patient how to communicate with their physician!!!

Because of these issues, it is critical that you are organized and ready for your visit. Not only do you need to dress appropriately, but you should have a few accouterments with you and your thoughts should be organized and well rehearsed. If you are organized you will not be as nervous and you will be able to properly discuss the pertinent issues with the physician---thus enabling the physician to help you.

As mentioned in my previous post, a pen and paper are a must. A smart phone with Evernote would be useful to snap pictures of the algorithms or diagrams the doc might draw for you on the chart or a whiteboard.

Physicians are taught to organize their thoughts in a certain manner. You should spend a few hours getting your thoughts together... do not wait until the morning of the visit... you WILL forget something important. Issues for you to consider:

• What are your symptoms?

• When did your symptoms begin?

• What were you doing when they began?

• When your symptoms began, had you recently changed medicines, shoe-wear, exercise regimen, started taking herbs/supplements, etc, etc, etc ?

• What precipitates your symptoms?

• When are your symptoms worse? (Morning, evening, coughing, sitting, supine, prone, after eating, etc, etc,)

• What relieves your symptoms?

• Anyone in your family have similar medical problems?

• Who have you seen for this problem?

• What tests did they perform? (BRING COPIES WITH YOU)

• What medications are you on? (BRING A LIST)
• What other medical problems do you have?
• What allergies do you have?
• Have you had surgery previously?
• Where, when, why?

For the exam, dress appropriately so the area that needs to be examined is accessible.

After the exam, your physician will review the pertinent studies which have been performed.... X-ray, blood tests, MRI, etc. Take notes!!!

After the physician has completed your history, physical exam and review of your studies they will likely arrive at a diagnosis, or a list of potential diagnoses. Take notes!!!

After the physician has discussed the diagnosis(es) with you, you will have the chance the ask questions... this is where most patients are too nervous to think quickly or clearly... and this is where it matters the most. If you have previously written down your questions, you will feel more confident and your thoughts will be more organized---thus allowing you to get the most out of your visit.

The questions you may want to address include (but are not limited to):

• Are there other possible diagnoses?
• Are there other experts I should consider seeing?
• Do you feel comfortable treating patients with this?

• Is further testing necessary (If the test will not change the plan of care, then it is possible that you do not require further tests)?

• What are the non-surgical and surgical alternatives available to treat my condition?

• What are the possible risks, side effects of the treatment?

• What will happen if I choose not to have surgery?

• What does the scientific literature or research recommend (many physicians still practice based on anecdotal experience [which might be appropriate, depending on the situation])
• Ask for online content references.