Ten Tips to Maximize the Value of a Doctor’s Visit

Doctor Who Tardis by Andrew* on Flickr!I’ll be the first to admit that I don’t like going to the doctor. I had a few terrible experiences with who I still call “the world’s scariest doctor” when I was a young child (“I’m going to clean it out now” in a frigid monotone, followed by the sound of a buzzsaw starting up and something cold and metallic jabbing me in the ear), and since then I’d rather do almost anything than visit a medical professional.

Thus, it’s not only in my personal best interest but my financial best interest to get the absolute maximum value that I can out of every doctor’s visit. Here are ten great tactics to maximize the value of any doctor’s visit.

Be on time, and don’t throw a fit about waiting – medical emergencies do happen

When you have an appointment, do your best to show up on time – don’t just fluff it off by saying, “Well, they’ll call me in late anyway.” That just means that someone else will get called in before you and you’ll be even later. Most medical professionals make a concerted effort to keep to their schedule – they want to go home, too – but medical emergencies do happen. You’d want your doctor to drop everything and help you in a medical emergency, would you not? So why not be understanding when he or she does the same for another patient?

Get any concerns you have off your chest

No matter what the purpose of your visit is for (unless it’s to a specialist), let your doctor know of any medical concerns you have right then. It’s better to deal with all of your concerns in one appointment than to “let it slide” and have to come back at a later time for another appointment. Not only that, there’s some chance that your ailments may be connected and may apply to the condition you’re suffering now.

Be fully honest, even if it means admitting some bad behavior

Doctors can only make a correct diagnosis if they’re given correct information, so that means telling the honest truth about your behavior. If you don’t exercise, don’t describe it as “light.” If you drink a six pack a day, don’t say you have “a beer or two once in a while.” If you smoke a pack a day, don’t say “I have a few a week.” Don’t say that you eat healthy when you just knocked back a few double cheeseburgers. If you use hard drugs, don’t deny it. If you’ve had a lot of unprotected sex, say so. Your doctor is there to heal you, not judge you, and you make it more difficult to get the treatment you need if you create falsifications about your situation.

Give as much detail as is reasonably possible

When describing your concerns or your condition, give details (within reason). Don’t just say “my chest hurts,” describe the pain. Is it a weight? Is it intense? Is it constant, or does it come and go? Does it occur after you do certain things? Let your doctor know all of this about any ailments you’re experiencing. Not doing this gives your doctor a false impression of the situation – a good doctor will ask questions to tease this out of you, but you’re better off just spilling it up front.

If something is unclear at all to you, ask

If your doctor describes something or makes a suggestion that you don’t fully understand, admit that you don’t understand and ask for more information. If you walk out of a doctor’s office confused about your condition and confused about what you’re supposed to do, your appointment just became a waste of your time and the doctor’s time. Don’t leave unless you understand your condition.

Ask about independent steps you can take to prevent recurrence

No matter what your condition is, ask the doctor what you can do on your own to help with the symptoms or prevent recurrence – and take the suggestions seriously. You’ll probably hear things you already knew about (eat better, exercise, stop smoking, cut back on the alcohol) and maybe a thing or two you didn’t expect (start taking a vitamin, eat more carrots, wash your hands). The key is to follow up on those things – actually make a real effort to do them so that you don’t get sick again.

Ask for prescription samples

If you’re given a prescription, ask for some samples of that prescription. This serves two purposes: it potentially reduces your overall cost for prescription, and it gives you enough of the medication that you can get out of the office and find a pharmacy with the lowest prices for your insurance or other payment situation.

Ask for a generic alternative prescription

Another option is to ask for a generic alternative prescription, especially since $4 prescriptions have become prevalent at many pharmacies. If there’s a generic alternative for your prescription, switching to that medication can save you a significant amount of money.

If you’re getting bloodwork done, ask for some general screenings (like cholesterol, etc.)

Almost always, your doctor will happily oblige, mark a few more spots on the bloodwork form, and your out of pocket cost will remain the same while you get more personal medical information. This is always a good thing to do, no matter what your perspective is on your general state of health, as it can flag problems that are coming down the road.

Thank your doctor and nurse

This seems trivial to some, but it can make a big difference to your doctor and nurse. Medical professionals have to deal with unimaginable stuff on a daily basis and it’s quite often a thankless job (even if the pay is solid). Many doctors are faced with belligerent patients, heart-wrenching (and sometimes stomach-wrenching) situations, and often go home to face a giant stack of medical school bills. Take a moment to sincerely thank your medical professionals for the work they do – it can make a big difference in their day.

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  1. Outsaving the Joneses says:

    To avoid long waits, try to schedule your appointment for first thing in the morning–supposedly you’re less likely to have to spend a lot of time in the waiting room. It’s seemed to work well for me so far.

    Also–the free samples are great. My prescription costs $40 per month. There is no generic, and other types of this RX left me feeling sick most of the month. Anyway, at my last appointment, my doctor gave me two month’s worth. Saved $80 right there!

  2. Egoldstein says:

    If possible, have a partner (spouse, best friend) attend with you. This way they can take notes, add additional observations that may be missed and may remember something that the sick patient later forgot. Similarly, I have found it helpful to write out questions to ask the doctor, or a check list of things to be raised at the annual exam, since the time in the waiting room, the smell of the Drs and stripping down to the hospital gowns seems to have a negative effect on my memory.

  3. Bethh says:

    This is really good advice. I’ve found that writing a list of my concerns, and holding it where it is visible, reminds me that I want to discuss x,y, and z. That helps me just get it out there, no matter how fast I want to get off the table!

  4. Khaki says:

    Not only do samples save you money and buy you time to find the cheapest price, but it also gives you the opportunity o see if you have any side effects that are unbearable. Perhaps you will not react well with Prescription A and need to switch to Prescription B…If you already bout a 30 or 90 day supply without trying it first you are stuck with the remainder of pills.

  5. CINDI says:

    Your tips our spot on. I am a nurse at a health
    center, and let me tell you a Thank You goes a long way. It can make a long crappy day so much
    brighter. If we make you wait we are sorry but not all pts problems can’t help but run longer than 10 mins. But we try hard to get you in and out in a timely manner. Thanks

  6. mollyh says:

    To expand on this just a bit, it’s probably financially responsible to go to your primary care physician yearly for a checkup even if you don’t feel sick because that small co-pay will contribute to maintaining current good health or possibly even catch any illness or disease in an early stage, which would save lots of money on future medical care. This, of course, gets even more import the older one gets, but even young people should be regularly visiting their physician. Really, you take your car in for regular maintenance, shouldn’t you do the same for your body?

  7. Mark F says:

    As the husband of a doctor, I appreciated reading this. Yes, doctors sometimes run behind. Often it’s because of medical emergencies, as Trent put forward. Sometimes, however, it’s because a patient comes in for a checkup and once in the room a patient drops a load of questions or concerns on the doctor.

    So taking that into account, I’d amend “Get any concerns you have off your chest” to say: when you’re scheduling your appointment, you should let the office manager/secretary/whomever you’re speaking with know that you’ve been having chest pain/are worried about cholesterol/are concerned about STDs. If they know beforehand, it’s much more likely that they’ll schedule you for a larger block of time and you won’t push back those with appointments after you.

    And while yes, physicians do make pretty decent money, it’s not the waterfall of money that most people imagine. (which is why I read blogs like this!)

  8. From an MD’s perspective, these are all good pieces of advice. I would caution on trying to add to much to your “routine bloodwork,” however. Remember, lab test give a quantitative value, not qualitative value (for most things) and this can actually cause more confusion than clarity if the test is not performed in the appropriate setting of a clinical background requiring the test.

    Also, while we’re on the subject, you may be interested in my recent blog post on ER Visit Style Tips: http://jeremyjoslin.com/index.php/2008/06/5-style-points-for-your-next-er-visit/

  9. Trent says:

    “it’s probably financially responsible to go to your primary care physician yearly for a checkup even if you don’t feel sick”

    I need to do this. My subtle fear of doctors always keeps me from doing it, though.

  10. aware says:

    the post title and TARDIS picture got my hopes up. I want The Doctor to visit me!

  11. Stephanie says:

    Great list!

    Here is my tip:

    I also keep a spreadsheet (slightly neurotic, I know) of every medication I have taken, the dose, the date, the reason why and any side effects. I highlight my current “as needed” and my current “daily” medications in different colors. Not only is this GREAT for new doctor visits so you can skip that section of the paperwork, but it shows the doctors that you are taking responsibility for your own health. Rather than my PCP flipping through my chart asking me “have you ever taken _______”, he can easily see if I have on the spreadsheet right in front of him. In my experience, that garners me more respect being an educated and well prepared patient.

  12. Rachel says:

    I’d like to reiterate and expand upon the tip on giving details… even if you think the details are embarrassing or gross, those details could be very important in figuring out what you have. I say this as someone with a bowel disease who has had to describe bowel movements to my gastroenterologist many times over the past year (and many more times for the rest of my life). It’s not fun, but necessary.

    Along the lines of getting free samples, also ask your doctor if there’s a patient assistance program for a medication. My medication costs almost $400 a month– but I’m getting it for free for this year because I proved I couldn’t afford it. If your doctor doesn’t know, do some internet searches. There is help out there!

  13. Katy McKenna says:

    I know this seems counter-intuitive, but take care when/how/with whom you discuss mental health issues. Your current insurance may cover anti-depressants and various conditions, but I have heard of folks leaving their employer to become self-employed and then being told they are completely uninsurable because of their mental health issues. Weird and wrong, but true. Don’t lightly claim to be “depressed.”

  14. Jica says:

    I went to the doctor for chest pain, which I thought might caused by my recent thyriod ablation. I mentioned this bump under my arm. The bump concerned the doctor more than the chest pains. I’m glad I asked.

  15. KC says:

    I’m only 35, but take a boatload (for a 35 year old) of medicines – some prescription, most OTC. But when it comes time for my annual check-up I just throw them all in a bag and take them with me – that way the doc knows exactly what I’m taking. She already knows my prescriptions drugs, but I include them, too, with the vitamins, fiber pills, fish oil and whatever other crap I take. I wish I were perfectly healthy and didn’t have to take any supplements, but alas I’m not and this is the easiest way I know to keep my doctor informed on everything.

  16. Jen says:

    As a doctor, (and an avid simple dollar reader because I’m just as frugal as you and definitely not “rollin’ in it”…) I agree with the number one way to maximize your visit with the doctor is to bring a written list of concerns and put it in full view. Did you know the average doctor will cut you off in 30 seconds and then be in control of the rest of the conversation? I try not to do that, but it happens. Time constraints and production mentality, etc. Also, just as important, be very clear when you make the appt what the purpose of the visit is. It lets the staff anticipate what you’ll need. Ask for generics, 90-day supplies, samples, OTC alternatives, coupons, savings programs–it’s all there for the asking. You can probably recoup the cost of the doctor visit with the savings. WalMart, Target, and Kroger all have $4 generics (the list varies by store) and you can ask for a list to take with you to your doctor’s appt. Personally, I never buy name-brand medical products or medications, because you are just paying extra for some company’s slick advertising campaign. Best deal by far–over-the-counter meds at Costco, the “Kirkland” brand, and for prescription meds not on the $4 lists, you can use the Costco pharmacy without a membership.

  17. cv says:

    I agree with most of this, but I have issues with free prescription samples. I’ve read a couple of books recently about the pharmaceutical industry in this country and the way that drug reps distribute samples and other goodies to physicians to influence prescribing habits. The whole system of free samples jacks up the costs of all drugs and means that your doctor is giving you some high-priced new drug that a 22 year old marketing rep told him to, not what the peer-reviewed medical literature said was best.

    Of course, this isn’t true in every individual instance, and drug samples have enabled many patients to receive drugs they couldn’t otherwise afford. But the entire system is totally screwed up and needs a major overhaul, and I’d prefer to go to a doctor who doesn’t meet with drug reps at all.

  18. Hi Trent,
    I never quite thought about the visit to a doctor in this way. This post was very helpful for me because I’m planning to visit a doctor sometime soon. Oh yes! I’m in the same boat as you, postponing that inevitable trip for as long as possible. But when I do bite the bullet, I’ll make sure I follow your advise. Thanks a lot.

  19. Great post…better site…

    I always get upset with my doctor when I am on time and he is not (concerning the appointment). My time is just as valuable as his/hers and it should be treated with such. However…I never thought about the emergency thing. I need to completely change my thoughts on this one.

  20. Actually it is usually not due to emergency (for most doctors) but rather patients doing what was suggested and laying out extra problems after the appt is scheduled. Previous poster said it best. If you want them to see you for more than one thing TELL them when making the appt. Also, a lot of doctors triple book/ quadruple book etc. My pediatrician schedules 3 visits at 8:30 because they have three rooms. He obviously can’t get all three done in 30 minutes so this makes for lengthy wait times if you don’t get an AM visit. I have literally waited 4 hours with a sick baby. But he is a great doc and that is why I wait.

  21. dave says:

    to cv

    idiotic statements by someone who is ignorant of the medical business. the samples drug reps give us are essential to help our patients who couldn’t otherwise afford them. only a knucklehead would prescribe a new med without fully understanding the science behind it. as far as getting goodies to help influence prescribing habits?? nowadays it’s a few pens or a meal at a restaurant while listening to a specialist detail about a product. and we’re not even allowed to bring our spouses with us. if you can find me a doctor who doesn’t see drug reps on a daily basis, i’d be amazed. good luck finding one.

  22. joanE says:

    Never let medical people shame you. Not for any reason. Ever. Tell the truth…stand up for yourself, get the medical care you need.

  23. rb says:

    My patients are encouraged to do several things to help themselves and me. Write down questions before the appt, be straightforward no matter how personal the issue is, keep questions short and concise, tell me the problem at the start of the appt-not at the end, check in on time or expect to wait. Most of us are crazy busy, but love what we do and really do care about the well-being of our pts. So if I recommend something you don’t like, tell me and we can see what works for you. Remember the pt is the customer and needs to have an active role in his/her healthcare. If you can’t afford the meds, tell me. I will give you free samples if I have them or find a cheaper medication. Some of us are also very frugal and can appreciate that there is a budget to follow. An ounce of prevention….get the cholesterol, blood sugar and thyroid tested every yr or so depending on your age.

  24. Tyler says:

    2 additional things:

    1. Check the official website of the drug. In the case of the ubiquitous nasal sprays you can find coupons (nasonex), discount cards (omnaris) or mail in rebates (patanase). These will cover part or all of you copay.

    2. Swap pharmacies. I currently have 2 coupons offering store cards for transfer existing prescriptions. One is Rite-Aid for $30 (from their website) and the other is a regional grocery store for $25 (from a newspaper ad) so for a little leg work, I’ll get $55 in gift cards. I also have coupons/discount cards for the drugs so total out of pocket will be $0.

  25. My friend is a nurse and she brings home sample “Z-Packs” and will give them to me when I feel a cold coming on. I know its a little dishonest…Ok, VERY dishonest, but hey…

    OK, I don’t know where I was going with this. Great post, Trent. Keep ‘em coming.

  26. Mitch G says:

    Too bad Z-packs (antibiotics) won’t do a lick of good against a cold VIRUS. At least you take free samples instead of using your insurance and driving up premiums for those of us who didn’t skip out on 8th grade health class.

  27. Great points, Trent. Way to go. I like the fact that physicians and nurses are part of this community and can offer specific insight on your suggestions. Their comments are helpful to all of us.

    Saying “Thank you” is big with me. I appreciate you making it a significant point. Each of us has the ability to raise the spirits of another through a simple gesture such as this. Doctors and nurses face unbelievable pressures and must put up with anger issues by patients.

    They deserve sincere words of appreciation. You have good awareness, Trent.

    Cade

  28. Sarah says:

    Cute image there, Trent.

    Hate to say it, Dave, but just because corruption is endemic doesn’t mean it’s not corruption.

  29. Gerard Sorme says:

    Well….let’s see….we have doctors here defending Big Pharma, doctors wives defending long wait times because some patients don’t appreciate being charged $100 or more for 5-7 minutes of time – just so he/she can go on to the next patient for another 5-7 minutes. Shame on those who actually want to discuss their health! Call ahead if you want to do something as bizarre as that! What is going on? Our health care system is in shambles and we’re defending some of the horrendous reasons why.

    The double and triple booking ALONE is enough to find another doctor. If you end up waiting 30- 45 minutes because the doc has to pay for his gated community by booking 3-4 patients at 2:00, 3-4 at 2:15, etc. you should find another doctor. They get away with it because **we let them**.

    CV was absolutely correct about the drug samples. I simply don’t believe “Dave” (above) is a doctor the way he slammed CV as almost all doctors know the truth about Big Pharma. Also, a *real* doctor wouldn’t be brazen enough to call health care – “the medical business.” I mean, we know that’s all it is – another BUSINESS – but a real doctor wouldn’t be so blunt.

    And “Dave the Doc”…The excuse of talking to the drug reps because they are “specialists” is rather bizarre. They are called, “MARKETING Representatives,” for a reason. They are there to SELL you their product – not to enlighten and “inform” you. The lunches are a shame in your profession. More info on the doctor/big pharma relationship can be found at:
    http://www.nofreelunch.org/

    We have to wake-up and smell the coffee about our health care system. It is NOT (as we have been told all our lives) the “best” health care system in the World. Not even close by standards of industrialized nations. It’s all about $$$$$. I’m surprised by so many of the comments here. We must FIX our system and to do that we first must get the answers to what is wrong and – as always – follow the money.

  30. Suzie says:

    I think the best thing to do is make a list of all your symptoms and just give it to the doctor. Whenever I go, no matter how awful I feel on the way, I always seem to feel guilty about wasting the doctor’s time as there are people in the waiting room who look much worse than me. Even the leaflets make me seem like a whinger!

  31. Anna says:

    Take notes — not only once but twice:

    1. Beforehand, to organize your symptoms and concerns, so you can discuss them efficiently (this has already been mentioned by several posters).

    2. During the visit, to help you remember what the doctor said. It’s very easy under the stress of the examination to forget half or more of what was discussed and recommended.

  32. Gayle RN says:

    Know your insurance benefits so you won’t get surprised by a bill that you have to pay. Just adding a few blood tests can ding you pretty badly if it is something the insurance company doesn’t deem appropriate.
    I totally agree with asking for generic medication, especially for chronic long term use. For example, there are off patent cholesterol drugs that work quite well. You may not get samples of these, as no drug reps are going to be pushing them.
    Carry a wallet card listing your meds and history, quite handy when filling out forms, or just hand to the nurse/md.
    Don’t just bring up everything that has been piling up for 6 months as a “by the way”. Ask for extra time up front. Otherwise you will probably be asked to return for another appointment.
    If you require a lot of information and education about your condition you can probably be referred to a nurse who can take the time and resources to do that. Besides we are educated to do that. Also cultivate a relationship with a pharmacist who can be a great resource.

  33. Arlene says:

    As a physician, I was happy to see you mention being patient if the doctor is running behind. I sometimes think people think we’re sitting back in our office with our feet up when we’re running behind, but usually it’s because of an emergency or because someone has come in with many more problems than they let on when making the appointment, which brings me to my next point. You suggest that patient’s bring up every problem they can think of during a visit. In this day and age of 15 minute appointments, there is usually not enough time to discuss every problem that a patient may have and another appointment is usually necessary if someone has multiple concerns. Lastly, if a patient wants the generic of a drug, they don’t have to ask their doctor for it other than making sure that they are being prescribed a medication that has a generic available. Unless the doctor specifically marks “Dispense as Written” or “DAW” the patient can request a generic at the pharmacy, and, in fact, the insurance company usually requires that a generic is substituted for the brand name unless the doctor indicates with DAW that it be the brand name.

    Otherwise, good article.

  34. Debbie says:

    @dave: my husband is a family practice doc and almost never talks to drug reps–he has no time! And he throws them out if they don’t know what they (and HE) are talking about (he argues the facts with them.) If he doesn’t have time to talk, they simply drop off their samples. But no way he talks to them “daily”.
    @cv: If you think your doc prescribes based on the advice of a drug rep, then you definitely need a new doc–he must be an idiot!

  35. Camilla Todd says:

    Good post! I hate going to the doctor too. Asking questions is a big one, i agree – i know people who just won’t because they feel awkward, and it always puzzles me. Questions are a vital part of good communication!

    >>It’s better to deal with all of your concerns in one appointment than to “let it slide” and have to come back at a later time for another appointment.

    This may have already been mentioned, i don’t have time to read others comments today unfortunately: Be wary, because i have been told by medical professionals (including doctors) that this is not a good idea and makes their job very difficult. They much prefer problems to be dealt with in different sessions, even if that means two appointments within a fortnight. Obviously this doesn’t apply when symptoms may be connected, but if you’re storing things up for one visit, that’s not good. :)

  36. getagrip says:

    I agree with going for morning appointments when possible since the later in the day you go, the greater the chances they’ve fallen behind in making their appointments (but isn’t this true in many areas that include some form of “diagnostics”, car repair comes to mind)

    We also tend to forget that sometimes when we come in for what we think is one thing, the doctor can recognize something else entirely. So there are those going in for what they think is a simple thing only to have the Doctor extend their exam to rule out possible serious issues. I can think of one occasion where they hooked me up to a heart monitor to make sure the pains I was having were not the result of a heart condition. That extended the visit a bit.

    Finally, never feel like a whiner. If you’ve got an issue, get it taken care of. If you’ve got a question or issues you forgot to mention when setting up the appointment, go ahead and bring it up (just please remember to try to include such things the next time). Don’t risk yourself or walk out forgetting something if you can help it. It’s ultimately better (especially for you) than taking up everyones time by making another appointment when you could have covered it in this one. Just try not to make a habit of it.

  37. Jackie says:

    I have to agree very much with the perscription samples! My birth control costs $50/mon and my gyno just gave me 3 for free when I asked!!

  38. Francine says:

    I thought the “idiotic statement” statement was harsh. I am honest and try to be helpful on these posts, and consider this a “safe” place to express my opinions – like friends gathering for coffee.

    That said, I agree with much that has been posted, so I will not repeat it.

    I wanted to add that my sister is a hand surgeon (I am so proud of her! It was a long, tough road). Her biggest frustration is patients are often quite late. She works at several offices, and is on a tight schedule. When she has to leave to go to the next office, she has to leave, with Chicago suburban traffic, and all. That is one of the reasons why patients end up waiting, and it is not fair to the later patients.

    Doctors are more compassionate today, as they now tell me what they are going to do, and warn me “this might pinch, or this might sting.”

    I hate having my blood drawn, and I find it helpful to look away and engage the person drawing my blood in conversation.

    Best Wishes,
    Francine

  39. Francine says:

    I thought the “idiotic” statement was harsh. I feel like this is a “safe” place, like friends chatting over coffee.

    I agree with much of what has been said.

    My sister is a hand surgeon, and she gets frustrated when patients show up half an hour late to on appointment. She has to go to several different offices and is on a tight schedule. That is one of the reasons why other patients end up waiting.

    I think doctors are kinder now, as they tell me what they are going to do, with “this might pinch, or this might sting.”

    I hate having my blood drawn and look away and engage the person drawing the blood in conversation.

    Best Wishes,
    Francine

  40. Richard says:

    I have to argue a little with number one. While I do believe you should be on time, I do not agree that the medical profession makes enough of a concerted effort to be cognizant of their customer’s time. I can’t tell you how many times I’ve waited longer than 15 minutes beyond my scheduled appointment time. The last time I was made to wait well over an hour. When I complained I was told there was a medical emergency. I responded that there would not have been an issue if they had not scheduled 4 patients for the same doctor at the same time which was evident on the sign in sheet. The doctor had no response for that one. I see that practice repeated time and again. It is because greed apparently goes hand in hand with do no harm.

  41. palm says:

    I am on the faculty of a pharmacy school and I agree completely with what cv said about free samples. Your best choice is to find a provider who doesn’t have samples to offer because they don’t meet with drug reps (check out http://www.nofreelunch.org for a list of providers and a summary of the issues). Prescription patterns change after drug reps meet with physicians and pharmacists to “detail” a new drug, even if the attendees receive nothing more than a pen. There are multiple observational and experimental studies that have shown this in the peer reviewed medical literature.

    The vast majority of my colleagues won’t take any prescription drugs that don’t have generic equivalents; the risks of new drugs are just too high. And that means we never have occasion to need samples. Drugs that have been on the market long enough to have generic equivalents are safer, and you’re safer staying away from physicians who are willing to let drug company sales reps tell them what to prescribe.

    I’ll get off the soapbox. The other advice was good, especially the comment about patience. I’ve been in the position of needing emergency care and causing everyone else behind me a hour delay, and I now appreciate a long wait to see a physician because it means I’m basically healthy.

  42. Liz says:

    Great Article! As an RN, I’d like to add a couple more suggestions–bring a list of all the medications you take with you, this is especially important if you see more than one MD. Take a few minutes before your appt to write down any questions you have, that way you won’t forget to ask them.

  43. Sharon says:

    Generic drugs are NOT the same as the brand name. If you are taking a drug with a narrow therapeutic window, going with the generic may create problems. I would suggest starting with the brand name, see how you do, and only then try the generic, while carefully monitoring how you are doing on both. Check your blood pressure on the brand name, then check it on the generic. Monitor your mood on the brand antidepressant, and have your loved ones monitor it, and then try the generic. There are many generics that simply don’t do the job for me.

  44. Martin says:

    I usually try to get an appointment earlier in the day if I can as it seems lateness typically trickles down to the later appointments.

    One thing which I don’t think has been mentioned is that it seems to me that doctors also deal with the unexpected (not necessarily emergencies) which can take longer. While it hasn’t happened often, there have been some times I’ve gone in with what I thought was one thing only to have the Doctor take some extra time or precautions to rule out or confirm something else.

    Diagnosis isn’t an easy thing. How many diseases start with a fever? Sometimes indegestion can indicate a lot more than just an upset stomach. Frankly, the best you can do is be upfront with all the symptoms, ask questions, ask when and what effects you should be getting from the treatment, and how long, if nothing changes, you should wait before getting back to them.

  45. Dave says:

    Wow, some heated debate about drug reps. In my clinic, I will say that 1) we don’t meet with drug reps, 2) they do leave behind samples, and 3) they are never for anything that I would want to prescribe. Once a class of drug has a generic option, most of the samples for “me-too” drugs seem to dry up. The key trick that reps are using is to get you to try a “newer, better” drug and then, if it works, both doctor and patient are more likely to continue using it, thus getting the patient “hooked” on one agent when another might have worked fine and been cheaper.

    Yes, generic drugs are not precisely the same as brand name. The rules are slack, with the FDA only requiring “test-tube” equivalence +/- 20% of the brand name agent. That said, generics make it possible for millions of people to afford life-prolonging and improving drugs they could not otherwise take. Ask anyone who has had to make the choice between their drugs and heating their home and ask if they think generics are a good thing.

    Trent, overall, thanks for the comments. I share the reservations of others about adding on “routine bloodwork”. I would also say that I cannot stress how helpful it is to try and think about the quality and timing of your complaint before coming in. I cannot count how many patients I have seen that complain of pain here, there, and everywhere, but cannot elaborate in the slightest making it nearly impossible for me to do anything but stab in the dark about what the diagnosis is and how to treat it.

    Thanks for everything you do on TSD, I love the blog!

    Dr. Dave, MD

  46. JReed says:

    Drug reps are not experts; they are sales people and their job is to sell. The free samples are helpful not only to financially challenged but also to see if the drugs work for a patient before having to order the 3 month supply required by many plans in order to qualify for the discount.
    I worked for three years in a medical office and advise the best thing a patient can do for his or herself is to take responsibility. Inform yourself, communicate with your doctor, be clear and concise about your symptoms, expectations and needs. Instructions, prescriptions and follow up appointment compliance are all your own responsibiity. In other words, be an adult.

  47. Mary says:

    I’d like to emphasize what was mentioned before about bringing to your doctors office and your dentist office a list of current medications that you take. Its important for your health care providers to see what you are taking to give you the proper care as well as to prevent any drug interactions. I would also recommend doing a little research about any conditions that you might have in order to understand them better and to be able to know what sort of questions you should be asking about your condition. Doctors don’t always realize that they may be talking over someone’s head, and patients don’t always realize that they didn’t get it. My point is to be informed, if there is something going on with your body its important to understand it because you have to live with it.

    On a side note about waiting in the doctor’s office its been stated that emergency situations come up, and that’s true. I’d say though that more often then that the cause for health care provider’s to be running behind is the build up of multiple patients showing up on time give or take five minutes and then having to fill out the paper work. Most visits require either the initial paper work or the updating to previous paper work. If more people showed up 10 to 15 minutes before their appointment there might not be so much of a delay. A cause of Dr’s overbooking is often related to last minute cancellations or “no show’s” and the dependability of this occurance from experience.

  48. Mike says:

    To everyone who’s complaining about having to wait, it’s because of people following suggestion #2. To barely stay afloat, primary care practitioners have to schedule 15 minute appointments all day long. That’s 5 minutes to review your chart, 5 minutes assess and diagnose you, and 5 minutes to chart it.

    If you need more than 5 minutes with your practitioner, ask for it. They can bill your insurance company for an extended appointment.

    If you don’t like the 5-minute appointment, blame the insurance companies who are squeezing medical professionals. Don’t blame them.

  49. info-about.com says:

    Helpful hints! Asking for samples is a great idea, but keep in mind safety issues with samples. Here is a Medication Safety Alert the Institute for Safe Medication Practices published on things to remember when receiving free prescription drug samples from your doctor. http://www.ismp.org/newsletters/consumer/alerts/Samples.asp

  50. Christina says:

    Don’t be afraid to let your doctor know that you’re on a budget either. They may not realize that the price of the drug is a major concern for you. ASK if the generic would work just as well, or if there is a cheaper option. Mr. MedSaver has a blog and a great business devote to helping people find ways to reduce their prescription expenses. One site I like for well=priced generics is http://www.ProgressiveRx.com. They get their drugs from FDA-approved factories and they require a prescription (NEVER purchase prescription medication from a company that doesn’t require this proof).

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