How to stress less about going to the doctor
A visit to the doctor can release stressors that are beyond your control. For example, the routine of stepping on the scale at the start of each appointment triggers anxiety in many people. Doctors say patients can ask not to be weighed or to postpone the measurement. It’s okay to say, “I don’t want to be weighed before I see my doctor, and I want to be able to discuss with him whether knowing my weight is necessary today,” said Tracy Richmond, an adolescent medicine physician and director the Eating Disorders Program at Boston Children’s Hospital.
Once the doctor enters the exam room, it can sometimes seem like you and the doctor have different plans. Maybe you’ve been thinking about that cough that won’t go away, but the doctor asks a million questions about a mole on your arm. What can you do? Richmond said it’s helpful to explain his goals and priorities up front. She said patients can say, “Here are the things that are at the top of my priority list [for this appointment]. …Are there things that you think should be on my priority list?” This allows you and the doctor to create a list of items that you know are covered.
Maja Artandi, a professor of primary care and population health at Stanford University School of Medicine, suggested going further by bringing a short, organized list of the top concerns you’d like to address at the visit. “As a GP I really want to understand what is most important to the patient before I start telling them what I think is important. I think if the patient has a list and is prepared for the visit, that’s a good thing,” Artandi said. “I would say if you want to bring a list, focus on your top three concerns.”
As you make the list, it’s possible that you’ll need a second or third appointment to cover everything in depth, especially if there are multiple important issues involved. “We have limited time and may not be able to address everything on the list,” Artandi said. “If someone really wants to address everything … they have to be willing to make another appointment.”
Writing down or setting your priorities in advance can also help avoid the disappointment of raising concerns in the last minutes of a visit, only to feel the doctor doesn’t have time to fully address the issue. “The worst thing for a clinician is that the most important issue gets addressed at the end…then they say, ‘Oh no, how am I supposed to address this appropriately when other patients are waiting?’ [Stating concerns] being direct and explicit makes it so much easier,” Richmond said.
You can also help increase the effectiveness of the visit by providing data. Do you have high blood pressure? Bring a log of your home blood pressure readings if you have taken them. Taking multiple medications? Consider bringing the bottles to discuss with your doctor. If that’s too much of a hassle for you, be sure to write down the names and doses you’re taking to make sure they’re up to date on your medical record.
Most of all, doctors want to know if you feel like you’re having a harder time maintaining your health, so don’t sugarcoat things in the discussion. “It’s about the health of the patient, not a testimony,” Artandi said. “It’s all part of the patient’s health journey. We are there to help them, especially when they are not feeling well.”
Of course, if you don’t feel heard or aren’t sure you agree with the doctor’s suggestions, you can ask your doctor about other options or if their colleagues have different thoughts.
Tammy Chang, associate professor of family medicine at the University of Michigan Medical School, said it’s okay for patients to ask doctors for peer opinions. “It’s the art of medicine,” she said. “There’s very rarely just one way forward,” she said. “So I think empowering patients means giving patients options and listening options from different angles. Doctors no longer work in isolation.”
And you can get a second opinion. While patients may worry that second opinions will upset their doctor, a good doctor should be comfortable with the idea. If not, maybe it’s time to find someone new.
“I always tell my patients that they are the main person – it’s their health that we are concerned about. So if they ask questions, get a second opinion or need clarification – that should be welcomed,” Artandi said. “If the doctor sees that as offensive, then that’s definitely a warning sign. We all work together as medical professionals to help our patients.”
Finally, some patients find that it can be difficult to follow everything the doctor says – either because there is simply too much information provided or too much medical jargon. Chang suggested taking notes during the visit — or even bringing a friend or relative to take notes for you. And you can always ask your doctor to explain in simpler terms if you don’t understand what he’s saying.
“It can be really complicated. And so we should write things down, and then if there’s a part that doesn’t make sense either during the visit or afterwards, the patient should never feel uncomfortable asking for clarification,” Chang said. “As a doctor, I really appreciate that.”
Under the new federal rules, patients also have the right to see all doctor’s notes about their visits, often through online patient portals, so you can read and review what was discussed.
Chang’s bottom line is that navigating appointments can feel stressful, but going into a visit with information and expectations about what you want can be helpful.
“I think it’s good for patients to understand that this is really a collaboration,” Artandi said. “We as medical providers are truly there to help our patients achieve the best possible health, but it’s a partnership.”