It’s one of the sorriest stats in modern medicine: The average doctor’s appointment lasts 15 minutes or less. No wonder you feel rushed! That doesn’t leave much time for chatting about the weather or your mood.
What you don’t realize — but what I see very clearly as a physician — is that in this era of in-and-out appointments, what the patient says is more important than ever. In fact, your comments can help me give you great care or make it much harder for me to figure out what’s going on.
Medical schools teach a specific way to conduct an office visit. Part one is the complaint, aka your description of your problem. Part two is the physical exam. And part three is when the doctor gives you a diagnosis and prescribes tests or a treatment. Chances are, you focus on part three, but the patients who receive the best care are those who master part one. The key is to describe in detail what you’ve been feeling — not just “bad,” but what kind of bad, for how long, and after what kind of activity.
Of course, that’s easier said than done. Even though I’ve been a physician for many years, I tend to be a little nervous when I’m the one sitting on the exam table; if I haven’t prepared, I lose track of the details I intended to share. So I take a few minutes at home to write down some crucial specifics. This is sort of like medical Mad Libs — just choose the right words to fill in the blanks. For instance, say you’ve been bothered by back pain:
I have had __________ [problem: back pain] for __________ [time: days, weeks, months, years]. It is worse when I __________ [context: awake, bend down, at the
end of the day]. The pain is __________ [type: sharp, dull]; it’s __________ [severity: mild, severe, intolerable] and __________ [duration: constant, intermittent]. It began __________ [when: with an injury, spontaneously, when taking a medication]. When
I take __________ [medication: aspirin, ibuprofen, narcotic], it makes it __________ [effect: all better, partially better, doesn’t affect it at all].
The doctor will then ask questions, but you’ve done much of the work already. Your examination will be more specific, and the diagnosis and treatment will be more accurate. You’ll have bought yourself time at the end of the visit to ask questions. And there may even be a few minutes left over for a little pleasant conversation!
Pamela F. Gallin, MD, is a clinical professor of ophthalmology and pediatrics at New York Presbyterian-Columbia University Medical Center and the author of How to Survive Your Doctor’s Care.