Category Archives: Using Health Care

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Describing Your Symptoms

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Whenever you have a doctor’s appointment, it’s a good idea to plan what you would like to talk about including questions for your physician. Making notes beforehand helps to make sure you won’t forget anything.

Since time with the doctor is often limited, it also makes sense to understand the best way to describe your symptoms so you’re prepared for the questions the doctor will ask. Here’s a list of 10 things to include:

  1. When did the symptom first start to occur?
  2. What were you doing when it first started?
  3. Where do you feel it?
  4. How long does it last?
  5. If it’s a pain, how would you describe it? Sharp, dull, burning, stabbing?
  6. If it’s a pain, does it seem to spread or move (radiate) to other locations?
  7. Is the symptom accompanied by any other symptom?
  8. What seems to make it get better or worse?
  9. Is it occurring more frequently since it started?
  10. Is it growing in intensity since it started?

These 10 questions give you a sense of what the doctor will be looking for when you tell him about your symptom. Knowing how to describe it in these terms will help him identify the cause and prescribe an effective treatment.

For Your Health – Dr. Bob

First PCP Visit – Eight Things to Check Out While Waiting to See the Doctor

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On my last post I listed some questions to ask your new PCP. Today I’ll mention some of the things I would look for at the doctor’s office even before I meet with the physician.

The doctor relies upon his office staff, and the caliber of that staff dictates the service you will receive and some aspects of the quality of medical care as well. After all, it is the receptionist who will set up your appointment when you call in, and you will rely on her judgment. So rather than thumbing through magazines or checking your e-mails in the waiting room, I suggest you pay attention to a few things:

  1. Is the waiting area clean and orderly? While the magazines may not be the most recent issues, does it look as though someone takes pride in maintaining a professional appearance?
  2. How courteous is the staff on and off the phone with other patients?
  3. Do they gossip about patients?
  4. Do they seem to be interested in helping the patients?
  5. Are they purely business-like or do are they more personable?
  6. Do they talk about other patients who aren’t present so the patients waiting can overhear? If they use identifying information and discuss personal health information this is a breach of confidentiality.  They may be talking about you someday in front of one of your neighbors.
  7. Do they keep to the schedule or at least inform the waiting patients when the doctor is running late?
  8. When you are brought into the exam room, does the nurse take the time to listen to you and answer your questions?

Now that I have you thinking along these lines, I’d be interested in some other things you look for in a doctor’s office. Please send me your thoughts so I can add to this list. Next time I’ll talk about how to prepare for a visit to your doctor including how to describe your symptoms.

For Your Health – Dr. Bob

First PCP Visit – Questions to Ask Your New Doctor

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Your first visit with your new PCP is your chance to see if this doctor and his practice are right for you. It’s always a good practice to make a list of your questions and concerns before any visit with a doctor, but there are a few more to have answered as well as some observations to make during this initial visit. In this post I’ll mention some of them, and on the next I’ll talk about some observations you should make. So before you go, make that list and be sure to take it with you:

Questions to Ask

· What’s the waiting time for a routine appointment? These are typically non-urgent follow-up visits for chronic conditions like high blood pressure or diabetes.

· How does the doctor handle acute illnesses like sore throats, the flu or back pain? Can you have an appointment the same day you call or will you be sent to an emergency room or urgent care center? Remember most insurance requires you to pay a higher copay when you use an emergency room instead of going to a doctor’s office.

· Are his office hours flexible enough for your schedule?

· How does the doctor handle calls after hours? Does he have other doctors with whom he shares call?

· Which hospital does the doctor use? Is it convenient for you should you need hospitalization?

As you get these answered, you’ll have a chance to gauge how well your new doctor relates to you and you to him. In my next post I’ll mention the kinds of things you will want to look for at the doctor’s office.

For Your Health – Dr. Bob

Choosing A PCP

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Since your relationship with your PCP will be a long standing one you need to focus on qualities & competence of the physician, and that of his or her practice. But before you can do that you need to identify your choices.

Start With Your Insurer

Your health care insurer is the place to start since health plans often require you to select your physicians from a specific list of providers who are in their network. If you choose one outside the network you won’t get the same level of coverage and possibly none at all, so making that mistake can be quite costly. These days most insurers have a website to help you with selecting an in-network physician. They often let you search by location, specialty, and gender. Often you’ll find information about their training and office hours. Some insurers have rating information available, too. If they don’t have such features on their website or you want to speak with a person, call the Member Services number on the back of your insurance card. Someone should be able to give you much the same information over the phone.

Do Some Research

Once you have the list, you’ll want to do a little research about them. If you are getting your insurance through work, ask your coworkers who they see and how they like them and the practice. This will give you a sense of the doctor’s bedside manner and the quality of their office staff. Remember, the office manager, receptionist, and nurses in the doctor’s office are critical to a smoothly run practice. You want to be sure that when you call with a problem, your issue is handled efficiently and brought to the attention of the doctor when appropriate. If you happen to know a nurse at the hospital where that physician practices, ask their opinion. This would give you a clinical perspective on the doctor, too.

Finally, you should check with your state’s medical licensing board to see if there are any issues with any of the physicians you are considering.

Time For An Office Visit

Once you have done this research, it is time to visit the doctor to see if you will work well together. I’ll cover how to prepare for that visit and what to look for in my next post.

For Your Health – Dr. Bob

What Is A PCP And Why Do You Need One?

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PCP stands for primary care physician.  These are physicians whose specialty gives them training in broad areas of medicine that enable them to diagnose most of the common illnesses that people develop.  When they can’t treat the condition themselves because of the limitation of the depth of their knowledge or skills, they will refer the patient to the appropriate specialist.  For infants and children, pediatricians and family practitioners serve as PCPs.  Adults have internists and family practitioners as their PCPs.  All three of these primary care specialties spend three years after medical school graduation learning their specialty.   So, for three years an internist in training focuses on adult medicine, a pediatrician in training studies pediatrics exclusively.  A doctor learning family practice spends their three years learning pediatrics, adult medicine, obstetrics and surgery.  Training for the medical subspecialties such as cardiology or gastroenterology requires several more years of training after the three years of internal medicine.  A similar progression of training takes place for surgical subspecialties beyond general surgical training.

In essence a PCP is trained to provide preventive care, make diagnoses, treat what he can and refer the rest.  They serve a role in coordinating their patient’s care and that can be invaluable.  They will recommend what screening tests and immunizations are appropriate for each of their patients based upon their age, gender and other factors.  Though there are times when you may need the expertise of subspecialists such as a cardiologist or an orthopedic surgeon, they don’t have the broader perspective of the PCP in regard to prevention.

It pays to have a PCP not just for prevention but also for acute medical problems such as colds, sore throats, rashes, body aches and pains.  While these can be diagnosed and treated in an emergency room, there are definite disadvantages to going to the ER.  First of all most health insurance plans will require you to pay more when you go to the ER rather than a physician’s office.  I’m aware of health plans where the copay for a doctor’s office visit is $25 and the ER visit copay is $250!  In addition, you can’t make an appointment for the ER so you can wait in the waiting room for hours while patients with more serious (and infectious) problems get seen before you.  Lastly, the ER physician usually views you as a single visit and doesn’t have the same preventive perspective as a PCP does.

In the next post I’ll talk about things to consider in identifying your PCP.

For Your Health – Dr. Bob