A User's Guide to Your Doctor's Visit
The key to a productive physical exam is preparation.
July 6, 2010 -- ABC News' senior health and medical editor Dr. Richard Besser recently visited his own primary care doctor and learned that a checkup is not as simple as it once was. Here are a few tips to help you find and prepare for your visit with your own primary care provider.
Why is it so important to have a primary care provider?
Data suggest that individuals who have an established, regular source of care, such as a primary care physician, receive more preventive visits and necessary screenings. Evidence also suggests that those who have good continuity of care with their doctors use the emergency room less often and may have lower rates of hospitalization. They may also have greater trust in their doctors and greater patient satisfaction.
What Is a Primary Care Provider?
A primary care provider is the main medical professional involved in your nonemergency care over time. The PCP's role is to (1) provide preventive care and teach healthy lifestyle choices; (2) identify and treat medical conditions; and (3) assess your medical problems in a timely manner, and to refer you to medical specialists when necessary.
It is important to establish a primary care physician before a problem occurs so that someone who knows you, your health and your body can care for and guide you through such a problem. For the primary care physician, familiarity with an individual's baseline or normal state when they feel well helps in the evaluation of when they are ill. Often, it may take a couple of months to get in to see a PCP if you are a new patient; however, once established as a patient in a practice, it is easier to get an immediate appointment for an urgent issue.
Going to the emergency room for a nonemergency can result in long waits. Average wait times in emergency rooms in the United States are almost four hours, according to the American College of Emergency Physicians. Going to the ER for nonemergency care can also cause problems for the sickest patients who are having real emergencies. Many hospitals have urgent-care centers you may go to instead of the ER if you do not have a primary care physician or if yours is not available. This will often save you time and money.
How Do You Find and Choose a Primary Care Physician?
Choosing a PCP is an important decision that can be confusing. Remember, you are choosing someone with whom you hope to develop a long-term working relationship. So it's important that you choose a person you're comfortable with in regard to their style of communication, their language, even their gender.
And remember, you do have a choice about gender. When you ask for an appointment, ask if your provider is male or female, and let the office know what you prefer.
Here are some more tips:
1) If you have health insurance coverage and want your visits to be covered, at least in part, it's important to find out the rules of your coverage. Sometimes certain primary care providers are in network, and your insurance may cover these practitioners at a different rate than those who are out of network. That may guide your search.
2) Things to consider when choosing a primary care physician:
Do you prefer a PCP focused on disease treatment or wellness and prevention?
Does he/she have a conservative or aggressive treatment approach?
Does he/she engage you in decisions regarding your health?
With which hospitals does he/she have a relationship, to which he/she might send you should you need to be hospitalized?
How available is the provider? How easy is it to reach him/her?
Are the office location and hours convenient for you?
Is the office staff friendly and helpful? Does the office return calls in a timely manner?
3) Where you can get recommendations for a primary care physician:
Trusted friends, family, neighbors or colleagues
Your previous health care provider or other health professionals
Many health plans have websites, directories or staff to help you select a PCP
Information on providers from state licensing boards varies by state, but some list providers' certification, education and disciplinary action and malpractice suits
Preparing for Your Visit With Your Primary Care Physician
What you should know and bring to your visit -- Do your homework and write it down.
You should know your medical and surgical history so you can describe it to your doctor. This includes medical conditions you have and times you've been hospitalized with dates. Surgeries you have had with dates are also important. Bring a list of medications you take, both prescription and over the counter, including herbal meds, their names and dosages. Bring in bottles if you can. Any allergies to medications or foods and what kind of reaction you have had are important.
It is also helpful to write down your questions before the visit and bring them in, because in a busy visit it is easy to forget them. Bring your concerns up early in the visit, as you may run out of time if you leave them until the end. If you have a medical problem before your visit, pay attention to when your symptoms occur, how often and whether anything brings them on or makes them better. Keep a log and bring it to your visit.
Know your Family History.
A doctor's visit is not one size fits all; it should be tailored to your health. This includes health information about your close relatives. Family history is important because families share common genes and this plays an important role in one's risk for certain illnesses. For example, there is nearly a twofold increase in risk of colon cancer, breast cancer, heart disease and diabetes for individuals with at least one immediate family member with those illnesses. This may affect the treatment plan your provider devises for you, including additional steps that may be taken to reduce risk, such as additional screenings or lifestyle changes.
Your provider will want to know about close relatives, including biological parents, siblings and children, and also information about grandparents, aunts, uncles and cousins. Important things to know are illnesses and age of onset. There are many illnesses that are relevant to family history, but some of the most common illness that primary care physicians are interested in knowing about in adults are diabetes, high blood pressure, stroke, heart disease (heart attacks, bypass surgery), colon cancer, breast and ovarian cancers, other cancers, and other genetic disorders such as cystic fibrosis and sickle cell anemia.
Consider discussing your family's medical history at the next family gathering. This can help everyone in the family. For help in getting your family's medical history, visit https://familyhistory.hhs.gov.