How to make the most of your visit to Sea Mar Clinic

It is clear that the time you are face to face with the doctor is very important.

When I was a child, family physicians made house calls providing treatment with a friendly chat.

However, since then medical care has become increasingly complex. The primary care physician (Family Medicine, Internal Medicine, Pediatrics) is still the main contact for most patients. But now there is less time for friendly chats, and patients sometimes complain of being rushed.

Physicians recognize this and also feel time-pressured, but their scheduling is dictated by many factors that are not always under their control. A 15-minute appointment is a norm for most visits with a primary care physician, consistent with expectations from Medicare and other insurances. Specialists have a different reimbursement rate and visits may be shorter or longer depending on the specialist concern. The pressure to keep up with their schedules means that physicians and other providers have to be focused on each patient, while quickly transitioning their attention to the next patient.

We all want to get the most benefit from our medical care. Physicians are patients too and from their experience, they know that good care benefits from a partnership with their patients. With an active partnership between the patient and the physician, 15-minute appointments can be very productive and give us the best care possible. The following are suggestions for how to be active partners in your own care, beginning with understanding more about the demands on the physician’s time.

When the physician walks out of the room, your care is only half over. All the details of the visit must be documented in the electronic medical record (EMR). EMR’s are complicated and the requirements for documentation are time-consuming. It is not unusual for physicians to spend twice as long on documentation as they do on direct care. The visit summary must include certain information. Specific codes must identify the diagnoses addressed. Other codes must accurately reflect the complexity of the visit. This documentation determines whether or not your visit is covered by your insurance. In addition, follow-up care takes additional time for phone calls to make referrals, ordering medications, requesting prior authorizations, and reviewing reports of labs and diagnostic tests that were ordered. Lastly, walk-in patients with acute conditions may need immediate attention, which may put the physician behind on their scheduled visits.

Knowing this information, it is clear that the time you are face to face with the doctor is very important.

One of the most important things you can do to make sure the visit time is well spent is to come prepared. Have a clear primary health concern rather than a laundry list. Know what you want to accomplish in the visit. A focused and organized 15-minute visit is going to be much more productive than a 30-minute visit that tries to cover too many issues.

Rather than saying “By the way…” to bring up a new problem as your visit ends, make an appointment for that other problem. Your visit for migraines is not the time to bring up your knee pain. Keep a notebook with information to bring to your appointments. Include any changes in medications or treatments from outside providers, including labs, and diagnostic tests. If you have a new symptom, write down when it started, what you have done to address it, what has helped and whether there is a pattern to it.

Write down questions ahead of time so that you don’t forget or wait until the last minute. Sometimes bringing a family member can help you ask your questions and remember what you were told in the visit.

Lastly, keep your focus on the reason for your visit, and don’t introduce distractions. Physicians may love to chat with you about your garden, but they need to have their full attention on your medical issues.

There may be things that we would like to change about our healthcare system, but we all want to get good care from our providers during our visits. Being an active partner in your healthcare is one of the most important things you can do to get the most benefit from your visit and help your physician give the best care possible.

*Note the term “physician” is used throughout for convenience, but this information applies to visits with primary care ARNPs and PAs as well.

Wendy Noble writes from her experience as a retired ARNP and is grateful for suggestions for this commentary from Mary Bergman, MD and Tom Erdmann, MD, Medical Director of Sea Mar Vashon Clinic. She is a Commissioner on the Public Health Care District Board.