When we make an appointment to see our doctor, it’s because we recognize that we need help with our health. But when we enter his or her office we need to be sure not to abdicate our responsibility.
We have the primary responsibility for our health. Diabetes is a disease that, perhaps more than any other, depends much more on those of us who have it than on the doctor.
Actually, how could it be otherwise for anyone? Few people will get more than 15 minutes of the doctor’s time every three months.
We decide what we eat, how much physical activity we get, and whether we will take our prescribed medicine. While that’s obvious, too often we trade this active role in managing our health for a passive role at the doctor’s office.
Have you noticed that people who are successful in managing meetings almost always prepare a written agenda? We need to do exactly that for each office visit.
An agenda works best when we write it out in our priority order. We need to cover a limited number of points that we can work on together in a quarter of an hour. The agenda should be bullet points, not paragraphs. It works best when we give a copy to our doctor.
When we prepare an agenda, it forces us to think out what we want to get out of our appointment. At the same time it leads our doctor to focus on what’s troubling us the most.
Most advice for preparing to see the doctor comes from his or her standpoint. The Canadian Diabetes Association has a short but useful video online, although in this video the doctor is firmly in control of the agenda.
We need to recognize that our doctor will have his or her own agenda. Every time we meet with anyone each of us has his or her own agenda. While people sometimes have a hidden agenda, meetings run a lot smoother when we tell people what we want.
To prepare this article I asked two of my favorite physicians how they would recommend that we prepare to see them.
Tim Reid, MD, who specializes in diabetes and metabolism at Mercy Health System in Janesville, Wisconsin, has done a lot of thinking about how we can get the most out of our office visits and he provided the most complete answers.
Dr. Reid’s agenda includes four main points:
1. His first point mirrors my emphasis on having a written agenda. “Come to an office visit prepared,” A great office visit is a team effort. Bring your questions. Think things out and write them down so we can go over them in an orderly fashion.”
2. Bring your medications — or at least an accurate list. This is Dr. Reid’s second recommendation for people going to his office. “So often patients will have had things moved around by another physician and they do not have the first idea what they are now taking,” he told me. “Put everything into a bag and bring it along. The worst that can happen is that we find out that my list matches your bag of medication. This review gives us time to look at each bottle and understand dosing, timing, and what the medication is for.”
For some of us the question of why we are taking a certain medication is obvious. I was surprised, however, when a new friend who has diabetes showed me the huge number of pill bottles that she has, few of which she had any idea why she took.
3. Take your blood glucose meter and any printouts from the meter that you have. “We download meters at every visit,” Dr. Reid says. “The information that can be shared from that dataset is invaluable. You get charts, graphs, and lists. We can spread it out and both learn from it. You worked hard for this information, so you might as well get the benefit from it.”
4. Almost all of us regularly see several specialists and sometimes get lab reports from them. Keep all of your doctors in the loop.
“If you have labs or letters from a physician and you know that they are not in the same medical system, bring them along,” Dr. Reid says. “We can copy them and include them in your charting. We can also review them to make sure we are not duplicating medications/labs/procedures.”
The other doctor who helped me on this article has been my friend and primary care physician, Jay Krakovitz, MD. But sadly for me he is moving out of state.
The suggestions that I got from Dr. Krakovitz reinforce Dr. Reid’s recommendations with emphasis on the first and second points above.
“Make a list of your questions ahead of time,” is Dr. Krakovitz’s first recommendation. Your list should include all the other doctors you see.
He continued. “A major part of what we do in our practice as a primary care physician is to make sure that our patients aren’t taking duplicate prescriptions and that they don’t interact,” he told me. That’s why he asks his patients to bring in all the medications they are taking.
But he goes further. “Bring in a list of everything that you take over-the counter, including all your supplements.” For most of us this will be a longer list than the prescription medications we take.
My friend Bob Fenton, who writes “Exploring Diabetes Type 2,” has also written his advice on preparing to see the doctor. He makes a lot of excellent points, but one that resonated most with me was to take off your shoes and socks.
Why? Because most people who have diabetes have some neuropathy in their feet. When we take off our shoes and socks we are being proactive in seeking the medical treatment we deserve. Sometimes our doctors may forget to test our feet, and our bare feet can help them remember to do their job.
This article is based on an earlier version of my article published by HealthCentral.
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