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How to Talk to Doctors


Be assertive and take an active role to improve your health care.

David Elfstrom 

April 1997
Revised Feb 2000

As a person with chronic inflammatory arthritis, I have seen many physicians, surgeons and specialists. Here's a few things I do to make appointments with my doctors run smoothly. Using these strategies, my doctors have been more open to trying new treatments that I suggest. At the same time, it's helped to identify other health problems that could have been overlooked. It's also kept me from falling between cracks in the health care system and caught small mistakes made by doctors. The end result is that my health has improved, going to see the doctor is no longer stressful or alarming, and I find myself eagerly anticipating my next visit.

Keep a record of your health events.

    Later, you will find this information invaluable when you see another doctor for the first time. It's even great for your regular doctor. If you are like me, my regular doctors have a two-inch thick folder of paperwork about me. When I want a corticosteroid injection, rather than looking in the file, my rheumatologist asks me: "How many injections have you had in that joint?". Do you think he wants to spend time looking through that huge file? No. But you know the answer, because you've written it down in your journal.

    Keeping the journal on a computer is a good idea. You can print a selection of it any time you need one. How to organize the diary is up to you, but over time I have split up my journal into these sections:

    1. Doctors. A list of doctors' full names, specialty, address, telephone numbers, fax number, email (if you're lucky), receptionists' names, date of first visit, and even the date of final visit if you are no longer a patient there. When I see a new doctor, I bring this along because sometimes they want to contact a previous doctor. I print out two copies of this list: one for my home phone book and one for my daily planner.
    2. Blood Tests. Record your blood test results and the date the blood was drawn. By recording a copy yourself, you can keep everything together and correlate changes in your body with changes in your blood. In my journal, I include the lab's stated limits for normal people and my doctor's interpretation of the test. I print out a copy of the table and take it with me to each appointment to remind me to ask for the latest blood test results.
    3. Condensed Journal. Every month, summarize the regular journal in this section. Just the facts. It's short, point form, one-line summaries. I send this to a new doctor before the first appointment. To the doctor, this is a gold mine. It's a complete history already prepared! She doesn't have to ask as many questions and I don't worry about forgetting an important event in my medical history. Here is a sample:
    4. March 
      • Two weeks after the corticosteroid, my knee has filled up with fluid again.
      • High thirst (drinking 4 L of water daily) still continuting
      • 1st visit with Dr. Lochnan
      • Dr. Lochnan: Blood test results: No calcium in blood
      • Radioactive iodine uptake thyroid scan done
      • Liver enzyme levels high (AST is 116)
      • Methotrexate and folic acid stopped
      • Second liver enzyme level test shows AST is down to 65
      • Dr. Lochnan's diagnosis: I have a hyper functioning thyroid nodule, NOT Grave's disease. Referral to Dr. Eisen.
    5. Regular Journal. The gory details. Record how you felt, what your doctor said, exact procedures that you had, including locations and dates. Remember, you'll be going over it again to make the monthly summary. So be expressive. If you're experiencing pain or other symptoms on a daily basis, you can keep track of your progress by using the 10-point scale as mentioned above. Write down everything you feel is significant. I keep this part private. Often just writing things down makes me feel better, because I know I don't need to think about it anymore. If what I'm experiencing later turns out to be an important symptom, it's down there in black and white so I don't have to remember it weeks later at the doctor's office.

Read as much as you can about your illness and treatments.

    1. One of the latest guide to prescription drugs. If the one you have is three years old, throw it out and get a new one. More than once I have been misled by an older edition of this type of guide. I currently have three:
    2. I recommend that you avoid purchasing a pharmacist's book. It lists every single side effect ever reported for each drug, easily leading you to attribute any little change in your body to the medication you're taking.
    3. A medical dictionary. I find the paperback book The Bantam Medical Dictionary (Bantam Books, 1990) to be the best combination of price and readability. There are other dictionaries with more terms, but the definitions are more complicated. The cross-referencing in the Bantam Medical Dictionary is excellent. Later, if you outgrow the basic medical dictionary and become interested in the Big Picture, I highly recommend the following textbook: Totora GJ: Principles of Anatomy and Physiology, 9th ed. John Wiley & Sons, New York, 1999. If you're an information junkie like me, move on up to Taber's Cyclopedic Medical Dictionary 18th ed. (F. A. Davis Company, 1997). However, some of you may be overwhelmed by Taber's graphic, full-color photos of human diseases.

Prioritize appointment objectives.

Be Assertive.

Avoiding the Power Struggle - Convincing a skeptical doctor to try something new.


Copyright ©1997-2000 David Elfstrom <david@elfstrom.com>

Permission granted to print one complete copy under Fair Use copyright law. This essay may not be housed on another server or republished without my written permission.

That's Useful, This Is Cool! Awarded "That's Useful" site of the day Saturday March 29 1997.

Author: David Elfstrom <david@elfstrom.com>
URL: http://elfstrom.com/arthritis/appointments.html
Beating Cancer with Nutrition: Combining the Best of Science and Nature for Healing in the 21st Century with CDROM
Last Revised: February 2000