Diagnosing lupus

How should I prepare for a doctor's appointment?

In today's managed care environment, the time you spend face-to-face with your physician is limited. To get the most from your health care providers (HCPs) and an accurate diagnosis, preparation is the key. Good preparation will also go a long way to alleviate any anxiety you may be feeling about the appointment.

You increase the likelihood of an accurate diagnosis if you come prepared with the details and history of your problem, anticipate questions, know your medications and bring medical records.

These tips can help you make the most of your appointment.

  1. Organize your history
  2. Anticipate what the doctor needs to know
  3. Know your medications
  4. Secure your medical records
  5. Request a verbal summary
  6. Prepare questions

1. Organize your history

What is the process of diagnosis? The majority of the work lies in your description of the problem. While it's true that a physician gleans additional information from the physical exam, laboratory and imaging tests, the history provides valuable direction. The more organized your presentation, the easier it will be for your HCP to arrive at a diagnosis.

Helpful suggestions:

  • Keep a journal of your symptoms.
  • Enlist a relative or friend to help you prepare for and/or accompany you to the appointment.
    Physicians appreciate an accurate history whether it comes from the patient or someone who clearly knows the problem. If someone does accompany you, be sure there's unified agreement to the story to avoid disagreements in the exam room.
  • Be specific.
    Telling the doctor you "feel ill" is not as helpful as, "I feel warm, ache all over, especially in my back and I'm coughing up yellow stuff." Give as much information as you can.
  • Talk first about the problem that worries you most.
    If you have more than one problem, prepare a separate history for each. Present them one at a time so you don't confuse your HCP and strive to make it clear and complete. 

2. Anticipate what the doctor needs to know

Let's say that, for example, you have pain. (If you have more than one type of pain you may need to describe each pain separately.) You should be prepared to answer the following questions:

  • Where is the pain most severe?
  • When did it start?
  • Does anything trigger it?
  • Is there anything you do to bring it on, make it better, make it worse?
  • Is it present every day, or do you have pain-free days?
  • Is it worst in the morning, as the day goes on, or constant?
  • On a scale of 1-10, how severe is the pain?
  • Is it constant or off and on?
  • Do you have any other symptoms with it such as chest pain, shortness of breath?
  • Does the pain stay in one area or spread to other areas?
  • Does it interfere with your daily routine?
  • What has been its course? Is it stable or getting worse?
  • Is this a new symptom or a recurrence of a previous problem?

These questions apply to most problems or symptoms. If you've thought about how you would answer them ahead of time, you'll be prepared. A shortened response time may leave more time to discuss your concerns before the end of the appointment.

3. Know your medications

Although you may recognize your pill as "the little blue one," there are probably hundreds of pills that are little and blue. The likelihood of your doctor being able to identify your blue pill is slim. Bring ALL your medications -- prescription, non-prescription, vitamins, herbs, minerals -- in their original containers to your appointment. This way the doctor understands the medication dosage, frequency and your need for refills. If you take medications chronically, keep an updated card in your wallet or purse with the names of the drugs, dosage and frequency. This helps your physician avoid potential drug interactions. It's not uncommon for patients to be seen by several specialists, each of whom prescribes different medications.

Each doctor needs to know what drugs you are taking, including those prescribed by other physicians. They assume you will be able to list all medications you currently take. If you can't, you may put yourself at risk.

4. Medical records

Bring copies of medical records from other physicians with you, including X-rays or MRIs as appropriate. If another physician has referred you, try to expedite the exchange of medical records. Very often, you must authorize the release of your records to the new physician. Not every doctor's office will anticipate this or contact you beforehand to arrange for the transfer of records. Call ahead and ask how these arrangements should be made. The successful transfer of your records may help you avoid the expense and medical risk of repeat diagnostic tests.

If your HMO (health maintenance organization) allows a consultation with a specialist, your first visit may be your only one with that doctor, so it helps to be as prepared as possible.

5. Request a verbal summary

While many HCPs are aware of the need to restate treatment plans or medication adjustments, others may not do so. Sometimes time restrictions decrease the amount of verbal reinforcement the doctor can offer. Ask for a brief summary to make sure all points are covered and necessary prescriptions filled out. Ask what kind of follow-up is needed. Be prepared to take notes.

Ask for a brief summary of your appointment. A recent survey revealed patients couldn't remember more than two-thirds of the medical problems their doctor diagnosed following a general exam.

6. Questions you should ask during a visit with your HCP

  • What is this problem likely to be among the possibilities?
  • Is further diagnostic evaluation necessary?
  • What can I expect from the natural course of this problem?
  • Is there treatment available to modify the course?
  • How long before I should see the effects of the medication?
  • Under what circumstances should I notify the doctor?

Your physician needs your help. If your expectation is that all you have to do is show up for an appointment and the doctor will do the rest, your visit is likely to be a frustrating one, and you may put yourself at risk for misdiagnosis. Remember, your doctors don't have scanners they can pull out of their pockets to miraculously diagnose your problem. The doctor's appointment is your opportunity to discuss medical problems and concerns. By preparing for the appointment, you will be less likely to waste the opportunity, and more likely to gain a degree of satisfaction from the visit.

Medically reviewed on July 08, 2013