It’s an uncomfortable reality—at some point, or even many points, in your lifetime, you will have to start a relationship with a new health-care provider. Perhaps your primary care doctor retires, or a health condition makes it necessary for you to see a specialist. The prospect may fill you with anxiety, but there are key steps to help you make the most of that first visit…
For many people, the right doctor has expertise and a comfortable bedside manner—being a good communicator may be as high on your list as being a good practitioner. Even if you’ve been referred to a new doctor by your current doctor and/or have consulted the in-network practitioner list from your medical insurance, also do some research to find more potential health-care providers in your area.
Ask friends and family members you trust which doctors they think might be good choices for you. List for them the three things that are most important to you—perhaps the amount of time the doctor devotes to each office visit…his/her philosophies regarding lifestyle changes as well as medication…and his ability to communicate in a way that will resonate with you.
Many health systems and practices have profiles of their clinicians online that include their philosophies along with details of their training. Read through these descriptions to help you narrow down your choices. Example: If you need a specialist or a general practitioner with a certain expertise, see if the health-care providers you are considering went beyond the requirements needed to practice medicine to focus on these. Becoming board-certified, taking additional fellowships, doing research and/or being actively involved in clinical trials demonstrate investment and proficiency in their fields.
Caution: It can be impressive when a doctor is affiliated with a large academic institution and runs a fellowship training or a lab or is the chair of a department. But find out how available that doctor is for his patients. How might the practice accommodate you if you need to be seen for an acute problem or regularly for a chronic condition but the doctor is in the office only twice a week? He might be backed up by someone else or otherwise work alongside a team of other providers, but you will want to know this up-front rather than learn it when you call the office for an urgent matter.
Another consideration: You may want to choose a doctor within the same health system as your other practitioners. This makes coordination of care easier because your health record will be accessible—there’s less onus on you to bring lab results and medication lists to the new doctor, and an opportunity for all of your providers to have a fuller picture of your health.
Warning: Be cautious about relying on any crowd-source websites with “patient satisfaction” ratings. Ratings can be based on a group of one and can be skewed to a negative or positive extreme.
On the other hand—once you’re a patient, receiving a patient satisfaction survey after a visit indicates that the practice is interested in finding out what can be done to make future visits better.
Gone are the days when you could talk to a new doctor in advance by phone to get a sense of his style. But you still can call a doctor’s office and ask the receptionist or office manager questions that can help set your expectations. Some offices have specific staff devoted to helping new patients become established. Questions to ask…
What is the protocol for urgent needs, and how does it differ during and after business hours? Also: How long might you typically wait for a call back? And how will you know whether you need to go to urgent care or the ER?
What is the doctor’s preferred style for communication between visits—
e-mails or phone calls?
Can a loved one accompany you to office visits?
Does the doctor tend to run on time or late for patient appointments? Many people develop preconceived notions about a doctor based on the amount of time spent in the waiting room and then are agitated when they get into the exam room or office. What matters most is the experience you have when you’re in the room with your provider and his/her presence and focus on you.
Note: If the office staff is too rushed to take the time to address your questions, that could reflect on the doctor and/or the pace of the practice.
You won’t know until you’re in the exam room if a new provider relationship is going to work, and even then, you might not know right away. But keep in mind two things about every practitioner—a doctor isn’t a mind reader, and he probably has an agenda for how he conducts office visits. What to do to get the most out of your first office visit…
Bring a list of three things that you need to get done. Your agenda and your doctor’s agenda might be different, but you can agree on what will be accomplished during the appointment. You can start off by saying something as simple as, “These are the things I am hoping we can accomplish today.” The best scenario is that the practitioner will respond with what he feels is most important and say that he will also address what’s on your mind.
Tell the doctor about yourself as a person. Say, “Here are things I’d like you to know about me that will help you to better partner with me.” You might communicate that your biggest health fear is about cancer…or that you have an analytical mind and will research everything he says…or that you really want to be given recommendations for what to do and how to make decisions.
Be as honest as you can be about everything. Be straightforward when you describe your health condition or answer questions—from symptoms and how bad they are…to sex, drinking, depression and drug use. One approach: Start small by saying, “There’s something I want to talk about, but I’m scared [or embarrassed] to tell you.” This provides structure to the conversation. It’s even helpful for the doctor to know if you don’t want to take action about what you’re sharing, such as “I know I drink too much, but I don’t want to stop now.”
Review communication options with the doctor. Rather than waiting for a follow-up visit, using a portal is a way to ask questions to optimize a care plan and share important feedback, such as drug side effects or clarifying the need for new referrals or labs. Ask if that’s the doctor’s preferred method or if you should call the office. Also ask about the average time frame for getting a reply.
As with any relationship, it can be difficult in the moment to recognize that it’s not going well. You might feel stressed, agitated and scared but find it hard to give voice to that. Tune into yourself…do a gut check…and try to put words to what’s not going well. If you can articulate what’s going off the rails, you may be able to remedy the situation. Examples…
If you feel that you’re not being heard or that the practitioner is just going through the motions without making a connection with you, you might say, “Can we slow down? I’m not sure you’ve had a chance to review my full history, and I’d like to share things that are important?”
If you are overwhelmed by the doctor’s jargon or rapid-fire recommendations, ask for clarification by saying, “Can you give me an example that I can better relate to?”
If something doesn’t feel right while you’re in the exam room, you are under no obligation to proceed. Call a time-out and say, “I don’t feel comfortable going forward.” The doctor might be willing to alleviate your concerns, but if not, you can leave or not schedule a follow-up.
What if after leaving the office, you feel the appointment went so badly that the relationship can’t be recovered?
Ask yourself if you’re making too quick a conclusion. The more anxious we are about a doctor visit, the more we want an instant connection, and we may be disappointed when it doesn’t happen as we expected. Like all of us, health-care providers can have bad days.
Think about whether you can collect more data—perhaps by trying again with a second visit or communicating with the doctor via e-mail. You might send a message saying, “You used words I didn’t understand, and I left scared. Can you explain it in language I can understand?” or “I don’t feel that all my questions were answered—can you tell me what to do about X until our next visit?” Most people who go into the health-care field want to help, and many will acknowledge that a first visit may have gotten off on the wrong foot.
If you don’t like the response you get, you may not want to invest more effort trying to make it work, especially if your condition is long-term or serious enough that you don’t have time to waste.
