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How to stress less about going to the doctor

If you find yourself anxious about going to the doctor’s office, you’re not alone. A study from the National Cancer Institute found that some patients avoid going to the doctor because of concerns about communication with their physician.

If you are one of these people, behind-the-scenes knowledge may help alleviate your concerns and anxiety. Here are some tips to help navigate a visit, courtesy of physicians who see patients nearly every day.
A doctor’s visit may unleash stressors that feel out of your control. For example, the routine of stepping on the scale at the beginning of every appointment triggers anxiety for many people. Doctors say patients can ask not to be weighed, or to hold off on the measurement. It’s okay to say, “I’d like to not be weighed prior to seeing my physician, and I’d like to be able to discuss with them if knowing my weight is necessary today,” said Tracy Richmond, an adolescent medicine physician and director of the Eating Disorder Program at Boston Children’s Hospital.
Once the physician enters the exam room, it can sometimes feel as though you and the doctor have different agendas. Perhaps you’ve been mulling over that cough that won’t go away, but the doctor is asking a million questions about a mole on your arm. What can you do? Richmond said it’s helpful to explain your goals and priorities upfront. She said patients can say, “Here are the things that are top on my priority list [for this appointment]. … Are there things that you think should be on my priority list?” That allows you and the doctor to have a list of items that you know will be covered.

Maja Artandi, a professor of primary care and population health at Stanford University School of Medicine, suggested going even further, by bringing in a brief, organized list of top concerns you’d like to cover in the visit. “As a primary care doctor, l really want to understand what the most important thing is for the patient before I start telling them about what I think is important. I think if the patient has a list and is prepared for the visit, that’s a good thing,” Artandi said. “I would say if you want to bring a list, focus on your top three concerns.”

When making the list, it’s possible you may need a second or third appointment to cover everything in depth, especially if there are several major topics to get to. “We only have a limited amount of time, and we might not be able to address everything on the list,” Artandi said. “If someone really wants to address everything … they need to be prepared to make another appointment.”

She went to one doctor, then another and another

Writing or stating your priorities upfront can also help avoid the disappointment of bringing up a concern in the last few minutes of a visit, only to feel as though the physician does not have time to fully address the issue. “The worst part for a clinician is having the most important issue brought up at the end … then they’re like, ‘Oh no, how am I going to address this adequately when I have other patients waiting?’ [Stating concerns] upfront and explicit makes it so much easier,” Richmond said.

You can also help increase the effectiveness of the visit by bringing in data. Have high blood pressure? Bring in a log of your home blood pressure readings, if you have done them. Taking multiple medications? Consider bringing in the bottles to review with your doctor. If that’s too much of a hassle, be sure to write down the names and the doses you take to ensure they’re up to date in your medical record.

Physicians especially want to know if you feel you might be having a harder time maintaining your health, so don’t sugarcoat things in the discussion. “It’s the patient’s health, not a report card,” Artandi said. “It’s all part of the patient’s health journey. We are there to help them, especially if they don’t do so well.”

Of course, if you don’t feel like you’re being heard or aren’t sure you agree with what the doctor proposes, you can ask your doctor for other options or to see if their colleagues might have other thoughts.

Tammy Chang, an associate professor in family medicine at the University of Michigan Medical School, said it’s okay for patients to ask doctors to seek the opinion of colleagues. “It’s the art of medicine,” she said. “There’s very rarely just one, single path forward,” she said. “And so I think empowering patients means giving patients options and hearing options from different points of view. Doctors don’t work in isolation anymore.”

And you can seek a second opinion. While patients may worry second opinions will upset their doctor, a good physician should be comfortable with the idea. If not, it may be time to consider finding someone new.

“I always tell my patients that they are the main person — it’s their health that we are concerned about. So if they need to ask questions, get a second opinion, or need to clarify something — that should be welcomed,” Artandi said. “If the doctor sees this as offensive, then that is definitely a red flag. We all work together as medical professionals to help our patients.”

In a change, patients can now read the clinical notes written by their physicians

Finally, some patients find that it can be hard to follow everything the doctor is saying — either because there’s just too much information being provided or too much medical jargon. Chang suggested taking notes during the visit — or even bringing a friend or relative to take notes for you. And you can always ask your doctor to explain in simpler terms if you don’t understand what they’re saying.

“It can be really complicated. And so we should write things down and then if there’s any part that doesn’t make sense either in the visit or after, the patient should never feel uncomfortable calling for clarification,” Chang said. “As a doctor, I really appreciate that.”

Under new federal rules, patients also have the right to view all doctor’s notes about their visits, often through online patient portals, so you can read and review what was discussed.

Chang’s takeaway is that navigating appointments can feel stressful, but going into a visit with information and expectations of what you want can help.

“I think it’s good for patients to understand that it is really a collaboration,” Artandi said. “We as medical providers are really there to help our patients to have the best health they can have, but it’s a partnership.”

Original Post The Washington Post

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By Netana Markovitz is a medical resident in internal medicine at Beth Israel Deaconess Medical Center/Harvard Medical School in Boston.