A HelpGuide guest article
Preparing for a Medical Appointment as a Complex Patient
Tips from medical professionals on how to prepare for an appointment, manage anxiety, and make the most of your time with a healthcare provider.
One of the most intimidating things about being a patient is the first stages in relationship building with a new healthcare provider. Some underlying questions oftentimes include: Will they understand my concerns? Will I finally get a diagnosis? Will I hear bad news? The following tools may help to enhance your initial appointment, set the stage for improved communication between you and your provider, and reduce your anxiety as a patient.
Step 1: Gather all medical records prior to visit
If at all possible, bring your previous records, especially if the new provider is in a different hospital system. It is legally much simpler for you to obtain them rather than for the clinician’s office to do so. Despite most health systems having electronic records, they do not connect to each other at all.
Having documents in hand also allows you to discuss the issues reported with your clinician face to face. The most important records to get are:
- Operative reports.
- Radiology reports (X-ray, CT scan, MRI, etc.) that show an abnormality.
- Abnormal blood tests.
- Any other pertinent records showing previous diagnosis or concerns.
Additionally, if you have seen PTs, OTs, and psychologists, you may request a treatment summary of goals and outcomes. Some clinician offices can receive these documents by email and incorporate them into your new record.
Step 2: Provide current information and history
Other essential information you could have ready is a detailed list of your current medications, including dose and how often they’re taken. Be sure to list any herbal supplement or vitamins you are taking. It is important, because supplements can produce drug interactions or unwelcome side effects the same way traditional medicines can.
Also, provide all of the contact info for any healthcare providers you are currently seeing. If you give permission, the new doctor can both discuss the case with the other members of the care team already supporting you and provide consult letters for their records.
Additionally, you may want to develop a historical account of your medical condition from its inception to the present day. A year-to-year account of how the condition or disease has evolved may include:
- How your symptoms have changed (escalation as well as remission).
- How you’ve responded to medication (effectively and ineffectively).
- Which clinician discipline seemed to make the most impact on your condition.
You may consider making a copy of this and handing it to your new provider and/or offering to send it via email.
Step 3: List primary concerns and considerations
Making a list in advance of the biggest issues that impact your life will give the clinician an idea of your current level of functioning. It is critical to emphasize exactly what you cannot do (but used to be able to do) day-to day. By explaining this, it conveys to the clinician your interest in wellness, rehabilitation, and working with your doctor on an action plan.
It is most productive to provide examples that are specific, highlight the functional/disability concern, and target area that you want addressed by the clinician. Here are some examples:
|Providing examples of your concerns|
|Not productive: “The mornings are really hard for me.”|
Productive: “I am very stiff in the morning, so I need to wake up an hour earlier to get to work on time.”
|Not productive: “My back hurts so bad, I cry a lot.”|
Productive: “My back has been hurting every day, so I have stopped driving to the grocery store and have to get delivery, even though it’s not in my budget.”
|Not productive:: “I am dizzy all the time.”|
Productive: “My dizziness made me fall in the shower, so my spouse had to install a seat and a safety handle for me to wash myself.”
|Not productive: “I am so depressed and anxious.”|
Productive: “I feel anxious that I may never be able to get my functioning back and this makes me feel sad because I enjoy being active, taking care of my family, and working.”
Once you provide at most three top concerns, it is recommended that you also develop some ideas for goals that you would like as the patient. Goals stem from your primary concerns and again, are specific and constructive so that your clinician can develop an action plan for you that is attainable and relevant.
For example, an unproductive goal would be: “I want to feel better again.” While a productive goal might be: “I want to be able to walk in the park for one hour without feeling dizzy or nauseous.”
Step 4: Manage and reduce anxiety
The majority of patients report varied levels of anxiety when meeting new healthcare practitioners for a variety of reasons, including a fear of being misunderstood, concerns related to not being taken seriously, and minimal time allocated to conceptualize the nature of the problem.
In order to tackle anxiety, the first step is to acknowledge your stress and to set up ways for managing anxiety prior to and during the office visit. While anxiety is absolutely natural, it may jeopardize clear thinking, concise communication, and your ability to advocate for yourself.
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Some people find bringing a friend, a partner, or an adult child to the appointment can be a big help to support you during the appointment. Anxiety also makes it hard to digest medical information, as do pain and discomfort. Another person taking notes can make remembering doctor’s instructions much easier. Your companion may also provide insights into the physician’s affect and behavior in the event of your anxiety playing tricks on your judgment.
Finally, a companion can validate your concerns and give extra examples of your functioning levels which can help to ameliorate anxiety around being understood. For example, your adult child may tell the doctor: “My father was always doing projects around the house, but the last six months I’ve seen him get frustrated because he is no longer able to help out.”
There are also specific tools that can help you manage your anxiety both before and during your visit. We have provided a few options below that you can practice to prepare for your appointment:
1. Breathe deeply, lengthening your outbreath
Anxiety frequently causes you to breathe rapidly which sends activation signals to your body gearing it up to over react which may cause you to hyperventilate. Deep breathing can slow down this response pattern by pulling up the rib cage, allowing the chest to expand and releasing pressure on the way down.
Example of a simple breathing exercise
Breathe in, counting for 4 seconds, hold for 2, breathe out for 6.
The key is to exhale very slowly, and to not focus too much on your inhale. Consciously linking your body to the slow pace of your breath can reduce pressure and help decrease overactive thoughts.
2. Befriend your senses
The goal of this exercise is to reacclimate your awareness to the present moment and your surroundings, bringing your mind into a calmer state of being. When you are focused on the here and now, you tend to be reminded that there is no major threat or imminent danger, and that you are safe and secure.
Here are a few ways to get centered while you are at the healthcare provider’s office:
Notice sounds or smells in your current setting. What do you hear? What can you see? Name them in your head or to your companion, or even write them down on a piece of paper or in your phone. If you have cold water nearby, feel the temperature as you grip the cup or bottle.
Tighten and release muscles. Muscle tension release movements can connect you to your sensations rather than having you focus on your anxiety and negative thoughts. Tighten and release your fists; tighten and release your biceps; tighten and release your shoulders. Continue to do this with your accessible body parts.
Look for colors. Pick a color of your choice and look for objects of this color around the room in which you are located and then name the objects.
3. Use positive self-talk to self-soothe
Repetition of personal mantras, prayer, or a self-soothing inner dialogue can be positive reminders of how you have successfully conquered anxiety or hardship in the past. Repetition can be brief or long; this is ultimately up to you, and can be determined based on when you obtain relief.
Examples of a mantra: “I am fierce. I know my body better than anyone else.” “A doctor’s opinion does not define me.”
Example of self-soothing inner dialogue: “I’ve experienced awkward situations before. I am safe and I have made it through other doctor appointments before. I will get through this one.”
Authors: Patty Irigoyen, MD, Stephanie Mihalas, PhD ABPP, and Tiffani Sainz, MA.
Last updated: August 31, 2022