7 things to bring to every health care appointment – and why
By Hope Winsborough
With a little advanced prep work, you can look forward to a successful visit with your provider
You wouldn’t let your hairstylist start snipping away without some advance direction, or allow a waiter to tell you what you’re craving for dinner. Yet, when it comes to our health care, many of us head to our appointments without giving the matter any forethought.
That can be a big mistake.
“Getting ready for your appointment ahead of time can help make it a smooth, productive visit for you and your provider,” says Mariana B. Dangiolo, M.D., a family physician who is also an associate professor of family medicine and geriatrics at the University of Central Florida’s School of Medicine. “This is especially true for older adults, who often have more health concerns and issues to cover in a short amount of time.”
To make the most of your time with your health care provider, come prepared with the following:
#1: An agenda
The most important thing you can bring to the appointment is a list of priorities, says Dr. Dangiolo. This is true for your Annual Physical and Wellness Visit, routine follow-ups, as well as so-called “sick” appointments.
“We typically have a limited amount of time, so it helps to create a list of main concerns and questions beforehand,” says Dr. Dangiolo.
For example, maybe you’ve narrowed it down to this: your foot has been hurting, you want to refill prescriptions and you need a flu shot. These specific priorities for the appointment can take the form of a list typed into your phone or written on a sheet of paper — which is what she most often sees. “Especially for a short, 15- to 20-minute follow-up visit, having a list is key,” she says.
In addition to these identified concerns, Dr. Dangiolo recommends being ready to bring up any symptoms or quality-of-life issues that are bothering you. “Let’s say you have a headache, which doesn’t seem so troubling,” she explains. “But what if they’re more frequent or more painful than usual? I want to talk about anything that’s keeping you from doing what you love.”
A good rule of thumb is to listen to your body in the days and weeks leading up to your appointment. Be on the lookout for issues that affect your day-to-day quality of life — your sleep, your mobility, your appetite, your mood or your energy level, for example. Take notes if you think it will help you remember things that you’re noticing, she says.
Finally, and most important, if this is your Annual Physical and Wellness Visit, let the provider know at the beginning of your appointment that you have a concern that you’d like to get their thoughts on. These annual checkups tend to follow a set checklist, so you’ll want to speak up early so that your provider knows to save time at the end to address your issue.
#2: Your eyeglasses and hearing aids
It may seem obvious, but Dr. Dangiolo says it’s common for patients to show up without their reading glasses or hearing aids. These are important communication tools, she points out. “I don’t want you to be left behind in the conversation,” she says. When you’re writing down your priorities (see above), add “Don’t forget glasses and hearing aids” to your list.
#3: An official notetaker
Speaking of clear communication, you may want to bring along a trusted friend or family member, for a host of reasons. “Memory or mobility issues may be a concern for some older adults, so they may have no choice, Dr. Dangiolo explains. “But many of my patients simply find they benefit from having a person they trust in the room.”
This is especially relevant if you’re managing more than one health condition, if you’ve just been discharged from the hospital or if you’ve recently received a troubling diagnosis, she says. “Having someone else supporting them and taking notes can help the patient review and comprehend details later, because many times information can seem overwhelming during the exam,” she says.
That said, it’s not at all unusual or problematic to ask your notetaker to leave the room if you’d like to speak privately with your provider for any reason. “It happens all the time,” says Dr. Dangiolo.
The key in all cases is to bring someone you’re completely comfortable with, who won’t inhibit your interaction with the provider but will take down key information.
“It’s a good idea to communicate with the individual beforehand [about] what their role will be,” Dr. Dangiolo says. For example, do you want them to step in and ask questions that may come to their mind, or just listen and take notes?
Recording your office visit is another option, however state laws regarding recording without the other person’s consent (in this case, your provider) do vary, so check local laws. Plus, it’s common courtesy to ask someone’s permission before pushing the record button.
#4: Plan for a translator, if needed
Health topics, by nature, are complicated. Add in a layer of translating the information you’re hearing from English to your native language and, well, things can get confusing pretty fast.
Increasingly, health care providers and networks offer translator services for many languages, says Dr. Dangiolo. When you schedule your appointment — and again when you confirm — let the staff know that you would like a translator present via phone during your appointment. And if one isn’t available, consider bringing along a family member or friend who is fluent in English.
#5: A list of recent medical changes
Everyone loves a good stroll down memory lane (remember that time you broke your arm at a concert?), but when it comes to sharing your medical history, your provider most needs to hear about any health and life changes since your last appointment, notes the NIA. Dr. Dangiolo agrees. She says small changes in your usual functioning, such as feeling suddenly sad or low in energy, or a new fall, can be the clue to a more serious underlying condition. Beyond that, she says, one or two years’ worth of medical issues is almost always enough information to be prepared to discuss with any new provider or specialist.
It’s helpful to let them know things like how long you’ve been managing diabetes or depression, or that you stopped smoking three years ago. “But the rest of the essential information we need is gathered during intake histories,” she says. So, there’s no need to go digging through boxes of old records to pull up details about past surgeries or procedures, or diagnoses that have been resolved.
And if you’re seeing a new specialist, do be sure to bring your most recent and current providers’ names and contact information. That’s useful in case the providers have questions for each other or need to keep each other informed of any new test results and treatment plans.
#6: A bag (literally) with your medications
It’s especially important to review your prescription and over-the-counter (OTC) medications, vitamins and supplements during your appointments, says Dr. Dangiolo. “Reviewing medications often takes about half of every appointment,” she says.
That’s why she advises showing up with not just a list but the actual bottles of any medication that you take regularly. “Throw it all in a bag and bring it in,” she says.
What’s she looking for? First, she wants to make sure that you understand what your medicines are treating and that you’re clear on the dosing instructions. “Many patients, of all ages, are confused about what they’re taking and when,” she says.
Second, Dr. Dangiolo says she wants to make sure that what you’re taking is still appropriate for your current health needs. Studies show that about one-third of older patients have been prescribed (or are taking) at least one drug that’s on a warning list of potentially inappropriate medications for older adults, according to a report in the Journal of the American Geriatrics Society. The list includes a range of prescription and OTC items found in the typical medicine cabinet — from drugs to ease stomach cramps to allergy relievers to sleeping aids.
She’s also looking to see if a different provider has prescribed something new that didn’t make it into your medical record. “When you’ve been in the emergency room or to a new specialist,” she explains, “those transitions of care can be times when medications get added without regard to a person’s overall drug regimen. Your primary care provider needs to see what’s happened.”
Finally, and closely tied to the above, she’s scouting for possible harmful interactions between medications. The average adult over the age of 65 now takes four prescription medications, according to research from Oregon State University. At the same time, patients who take more than one medication for multiple conditions experience increased odds of adverse effects, hospitalizations and even death, notes a Pharmacy Times report.
“Too often there’s unnecessary duplication, changes in doses, errors of some kind — so we can help simplify everything through this process, called medication reconciliation,” she says.
#7: A willingness to have tough conversations
Dr. Dangiolo says she discusses end-of-life planning with her older adult patients about once a year. It’s never an easy topic, she admits, but it’s incredibly valuable to have your wishes noted should someone else need to step in and help make decisions about your health.
That’s where advance medical directives come in. These legal documents spell out what kinds of care you’d like to receive (or not) in different situations. You can complete yours with the help of your provider as part of your Annual Physical and Wellness Visit. The document will be added to your medical record and can always be updated. In fact, Dr. Dangiolo recommends reviewing it every year with your provider.
“These documents aren’t just valuable over the long-term,” she says. “They spark conversations and generate trust between provider and patient.”