Communicating with Your Physician

May 15, 2006

Speaker: Dr. Mary Malcom, Emergency Room Physician

In the rush to get your family member to the Emergency Room, remember to take with you several things:

1) A list of current medications, over the counter medications, and vitamins and supplements, as well as the dosages of each, that your loved one is currently taking or has recently taken;

2) A medical history of your loved one that lists out allergies and reactions, surgeries, illnesses, and the dates that go with them;

3) Name and address of your loved one’s physician(s); and

4) A copy of your loved one’s Living Will, Advance Directives, and Medical Power of Attorney.

All of these documents can be typed out ahead of time when you have time to think about it and collect the information, then photocopied in a reduced format to be easier to carry in your billfold or purse for the time that you will need them. Make it a point to gather this information in the next week!

Once you get to the emergency room, and even on the way to the hospital, you will probably be asked the same questions repeatedly by everyone that comes in contact with you. There are several reasons why the repetition of information is important, so please bear with your care providers and repeat it each time:

1) One reason is to jog your memory.

2) As you tell it each time, you may be adding critical information that is helpful in forming a diagnosis and care plan

3) It serves to verify the information and

4) It serves as a safety mechanism for you to prevent treatment errors.

When making an appointment for a physician’s office visit, if you believe you need extra time to talk with the doctor, make sure you ask for the extra time so it can be scheduled appropriately. If you want a moment or two to talk to the doctor before he/she sees your loved one, ask for that opportunity. It is a good way to communicate sensitive information that your loved one may deny if conveyed in the presence of your loved one. The physician may repeat your concern to your loved one, however.

Prior to going to the physician’s office, make a list of symptoms, changes in behavior, or concerns that you have. Put those concerns in priority order, the most important first, so you make sure to get the most important things covered or conveyed in the appointment time.

Whether you are in the physician’s office for a regular visit, or in the emergency room, you will be asked a lot of questions. The physician will address a lot of these questions to your loved one (if that is the person being treated). Remember to let your loved one answer for him/herself. Provide information only when they cannot or if the information isn’t accurate. During the examination, the physician will ask you what is your chief complaint. This is the reason that has brought you to the physician’s office or the emergency room. Please get to the point quickly, even if it is something you think is a bit embarrassing to discuss. This helps the doctor stay on time on his/her appointment schedule, and makes sure that you get the things covered that have brought you into the office or ER in the first place.

You will also be asked to describe the history of your complaint/concern. Describe the timing of the symptoms and the nature of the symptoms as completely as you can. You will also be asked about your medical history and any medications that you are on. That is where your homework ahead of time can be very beneficial, so you don’t leave out anything important.

The physician will ask about your family’s medical history as well: what major diseases your parents, siblings, grandparents, and aunts/uncles have experienced and the ages of their death if they have already died. You will also be asked about your social history including your smoking and alcohol habits, diet, occupation, who lives with you, and so forth. Then the physician will perform the examination that will include all of your body systems. He or she may order some tests to help with the assessment and diagnosis in preparation for the plan of care.

The doctor is so rushed I don’t have time for my questions.

Don’t be afraid to ask for a second opinion. You can always ask: If this were your father, who would you go to?

Ask for some extra time when you schedule the appointment.

Ask for additional sources of information

Call back to the office from home with questions you would like to have answered. The physician or nurse will get back to you with answers.

How can you refuse medical tests?

Ask the physician if the results of this test would make any difference in the course of the treatment or the plan of care.

How can I communicate my concerns to the physician without embarrassing my loved one with Alzheimer’s disease?

Catch the assigned nurse out in the hallway and explain the person has Alzheimer’s disease and share your concerns.

Ask if you can visit with the doctor for a moment before he/she sees your loved one.

How do you describe a change in a person who can’t speak accurately for him/herself?

Describe the change as best you can. Try to be specific in describing the different behavior rather than just saying “He isn’t himself.” The more vague the description of the symptoms or situation, the more tests will be run.

Just a reminder:

Remember that people with Alzheimer’s disease don’t function as well when their routine has been disturbed, or when there is a lot of confusion, noise and distractions around them. Both of these conditions exist when a person is in the emergency room, doctor’s office, or hospital.

Source for Additional Information:

An excellent source of information for medical conditions, diseases, and treatments is: www.MEDLINEplus.gov/pcms