Work Closely With Your Doctor

Topic Overview

A strong partnership between you and your doctor is key to getting great care and reducing costs. A doctor who not only knows your medical history but understands what's important to you may be the resource you need most when you face a major health care decision.

Find a Doctor Who Will Be a Partner

A primary care physician such as a family medicine doctor or an internist who knows and understands your needs can be your most valuable health partner. Specialists who work on separate health problems may not see your whole health picture or get a good understanding of what's important to you. When you choose a doctor, there are lots of questions to ask, but these three matter the most:

• Is the doctor well trained and experienced?
• Will the doctor be available when needed?
• Will the doctor work in partnership with me?

For more information about choosing a doctor, see the topic Choosing a Health Care Provider.

Training and experience

For most people, a good choice for a primary care physician is a board-certified family medicine doctor or an internist. For children and teens, a board-certified pediatrician or family medicine doctor is a good choice.

A doctor becomes board-certified by completing training in a specialty area and passing an examination to demonstrate that he or she has the skills and experience needed to practice that medical specialty. To maintain their certification, doctors must take continuing medical education courses and pass periodic examinations. Board-certified family doctors, internists, and pediatricians have knowledge about many common medical problems. For more information, see the topic Medical Specialists.

Availability

Because health problems rarely develop when it's convenient, it helps to have a doctor who can see you when needed. Ideally, you want the best doctor you can find who is conveniently located and who belongs to your health plan.

Other things you may want to consider include:

• If I called right now for a routine visit, how soon could I be seen?
• How much time is allowed for a routine visit?
• Will the doctor discuss health problems over the phone or by email?
• What hospitals does the doctor use?

Partner potential

During your first visit, tell your doctor that you would like to share in making treatment decisions. Pay attention to how you feel during the visit.

• Does the doctor listen well?
• Does the doctor speak to you in terms you can understand?
• Does the doctor spend enough time with you?
• Do you think you could build a good working relationship with the doctor?

If the answers are no, look for another doctor. It may take more than one visit for you to decide whether you will be able to work with a doctor.

Learn All You Can From Your Doctor

Use your doctor as a teacher and coach

Some patients just want their doctors to tell them what to do. They don't want to know the whys and the hows. Some of the time, that's fine. But if you really want to get care that best meets your needs, be a patient and a student.

Don't just ask your doctor what you should do. Ask why. Your doctor can help you understand your care.

Don't worry about being thought of as a "difficult" patient. Asking questions is not being difficult-it's being an active participant in your own health care.

Always ask to see if you have options. Which options seem best for you? What are their pros and cons? What effects might your choice have in the short term and over the long term?

Benefit from your doctor's experience with other patients. Even though every patient's situation is different, your doctor has probably helped other patients work through the same questions and decisions that you have to deal with. Some doctors may be better teachers and coaches than others, but they really do want to help you get the answers you need.

Tell your doctor that you care about cost

A doctor's main focus is to help you get better, not to save you money. But if you speak up, your doctor may be able to help with both.

Don't expect your doctor to know the exact cost of a drug or test or treatment. There are so many things that determine the cost of care-your health plan's arrangement with your doctor, how your plan bills for care, where you get the care, and others. But your doctor can give you an idea of how the cost of one choice compares to another.

Prepare for every doctor visit

This helps your doctor give you better care and helps both of you make the most of the visit.

• Be ready to say what your main symptoms are, when they started, and what you have done to treat them so far. It may help to write these things down before your doctor visit.
• Write down the three questions that you most want to have answered. If the doctor doesn't bring them up, don't be afraid to ask.
• Bring a list of all the medicines, vitamins, and herbal supplements that you are taking.
• Bring copies of recent test results if the tests were done by a different doctor.

Take an active role in every visit or call

• Pay attention. Ask questions if you don't understand something.
• Write down the diagnosis, the treatment plan, and guidelines for self-care and follow-up visits or calls.
• Have a family member or friend with you during your appointment, if possible. He or she can take notes, ask questions to clarify information, and help you remember what your doctor says.
• Be honest and direct about what you do or do not plan to do.

Learn all you can about your health problem

Good information-whether you get it from your doctor, the library, or a trusted website-is a powerful tool for helping you make wise health decisions. If you have a complicated problem or want to know more about your health options:

• Start by asking your doctor if he or she has information about your problem that you could take home. Some doctors offer DVDs, CDs, brochures, or reprints from medical journals. Some doctors can send links to video, websites, or other electronic information.
• If you need to make a decision about a treatment, find out how quickly you need to decide. You may have a few days, weeks, or months to explore your options.
• If your health plan has an advice line, call and ask if they can help you get more information.
• If you use the Internet to find health information, start by searching sources such as the Agency for Healthcare Research and Quality (AHRQ), the Centers for Disease Control and Prevention (CDC), or a national organization that represents a particular disease, like the American Diabetes Association or the National Cancer Institute. These sources present information that is based on the analysis of a large body of medical evidence. Your health plan may also provide health information on its website.
• If you have questions or concerns about the information you find, discuss them with your doctor.

How to ask questions

When you're not feeling well or you're worried about your health, it's harder than usual to understand what a doctor is saying.

When there's something you don't understand, ask questions. Don't know how to ask? Try one or more of these suggestions:

• "I want to make sure I understand. Would you go over that again?"
• "Tell me more about ... "
• "Could you explain that in a different way?"
• "Can you draw a picture for me?"
• "Can I read more about this somewhere? Do you have anything you can send me electronically?"

In the hospital

Being in the hospital can be even more stressful than an office visit. And stress makes it even harder to process information.

If you think of questions when the doctor isn't there, write them down so that you can remember to ask them. This is important because your doctor may come by only once a day. Any questions you forget to ask might have to wait until the next day.

It can also help to have a friend or family member in the room when you expect your doctor or another provider to visit. This person can help you remember things you wanted to ask and may think of questions you haven't thought of.

Working With Doctors in the Hospital

When you're in the hospital, it may take extra effort to be an active patient and to communicate with all the different doctors, nurses, and other providers you will work with.

It's important to remember that even though you're in the hospital, you still have the ability to speak up and make decisions. But instead of just talking to your doctor in his or her office, you'll be talking to a variety of providers who come to your room.

Your attending physician

Your main doctor in the hospital is called your attending physician. Your attending physician is like the head coach of your health care team. He or she is in charge of coordinating your care and making sure that all the players are doing their jobs.

If you're in the hospital for surgery, your attending physician might be your surgeon. If you're in the hospital for an illness, your attending physician might be your family doctor or a specialist you were seeing before you were hospitalized.

Or your attending physician might be a doctor called a "hospitalist." A hospitalist specializes in treating hospitalized patients and doesn't see patients outside the hospital.

Attending physicians check on their patients during daily "rounds." This is your attending physician's time to see how you are doing and answer your questions. Your doctor or your nurses may tell you what time of day you can usually expect rounds. But don't be surprised if your doctor comes much later than expected on some days.

Before you go into the hospital, you may want to ask your primary care doctor these questions:

• Will you be my attending physician?
• If not, how will you keep in touch with me while I'm in the hospital?
• How will you communicate with the hospital doctors?

Remember that doctors aren't on the job all day and all night every day of the week, so your attending physician may change on certain days. Find out who your attending physician is, and ask to be notified if that person changes.

Other health professionals you may meet

During your hospital stay, you'll be cared for by a number of different health professionals, depending on the reason you're there.

The providers you'll see most are your nurses. They work in shifts, so you'll probably get to know three or more nurses during your stay. These men and women are a great resource. They're trained to help you know what's going on. If you have a question they can't answer, they will know how to help you get the answer.

For certain health problems, nurse specialists may be part of your treatment team. These are nurses who have special training about the health problem you're having.

Other health care providers you may meet include:

• Nurse's aides, such as LPNs or LVNs and nursing assistants.
• An anesthesiologist.
• Hospital technicians. For example, a lab technician may come to your room to draw blood samples. A technician may come to your room to do an ultrasound. Someone from the hospital pharmacy may visit you to explain a new medicine.
• Medical specialists. These are doctors or surgeons who are expert in whatever health problem you're in the hospital for. For example, a cardiologist specializes in treating heart problems. An oncologist specializes in treating cancer.
• A nurse educator. This is a nurse who specializes in teaching people how to manage their health problems.
• Other providers, such as:
  • A dietitian.
  • A physical therapist.
  • A social worker.
  • A psychologist.