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Wednesday, April 23, 2008 10:30 AM

Navigating Health Care: Getting the Most Out of Your Next Checkup

Rand: Eating well, exercising and getting regular medical check-ups are important ways to stay healthy, but how do you get the most out of your annual physical? Well AHRQ Director and medical internist Dr. Carolyn Clancy is with us to offer up some tips for Navigating the Healthcare System, and ensuring that you get what you need during your next doctor’s visit. Dr. Clancy, thanks for joining us. You have said patients should be active participants in their own care. What do you mean?

Dr. Clancy: As a physician I’m often struck by the fact that many people invest more time in preparing for a visit to a car mechanic than they do coming to a physician’s office. I think potentially because the encounter with the doctor may be a bit threatening or intimidating, people arrive, sit back and expect the doctor to be the conductor of the conversation and the visit. And many doctors are prepared to do just that. On the other hand, we know from many studies that people who play an active roll in their own health care have better outcomes.

Rand: So what can I do get more out my next medical visit?

Dr. Clancy: It’s very important to prepare and write down questions. It doesn’t have to be fancy. You don’t need to bring it in on a CD or a little thumb drive or anything like that. It can be written on the back of a napkin. But, it’s important to give some thought ahead of time to what questions you have.

Rand: Okay, so what if I ask a question, but I don’t understand my doctor’s answer or advice?

Dr. Clancy: If you’re not understanding answers to questions, you need to say, "Can we back up?" or "Can we go back to the answer you just gave me? I’m not sure I get it. It sounded logical" or "I thought it made sense, but as I’m thinking about it a few minutes later, it doesn’t." It can save unbelievable amounts of time in the future. If you sit there and nod, and say, "Uh huh, uh huh," you’re waiting for the doctor to pick up on the fact that she’s not getting it at all. In which case you will have wasted more time together than would have been the case if you had simply said, "Excuse me, I need to go back a step or a couple of questions."

Rand: What about medical histories? If this is my family physician, do I really need to do a thorough history?

Dr. Clancy: In theory, a physician that you’ve been seeing on a regular basis does have your whole history and will know what medicines you’re taking. However, many people see more than one doctor and another doctor may have made changes in the medicines that you’re taking. Sometimes charts aren’t available. Or, in the modern era, the computer or network may be down. So, it’s very important that you have a copy of all of this information and can actually make that available to the doctor.

Rand: Alright. And what if my doctor says I need some tests?

Dr. Clancy: Two questions to ask about all tests - one is, why am I having it? The second is, how will I find out about the results? Many practices have completely different policies and if you don’t ask, you won’t know. In general, I think it is much better if patients, themselves, play an active role in finding out what are the results. I think it’s important to remember that a good physician-patient relationship is a lot like a marriage. There will be some bumps in the road, but it requires good communication on both sides.

Rand: Dr. Carolyn Clancy, thank you for joining us.

Dr. Clancy: Thank you.

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