I once had an elderly patient of mine very closely approach kidney dialysis. She had recently established her care with me as her new primary care physician. She was a diabetic, hypertensive patient taking over 12 prescription medications.
I sent a referral for her to see a kidney specialist in order to commence possible dialysis. But after having met with her a couple of times, getting to know her, and asking her questions, I realized ... something was not quite right. She was unaware of what medications she was actually taking.
So I insisted that she bring her medication bottles with her to the next visit. Low and behold, she had several repeat bottles of the same medications. And she was astonishingly taking all of them. It was overwhelming her kidneys, taking the maximum limit of several drugs. This caused her kidneys to malfunction and begin to shut down. She was nearly set for dialysis! If I hadn't asked her to bring her bottles to review individually, this patient may have endured some unnecessary medical suffering.
Therefore, learning how to take charge of your health as a patient is truly a must. And making your doctors visits as smooth and efficient as possible will help return that sense of self-control and satisfaction.
The following five tips alone will help keep you from some very common medical pitfalls.
5 Things to Never Do at the Doctor's Office
1.) Forget to Confirm Your Appointment
Let’s start at the beginning. Make sure to confirm your appointment day and time at least 48 hours in advance. Even though my staff is very well-trained and experienced, mistakes and misunderstandings happen. And for whatever reason, every once in a while, I still see a patient who tells me that they thought their appointment was at a different time slot. If the doctor is booked, this may mean that the patient needs to reschedule. And some doctor’s (and dentists, eye doctors, acupuncturists, hair stylists, masseuse, etc.) offices even charge a fee for missing an appointment. Therefore, in order to avoid any last minute surprises, if the doctor’s office has not called you to confirm your appointment first, please make sure to call them yourself.
2.) Forget to Bring Your Medication Bottles
For those of you who can recite the names and doses of your meds in your sleep, this may not be an issue. But for the rest of us, especially those taking multiple medications, even pronouncing something like lisinopril/hydrochlorothiazide (a very commonly prescribed generic blood pressure medication) is a lot to ask. And if you are on multiple medications, remembering that list becomes even more daunting.
I know what you are thinking—"Doesn’t my doctor have an electronic version of my medications in my chart?"
The answer is yes. However, doctors know to never rely on a computer rather than their live patients. Even if the patient is “supposed to be” on a medication on their list, it doesn’t mean they are actually taking it. So physically viewing the bottles is irreplaceable information. In addition, if I need to tweak a blood pressure medication, for instance, and the patient is on multiple ones, having physical access to their bottles will allow me to not only point them out individually, but also to write on the bottle when I ask them to make any changes.
Bringing your bottles to your visits will help eliminate errors and misunderstandings.
3.) Forget to Turn Your Cell Phone Off
As a physician, I do carry my cell phone in my white coat. But I keep it on vibrate and am proud to say that I have never to this date answered it while in an exam room, or even looked to merely see who is calling. Why? Because I strongly believe in common courtesy, most especially in a professional setting such as the doctor’s office.
Also, it interrupts the visit and that is one of my biggest pet peeves as a doctor. I lose my train of thought and it takes time to regroup. Along the same lines, I have asked my staff to never interrupt me while I am with a patient, unless it’s absolutely dire. The only time I now get interrupted is during a true patient emergency, which is infrequent.
And I simply ask the same of my patients. Please do not forget to turn your cell phones off—this is one of the most disrespectful things I can do to a patient, and I would expect the same courtesy in return.
4.) Lie About Your Health
If you drink a bottle of whisky every night, smoke weed all day long, if your anus itches, if you have the most unsightly fungal growth on your toenails, peculiar hair growth on places there shouldn’t be, or a rash in a potentially private body part, please tell your doctor. We are not here to judge you. And we cannot help unless you are completely forthcoming.
And for the record, there truly is nothing we have not heard many times.
5.) Lie About Not Following Through With Your Treatment Plan
Just last week I had one of my very kind diabetic patients follow up with me in clinic after having labs drawn. Her lab result, called the “hemoglobin A1c” (which is a reflection of the previous 3 month blood glucose averages) was relatively unchanged from her previous one months ago. We had initiated a new medication for improved glucose control at that time. And had discussed some dietary changes that can reduce her blood sugar levels.
So what happened?
“You caught me, Doc. I never started that medication you prescribed. I filled the prescription and planned on starting it, but my neighbor convinced me to try an herbal remedy for diabetes instead.”
“Did you follow our nutrition plan, then?”
“Yeah, I started to follow the plan but reverted back to my old habits after having flown to the East Coast to visit my family. My sister is the best chef. It was hard to resist.”
OK, good to know. If she wasn’t forthcoming about her lack of adherence to our treatment plan, my next step would have been to increase her current dose. And increasing her medication dose would not have been the right thing to do knowing that she’s not taking it in the first place. It’s also important to know if patients are taking any over-the-counter (OTC) supplements because they are not all safe, effective, or FDA approved.
Therefore, being honest about your adherence to the treatment plan is vital. And if you suspect any obstacles in the way before the treatment plan is agreed upon, then please don't be shy to say so. A treatment plan should be one that both the doctor and patient create together and both agree upon. The plan can be devised in clinic, but it's you the patient who will need to execute.
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Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.
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