5 Rules for Effective Physicals

Knowing how to talk to your doctor could set you on the road to a healthier year – here's how to ace your yearly exam

If you’re scheduling your first routine physical, or first in years, you may anticipate a conversation similar to speed dating.

You want your doctor to know as much as possible about you, but you have a limited amount of time to share it.

In addition, you may wonder if, as in speed dating, you should omit a few less appealing facts until the patient-doctor relationship progresses.

Although physicians each have their own preferences about how much they want to address in one session, they do have general areas of agreement.

Here are five things physicians want to hear from you during that first visit:

1. Why you made the appointment

“You may say you’re here for a physical but you probably have an issue,” says Dr. Richard Sandovsky, associate professor of family medicine, SUNY-Downstate Medical Center, Brooklyn, N.Y.

“Be clear to say why you’re here. The doctor will explore that,” Dr. Sandovsky says.

Have ready your list of concerns. Some physicians want your top 3; others don’t mind all 30.

“We take an ‘everything’s on the table approach,’ but not everything might be addressed on the first visit. It may take more than one visit to address all the concerns,” says Scott Massey, professor of physician assistant studies and program director, Misericordia University, Dallas, Pa.

Prioritize – introduce the most urgent health matters first.

If you’re unsure, think about any symptoms you experience. Ask yourself whether these are continuous and whether they’re getting worse, says Dr. Christopher Fitzgerald, internal medicine-pediatrics, Cedars-Sinai Health Systems, Cedars-Sinai Medical Group, Beverly Hills, Calif.

“If symptoms are getting worse we have to address them,” Dr. Fitzgerald says.

Physicians will also encourage you to mention symptoms you consider trivial, especially if recurring and bothersome, such as intermittent heartburn.

“There may be a disease lurking under trivial symptoms,” Massey says.

2. Your health history

Include your medical records, medications, family history going back to your grandparents and your lifestyle habits, Massey says.

Smoking, drinking and lack of sleep, can affect your health.

Don’t hold back because you think you’ll be judged.

“Most doctors aren’t judgmental, even with things that might be embarrassing. If you feel you can’t be honest, get another doctor,” Dr. Fitzgerald says.

3. Your expectations

If you have a tendency to be deferential – to not ask for what you need because you don’t want to be perceived as a “bad” patient – you may not be getting appropriate care.

Don’t be afraid to speak up.

“You want the physician to know what concerns you,” Dr. Sandovsky says.

Being forthright helps physicians as well, he says.

4. Your follow-through plans

Ask your physician what your next steps should be. These may include treatment for any conditions, screening tests according to your age and risk factors and a review of the test results.

5. Your doorknob question

This is what you bring up when you or the physician are halfway out the door.

Ideally this wouldn’t come up because you came prepared and are feeling comfortable with the physician. But, speak up if something is still on your mind.

“In my practice I would rather have a patient ask and take an extra minute than not,” Dr. Fitzgerald says.

It’s easy to play Internet MD, looking up symptoms for various conditions you’ve self-diagnosed.

There are advantages and disadvantages to this, Dr. Fitzgerald says.

You could use the information to take better care of yourself. But if you visit a site that’s not from a credible source, you could be misinformed.

Your health professional is likely to commend you on your desire to be up to date, but then recommend you not get too far ahead or read too much into the symptoms, Massey says.

For guidelines on the frequency of a physical exam and screening tests for your age and gender, visit the National Institutes of Health website at: http://1.usa.gov/PTHNDZ

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