Melanie Cole (Host): Patients want to make the most of each visit to their medical providers but there are so many services offered and details to remember, it can be difficult to cover everything. Welcome to Conversations with MIT Health. I'm Melanie Cole. My guest today is Dr. Cecilia Stuopis. She’s the Medical Director at MIT Health. Welcome to the show, Dr. Stuopis. So, patients do want to make the most of each visit. How do you suggest patients prepare for their appointments with docs? 

Dr. Cecilia Stuopis (Guest): I think the first things patients should do is really think about the kind of appointment they are coming in for. From the healthcare provider’s standpoint, there is a difference between a routine physical type of appointment and a problem-oriented appointment--something that you’re coming in for where you’re having an issue you want to discuss with your doctor. When patients come in for a routine checkup, those kinds of appointments are a time when the doctor or the nurse practitioner is trying to go over your entire health status. Things like your personal history, your activity, your diet, your regular vital signs, what kinds of routine labs you might need. They’re really considering your whole person for those kinds of visits and are not as focused on the various medical problems you might have, and they’re really taking a viewpoint around wellness for the patient and making sure that everything that you need to have done or you should be doing is focused towards wellness.

Melanie: Okay. So, they have to first decide what their visit is for, know what their visit is for, and if it’s for wellness or their annual, physical kind of thing, that’s going to be a different kind of appointment than if they’re going in to focus on one specific topic. Do you doctors like it when patients come in informed, whether it’s a topic or a physical with questions--things maybe they’ve read on the internet? Do you like that? Or, no?

Dr. Stuopis: No, we do like that because it shows that the patient is thinking about their health. We want patients to think about the symptoms that they’re having, to be able to describe them to us, to tell us things like how long they’ve had their symptom, what things they’re seeing in addition to a symptom. Take a headache, do they have nausea with the headache or do they not? Every health condition that you might have, there are certain things that we are going to probe the patient for additional information around. So, we’d like them to think about what those additional things might be, and be able to describe them--the duration of their symptoms, what kinds of situations they coincide with, and just general things around timing, location, severity--those sorts of things.

Melanie: So, how can they use their time in the office efficiently as far as hearing what you’re telling them? So, they’ve given you their symptoms, they’ve given you all these things, they’ve asked you their questions, and now you’re giving answers. Should they be writing them down? Because sometimes, Dr. Stuopis, these things go in one ear and out the other for patients. Do you like them to bring somebody with them? What do you like them to do as far as getting that information from you and processing it?

Dr. Stuopis: So, I think the best patient-provider interactions are going to be a two-way interaction whereby the patient asks questions, the provider answers them, but also the provider asks questions and the patient answers back as well. And for most patients, particularly if we’re talking about something that’s a bit more complicated, it is best to be able to have some way to write down notes or bring a person along with them if they feel like it’s a very significant health issue. Sometimes, two sets of ears remember things better than one.

Melanie: If a patient chooses a primary care provider that turns out to be not such a great fit, can they switch? How does that work?

Dr. Stuopis: So, at MIT Health, we, of course, have primary care providers of all types that our patients can choose amongst. I think to have the best therapeutic relationship with your provider, it’s important that when you’re in the room with them, you feel a connection to each other. And, if you’re not feeling that connection or that the provider is the right fit for you, certainly you can change your primary care provider. That’s done easily by contacting the health plan desk or through one of the secretaries up front. Providers don’t take it personally when someone switches away from them to another primary care provider. We recognize that it’s a very personal decision and someone that you may have been assigned to by chance, might not be the best person for you. So, don’t ever feel that if you are making a switch from one primary care provider to another that we’ll think less of you because you’ve made that decision. We want you to have that great therapeutic relationship with your primary care provider.

Melanie: I’m so glad that you said that because people do think maybe it would be a little uncomfortable or what if they’re going to see that primary care provider in the hallway somewhere. So, I’m glad that you pointed that out. That’s so important, Dr. Stuopis. Now, what about resources for patients that may have accessibility issues for interpretation, translation services or assisted listening devices?

Dr. Stuopis: All medical facilities are required to have those kinds of assistive devices and services for their patients. So, we offer an interpretation phone line for our patients who need medical interpretation, and we do have the assistive listening devices as well. Of course, we want to work with you, no matter who you are, to get the information to you in the best way that you can understand it, whether it be written through a patient message on our portal FollowMyHealth or through regular verbal communication.

Melanie: Can patients access their medical records outside of appointment times? Can they go on and look at their blood work or things like that anytime they want?

Dr. Stuopis: So, yes, at MIT Health we have the FollowMyHealth patient portal, and through that portal, patients can access certain portions of their medical record, including their medication list, allergies, a problem list, and it has the ability to send messages back and forth with the provider. We always recommend that any messaging with a provider be done through the patient portal because it is a secure portal and compliant with the HIPAA laws, the privacy laws.

Melanie: And, what should patients know about their own insurance coverage?

Dr. Stuopis: So, I think in particular at MIT Health, especially as it relates to our students, a number of our students have health plans that are not provided by MIT Health. They have what’s called--have waived the student health insurance plan. And, for those students in particular, we need them to understand the requirements of their home health insurance, what the network would be if they have a medical condition. All consumers of healthcare need to understand basic terminology around deductibles, co-pays and referrals. Those kinds of things that can be frustrating for people when they’re sick, so it’s better to take some time when you’re not feeling sick to understand how your health insurance works.

Melanie: That’s great advice. So, wrap it up for us, Dr. Stuopis, in the last few minutes here, about being your own best health advocate, and what you want patients of MIT Health to know about being an engaged patient and knowing their health history and being able to relay all of that information to their primary care provider?

Dr. Stuopis: So, I think, it’s just to pay attention to your body is number one. I think, patients sometimes just gloss things over and aren’t aware of the signals that their body might be sending them. And, it’s important to just pay attention to those details, and then be able to relate them back to the healthcare provider when you are seeing them. It’s hard to help people if they can't tell you exactly what’s going on with them. So, taking notes, sometimes keeping track of symptoms on calendars, those sorts of things, are very helpful for us and for the patient to understand what is going on with them. It’s important that patients really try and develop that relationship with their primary care provider, or whomever they’re seeing, actually, and be honest with what is going on. I think one thing we see quite commonly is that patients will book an appointment for one issue but really want to talk about another issue. It really helps us to be the best prepared for your appointment if you just right upfront tell us why you want to come in and be seen, rather than make us try and dig it out through the course of the interaction. We are all bound by the privacy and confidentiality law, so you can rest assured that your information is safe with us.

Melanie: Thank you so much for being with us and really clearing that all up for us. It’s great information. Listeners can visit Health.mit.edu for more information and to get connected to one of our providers. That concludes this episode of Conversations with MIT Health. Please remember to subscribe, rate and review this podcast and all the other MIT Health podcasts. . I'm Melanie Cole. Thanks so much for joining us today.