Transcription:
Getting the Most out of Your Doctor's Appointment

Prakash Chandran: Have you ever gone to a doctor's visit and left confused by the information and treatment options given to you? It's difficult to make sound informed health choices when every part of your visit isn't properly understood. So how do you get the most out of a doctor's appointment? We're going to talk about this today with Alison Caballero, Director of the Center for Health Literacy at university of Arkansas for Medical Sciences. This is UAMS Health Talk, the podcast from the University of Arkansas for Medical Sciences. I'm Prakash Chandran. So Alison, it's great to have you here today. Can you just start by telling us what exactly is health literacy and why is it so important?

Alison Caballero: Sure. Well, thanks for the invitation to be here. I really enjoy talking with people about what they can do to get the most out of their doctor's visits. So health literacy really has two definitions. It's kind of got two sides. So on one side, it's all about a person's ability to find health information, understand it, find meaning in it, and really just use that information to inform their own health related decisions and behaviors. And on the other side, it's a bit of a measure of how well an organization does making that easy. So how well do the health care organizations that we seek care from do with regard to helping us find and understand and use health information.

Host: Got it. That makes a lot of sense. And so just kind of breaking it down for a lay person like myself, what do you suggest that I personally do to get the most out of my doctor appointment?

Alison Caballero: Oh gosh. Well, it actually starts before you ever set foot in the door. So even when you call to make the appointment, it's really important to let the person on the other end of the phone line or the computer, if you're using a computer to make your appointments, let the people know what you're coming in for. And that ensures that they set aside the right amount of time for you and your doctor, so that you have plenty of time to talk about the things that you need to get resolved at that visit. So it kind of starts there. In addition to that, thinking about what you might need to bring with you to the visit in advance is always helpful. So there are some things that you might need to bring in your hand or in your bag and like your insurance card and your ID. And people always ask me, well, you know, don't the doctor's offices already have those things on file. And perhaps they do, but perhaps they're updating records or they've changed their electronic health record systems.

And it's always a good idea to have those because the last thing you want to do is get there and not be able to get the services that you need because you don't have this thing. You know, another thing that really inhibits our ability to communicate clearly could be not bringing glasses or a hearing aid. If that's something that we require to communicate. And bringing along a friend or a family member, it's great to have someone there with you to listen alongside you and help you take notes and help you remember the things you wanted to get accomplished during the visit. But I think the most important thing that people can bring with them to visit has to do with information. And so writing those things down can be really helpful. So I'm going to quiz you a little bit here. What's the first thing, whenever the nurse sits you down in the exam room, what do they ask you?

Host: They kind of just ask me how I'm feeling and what I've come in for.

Alison Caballero: Right. What brings you in, right? And so you're likely to hear that question from, you know, from the nurse and then perhaps again, from the doctor, if you've got, you know, a student participating in your visit, all of them are probably going to ask you that question. And that's where I think we get tripped up a little bit, we ramble on a little, or maybe leave something out. And so if you can write down what your goals are for that visit before you ever set foot in the door, you can refer to those notes and make sure you get it all. And sometimes it's really simple. I've got this huge headache and that's been here for three days and I need some help. But other times perhaps you need a form filled out for your child for school, or you need a medication refill. Sometimes there's multiple reasons for our visit. So to be able to say all of those clearly to each person that asks is super important and the best way to do that is to write it down before you go.

Host: Seems to make so much sense to me. One of the things I wanted to ask you about is people on the other side of the spectrum, the ones that potentially do too much research and they come armed with all of the stuff that they've been Googling. Do you have any thoughts about that?

Alison Caballero: Oh goodness. So that could be a separate podcast. I tell you. So there are so many places online where people can go for information and not all of it is great. And so I'd love to share some tips at some point about what makes for good health information online, and help people try to evaluate those different sites. But I think bringing, you know, the most important thing you can bring to your visit is information about yourself. So all the information about the medications that you take, how much you take when you take them and how they're working for you. Another thing that you'll often need to complete forms that they ask you to complete is your history in terms of any surgical procedures, other doctors that you see, things that you're probably not going to remember off the top of your head that you probably need to write down. But, you know, I think the tide is shifting a little bit, the way from the doctor speaks and we listen to let's have a conversation, and we call that shared decision making. And it's becoming more and more common than, and, you know, just depends on the diagnosis or the health problem that you have. But, you know, I think it's helpful when you come with some idea of what you think might solve your problem. And then your doctor is there to talk through those ideas with you. So if you've researched some things online, it might not be a bad idea to kind of just write down the top two or three things that you learned in that research and bring that with you and share that with your doctor.

Host: Absolutely. You know, it really does sound like it. You need to strike a good balance, but the most important thing is just being self aware and making sure that you write it down to work with your doctor almost as a team, right. You're trying to solve a problem together. And so the more information that you can give them about yourself, about how you're feeling about the medications that you take, the better of a job that they can do, isn't that right?

Alison Caballero: You are exactly right. And it really is much better when it's done as a team. You know, your doctor, your nurse practitioner, your other members of the healthcare team, they know so much, but you know, so much about yourself too. So bringing all of that information to the table can help you get the best possible care.

Host: Okay. So let's talk a little bit about how it might break down after the initial setup for the visit. So I'm sure you noticed that sometimes after the visit, the patient might leave and not really remember what you're either prescribing them or the things that a doctor might tell them. Maybe talk a little bit about that and maybe the most common places where you see that communication breakdown happen.

Alison Caballero: So, you know, if you think about the last time that you went to a doctor's visit, maybe it was for just a checkup or a wellness visit, but most of the time when we go in, we're going, because we don't feel well. So we might be in pain. We might just really feel crummy, be tired from not sleeping well. And a lot of us just get stressed when we get into the doctor's office environment for some reason. And so we're really not in the best state of mind for a lot of learning. And typically there is a lot of learning to be done when you're in a doctor's office for an appointment. And so one of the things that you can do to kind of keep the communication strong is to ask your doctor to pause from time to time. So you might ask them if they say a word that you're not familiar with and they know them, right. They spent years in school, learning of new vocabulary that the rest of us hadn't learned. So if they say a word or something that you're not quite familiar with, just pause them and say, I hate to interrupt, but could you explain that to me in a different way?

Or could you use a different word for that? I'm not exactly sure what you mean. And the other thing I would encourage everyone to do is, you know, really just ask questions when you, when you don't understand. So if they say, well, your treatment is going to look like this, and you don't understand what they're saying or why you might be getting that particular treatment. That's another good opportunity to say, well, can you explain to me a little bit more how that particular treatment is going to benefit me? What other treatment options do I have? So ask those questions. And that's tough because again, most of us grew up in an environment where the doctor spoke and we listened and things really are changing. And, you know, the healthcare team wants the same thing that we want. Everybody is on the same page. We want people to be healthy. And so they would prefer that you ask that question, right? Another thing that you can do just to kind of make sure you have, it is just repeat back what you heard before you leave that visit, make sure, you know, what did the doctor say?

What is my major health problem? What did he call that? Or she call that? What are we going to do about it? What is the treatment plan? And what is my part of that plan? Do I need to make an appointment for a follow-up visit? Do I need to go to the pharmacy and pick up a medication that's called in? Do I need to stop at the front desk and pick up a paper prescription to carry into my pharmacy? There's lots of details there. So whatever those actions are that are yours, just repeat back. Gosh, Doc, we talked about a lot of things. I want to make sure I have my next step straight before I leave the office. Here's what I think I'm supposed to do next. And then let them help you. Correct? Any places where maybe you're not on the same page.

Host: Yeah. I love the way that you talked about asking the doctor, you know, what are my options here? You know, using my mother as an example, I have heard her kind of jump down a doctor's throat when they recommended that you take medication because, you know, she grew up never needing or wanting to take medication. And I've told her, I said, you know, there's a good way to ask that question. You can say, Hey, you know what, what options might be available to me? In my upbringing, I never took medication before. And I'd feel more comfortable if I didn't have to. So what is available to me because at the end of the day, the doctor is there to try to give you the best outcome, you as a patient the best outcome. And there's a nice way to always ask everything. Wouldn't you say?

Alison Caballero: Absolutely. I really loved the way you phrased that to say, to kind of explain to the doctor. Well, this doesn't really work for me and here's why, what else do you have? What are my other options? The worst thing you could do is to nod your head and say, okay, fine. And leave that visit knowing full well that you're not going to go and fill that prescription. So hopefully this will help your mom out a little bit.

Host: I hope so. Yeah. You know, just as we close here, you've probably focused on this a lot. You've seen a lot of people come through with different levels of health literacy. If you could leave people or people listening to this conversation with one piece of advice, what might that be?

Alison Caballero: Speak up for your own needs. You know, articulate that, speak that very clearly. As soon as you sit down in that exam room and someone asks you, what's brought you in, continue to repeat that as other people ask, what's brought you in, speak up to let the doctor know your thoughts about what he is suggesting you do for your health problem. Ask for those other options, ask when you don't understand something and just make sure you know before you leave the office, what you are supposed to do, what you're responsible for.

Host: Well, Alison, I think that is the perfect place to end. Thank you so much for your time today. That's Alison Caballero director of the Center of Health Literacy at the University of Arkansas for Medical Sciences. Thanks for checking out this episode of UAMS Health Talk. For more information on this topic and to access the resources mentioned, visit uams.com. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks, and we'll talk next time.