Stephen G. Sanders, M.D.

May 4, 2009

It is a busy world these days. You are aware of this when you visit your doctor's office too. There are several things you can do to get the most out of your appointment. After all, you are the most important part of the visit.

Your primary care physician is responsible for all aspects of your heathcare and this is a big task. Computerized records and efficient staff are important, but an educated and prepared patient is a great addition.

Medications have tremendous benefits but carry some risk of side effects. Safety of medication administration is enhanced if they are correct in the chart. Medications may have been changed since the last visit by other physicians, pharmacists, night time phone calls, and, unfortunately, on the advice given by friends and neighbors, or even information obtained on the Internet. Don't assume your physician has the correct inforrmation.

"Shoulds" and "Should Nots" for patients:

"Patient Shoulds"

+ know medication name, mg strength, and number of times taken daily

+ know whether a 1 month or 90 days supply for refills is needed(90 day preferred by most insurance companies)

+ bring a list of your medications or the individual medications to the visit

+get a printed list at the end of the visit of your current medication list after any changes are made

"Patient Should Nots"

-Say "It's the pink pill"

- Tell the doctor,"You should know, you gave it to me!"

-State, "I don't know my medications!"

Patients can enhance what is received in the short time of a doctor's office visit in several other ways.

1. Bring a list of questions or problems you need to have addressed.

2. Bring a list of tests done and other physicians visited since your last appointment.

3. For routine follow up visits, blood tests can be done ahead of time, with discussion of the results at the visit.

All of this will help you get the most out of your visit. It will also provide a more satisfying and efficient visit for your physician.

Nancy D. Doering

Photograph courtesy of Webster University,St. Louis, Missouri campus, 2008 

A recent experience  gave cause to reflect on the wisdom of finding suitable specialists who practice at the same facility as one's family doctor. My primary care physician practices at the second largest medical center in St. Louis, Missouri, St. John's Mercy Medical Center.  There are many reasons this facility is the hospital of choice for my family, beginning with the confidence level we share for our physician, along with a number of  positive outcomes of our hospitalizations, national awards earned by the facility and individually by many of our physicians who practice there,  superior  testing facilities, a long  history of cleanliness and aggressive protocols for communicable diseases to keep patients out of danger, a good safety record for patients and their visitors, and convenience that spans many decades. In addition, this facility has established a mission to continue offering better service to patients and their families. All of these facts support the logical conclusion that it helps in many ways to seek physicians within a common facility whenever possible.

Very recently, a specific example supporting the habit of utilizing the same facility came to light. Last fall and into the winter, I waged a rather nasty battle with pneumonia. In the midst of the testing required to properly diagnose and assess treatment options for this condition, it was discovered that a small lesion was present on my liver. In addition to completing appropriate treatment  and follow up for the pneumonia, additional testing was ordered to determine the nature of the lesion and if it required treatment.  Subsequently, in tracking the  history of this particular problem, an earlier CT Scan was found in the records from five years earlier, due to an earlier visit and admission through the Emergency Department for a life-threatening condition. When the second CT Scan in 2008 showed no change over several months, coupled with the film from years earlier, it was determined that a five year history with no change in this lesion  rendered it harmless and requiring no further diagnosis.  Although I had long forgotten the presence of this lesion, the tests did not lie and spared both me and my family the agony of waiting it out for four more years until a five year history could be established.  Had the test been completed at a different facility , it might have necessitated more testing, more cost, and more emotional trauma to rule out the possibility that this was of serious concern. Since we had all testing completed at the same medical center, I am happily playing with a new grandchild this fall instead of worrying over a possible cancer in my liver.  Thanks, St. John's, for such excellent records; and Dr. Sanders, for a thorough review of the test results!

"If God sends you down a stony path,may he give you strong shoes."

Irish  blessing