The document provides tips for having a good doctor's appointment by being well-prepared and an active participant in one's healthcare. It suggests choosing a doctor wisely by asking others and considering their training and approach. It also advises being prepared by making a list of questions, symptoms, and medications; asking questions and taking notes during appointments; and being an active partner by tracking health over time.

1. Good Doctors How to have a Presented by Jane Lump March 11, 2011 appointment

2. Let’s take a little quiz. . . I have one doctor who acts as the central clearing house for all the medical care I receive—I ask all my other doctors to keep him/her informed I have a list of all the medications I carry with me at all times—and I can show it to you today I understand the benefits and potential risks of each medication I take I know how to pick the best doctor for my condition and my personality My doctor takes time to answer my questions and explain my treatment options

3. How did you do? If you scored 5 Congratulations! If not, This session is for you!

4. Healthcare today. . .

5. What Your Doctor Wants You to Know Good physicians take the long view Respect is a two-way street Please take your medicine Pain is tough to treat You need to take responsibility for your history Research on-line can be helpful—but tricky He/She is more pressed for time than ever before

6. A typical Primary Care doctor’s day. . . According to a recent study published in the New England Journal of Medicine the average internal medicine physician Sees 18 to 20 patients Receives 24 phone calls Gets 17 e-mails Processes 12 prescription refills Reviews 20 lab reports and 11 diagnostic imaging reports from consulting physicians and others

7. The practice of medicine. . .

8. 5 Steps to Getting the Best Care Choose your doctor wisely Be prepared Ask Questions Take Notes Be an active partner in your health

9. More information than ever before. . .

10. Step 1: Choose your doctor wisely Ask people —and consider the source Ask questions —before making the first appointment, know where the doctor trained, his or her philosophy of care, attitude toward referrals/teamwork, locations, office hours Set out your expectations —use your first appointment as a chance to learn more about the doctor’s style and to discuss your expectations. Make it clear that you want a partnership and want to know what he/she expects of you as well If it isn’t working —choose a different provider and ask to have your records transferred.

11. Step 2: Be prepared Jot down a list of your questions —and prioritize them so you get to the most important issues first. If you run out of time, set up a follow-up appointment Know your symptoms —keep a log of what you are experiencing, when symptoms occur, how long they last? Ask Questions and LISTEN to the answers —if you don’t understand, ask your doctor for clarification or ask if a nurse can go over the information again Take Notes —or bring a friend or ask your doctor if you can record the conversation so you can go back over it later

12. Step 3: Ask Questions What is my diagnosis/condition? Can this condition by cured? Managed? What are my treatment options? What are the benefits and risks of each option? What treatment do you recommend and why? If you recommend a prescription— Is there a lifestyle alternative—such as diet? What are the possible side effects? Is there a generic version of this drug?

13. A word about generic drugs Program Price Fee Note Costco Varies by location $50 annually Only for drugs not covered by insurance CVS Health Savings Pass 90-days $11.99 $15 annually Open to all K-Mart Prescription Savings Club 30-days $5.00 90-days $15.00 $10 annually Also up to 35% discount on all generics, 20% on brand name Target 30-day $4.00 90-day $10.00 Free Open to all Walgreens Prescription Savings Club 90-day $12.00 Individual $20 annually Family $35 Open to all Wal-Mart / Sam’s Club $4 Prescription Program 30-day $4.00 90-day $10.00 Free Open to all

14. A word about generic drugs Consumer Reports, Best Buy Drugs, March 2011 Condition / Brand Name Drug CR Best Buy Drug Monthly Savings Annual Savings Diabetes Actos , one 30-mg pill per day $280/month Metformin (generic) one 500-mg pill three times per day $49/month $276 $3,312 High Cholesterol Lipitor , one 10-mg pill per day $112 per month Lovastatin (generic), one 20 mg pill per day $4 per month $108 $1,296 Heartburn Nexium , one 20mg pill per day $203 per month Omeprazole (generic), one 20-mg pill per day $19 per month $184 $2,208

15. Step 4: Take notes Ask a friend or relative to attend the appointment with you to take notes for you Use a small tape recorder or the “record” function on your phone to record the conversation with your doctor so you can go back over it later. Use the appointment planning sheet to prepare your questions and to take notes during the appointment Keep your notes and refer to them as you prepare for your next appointment

16. Step 5: Be an active partner in your health Create a system for tracking your appointments, billing, insurance payments, etc. Create a long-term view of your own health—make sure you review this info and take it with you to your appointments Let someone know where you keep your records and how to access it in case of emergency. Take care of the “legal stuff” Living Will Power of Attorney Medical Power of Attorney—health directive

17. Questions?