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Neurology Now:
DEPARTMENTS: Penny Wise

Making the Most of Your Doctor Visit

Stone, Kathy

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Kathy Stone is a freelance science and health writer whose articles appear in the Applied Neurology magazine, and in several newspapers, including the St. Paul Pioneer Press in St. Paul, Minn.

If you want the best health care possible, be prepared and informed. Doing both can also save you money Just ask Mary Elizabeth McNary.

She was diagnosed with multiple sclerosis (MS) in the late 1980s and now works as a rehabilitation counselor in the National Multiple Sclerosis Society's Washinngton, D C. office

“You are a consumer of health care,” she advises people who are newly diagnosed with MS. “You owe it to yourself to take 15 to 20 minutes to list your questions for your doctor visit,” she tells them. “And don't you dare leave that office until all questions are asked,” she adds. She also suggests keeping a calendar of tests and procedures performed for cross-referencing when the billing statement arrives.

Of course, in an emergency situation, there isn't time to sit down and note questions or to write down a personal health history That's why it's important to maintain a health record that can be shared with a doctor at each visit, she says.

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Take a Team Approach

What you do during a doctor's visit can mean the difference between a productive meeting or a frustrating experience, says University of Alabama at Birmingham psychologist Joshua Klapow, Ph.D. “Bring a list of your symptoms and medications and prioritize your concerns. Leave with a plan. Write it down and repeat it back to the doctor. If you don't understand the plan, ask for clarification,” he advises.

Sometimes the responsibility for asking falls to a parent or caregiver. Sue Mielenhausen's 12-year-old son was diagnosed with epilepsy at age five. The Mielenhausens, of St. Paul, Minn., consider themselves part of a collaborative decision-making team with their son's pediatric neurologists.

“No one knows your child like you do,” says Mielenhausen. Part of having a good working relationship with health care providers extends beyond the doctor to the clinic staff, she says. “It's important to be able to get through on the phone. We've had a good experience with the triage nurse. She returns calls immediately”

She makes sure her son is involved as well.

“It's really important that the child be engaged” during conversations with the doctor. A child is going to feel more comfortable asking questions if they've been involved in conversations,'' she adds.

Mielenhausen keeps records of her son's care. “I've tried to keep a good record, noting dates and times of reoccurrances.”

Figure. Sue Mielenha...
Figure. Sue Mielenha...
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The American Academy of Neurology (AAN) also offers tips on working with your neurologist on The Brain Matters, a Web site for patients. The tips include asking a relative or friend to come with you, because “sometimes a second pair of ears may be helpful.” Your companion can also jot down notes during the visit, which can be extremely helpful afterwards, the site notes.

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Good Personal Health Records Ensure Safety

Maureen Callaghan, M.D., a general neurologist in Olympia, Wash., estimates that only about one-third of her patients come in prepared. Sharing pertinent health records “is a matter of patient safety,” Dr. Callaghan says. This helps prevent the prescription of medications that may counteract with existing prescriptions. Good records can also avoid ordering redundant and expensive diagnostic tests.

Neurologists also need to be aware of all existing conditions, such as high blood pressure or diabetes. Bringing along a health record of other conditions and names of other health care providers makes providing care easier.

Stacey Rudnicki, M.D., an associate professor of Neurology at the University of Arkansas for Medical Sciences Medical Center in Little Rock, Ark., routinely sends new patients a questionnaire that covers symptoms, family medical history, previous tests, prior surgeries, alcohol use and cigarette smoking history and medications.

Many patients assume they will have only 15 to 20 minutes with their doctor at each visit. But Dr. Rudnicki advises new patients that a neurological exam is usually more involved and requires more time than other office visits. “Neurologists tend to spend more time with patients than the average doctor. We might meet for 30 minutes to 90 minutes. They should come in with the mindset that they may be in a little longer,” says Dr. Rudnicki.

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For more information:

Working with Your Doctor American Academy of Neurology Foundation The Brain Matters

www.thebrainmatters.org

Click on “Working with Your Doctor” at the bottom of the page.

Partner with Your Doctor Alzheimer's Association www.alz.org/CARE/overview/asp

Click on “Partner with Your Doctor.”

Talking to your Doctor Epilepsy Foundation:

www.epilepsyfoundation.org/answerplace/Medical/treatment/treattalking.cfm

Improving Doctor/Caregiver Communications National Family Caregivers Association www.thefamilycaregiver.org/pdfs/DrCrgvrComm.pdf

©2005 American Academy of Neurology

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