How to get the most from a primary care visit, family physician says

You finally got a doctor’s appointment. But once the visit begins, patients can struggle to remember everything they wanted to bring up, including questions, symptoms and medications.

Dr. Sarah Nosal, president of the American Academy of Family Physicians, told the Associated Press that even doctors find it difficult. “It is really hard — even for me as a doctor going to see my own family doctor — to remember the things that I wanted to bring up,” Nosal said. She also said the problem is that once the appointment is over, patients may realize they had additional concerns they did not mention. “You’ve lost that time,” she said.

To reduce that risk, Nosal’s top tip was to bring a list of symptoms and questions and show it at the start of the visit. The first item on the list should be the patient’s top concern, but bringing the full list helps the doctor prioritize what’s most medically urgent, she said.

Nosal said she focuses on making sure the doctor and patient quickly address whether there are any “red flag” issues. “I’m actually going to be able to see, is there a red flag?” Nosal said.

The article also described primary care as more than routine checkups meant to prevent illness. It said a relationship with a primary care provider matters for overall health and that primary care includes detecting and treating common problems such as high blood pressure, as well as helping coordinate specialty care when needed. Nosal said that ongoing relationship helps her know a patient’s “normal,” and that when something changes — or the patient feels off — the doctor and patient can work together to figure out what is going on.

Family medical history and prior records can also shape what comes up during an appointment. The article said patients should be ready to update information about close relatives’ health problems and outcomes, including patterns such as diabetes in a family or cancer at a young age. It also noted that patients may need help with forms, including vaccination and anesthesia history, and that some may have to request records from former pediatric offices or ask parents for information.

Before the visit, the article advised filling out paperwork ahead of time so patients can double-check medication bottles for the name and dose. It said that both prescription and over-the-counter medicines should be included, along with pills or creams, and it warned not to forget vitamins and supplements. The article said some supplements can interact with prescription medicines, and cited Nosal’s example of patients whose longstanding treatments stopped working after they started taking turmeric as a supplement.

The article also said patients should check whether the doctor has received records of recent lab tests, hospitalizations and visits to other health providers, noting that electronic medical records are not always automatically shared. It added that patients should start a running list of questions before checkups and follow-ups, describing symptoms in a specific way so they do not get forgotten.

The article said Nosal keeps a running list on her phone and sends it ahead of visits through her patient portal, and it advised patients to add their lists to check-in forms if that is how their appointment process works. It also said questions about mental or sexual health and wellness especially tend to come up at the last minute, and Nosal emphasized that patients should bring their list. “please bring that list,” Nosal said. “That’s the most critical of all pieces.”

Finally, the article urged patients to ask follow-up questions during the appointment, including asking the doctor to explain what else could be going on. Nosal advised patients to say, “Explain to me what else could be going on,” and then to ask, “What would be the next step? How would you evaluate that for me, to know if it’s this or that?” It also said it is acceptable to ask again about diagnoses and treatment plans — and that people can use friends or relatives for help taking notes and asking questions.

Nosal said patients of any age may forget details after leaving. “Whether you are 20 or you are 85, you will not remember everything from your medical visit,” she said.