Doctor Visits

Your doctor needs a lot of information from you in order to make personalized recommendations for you. If your doctor doesn’t have any information from you until you show up, then much of the visit can be spent gathering information from you. Some of that information has to be collected during the visit, but a lot of that information can be collected or organized ahead of time. When the needed information is already well organized for your doctor at the beginning of the visit, then there is more time available to discuss your management plans.

Medication list

Many of your chronic conditions and any new symptoms must be interpreted in light of what medications you are taking, so complete review of your current medications is required for every office visit.

• What can you do?

  • Bring a written or printed list of all the medications (both prescription and over the counter) to your visit. Include the dose of the medication, how many you take at a time, and how many times a day you take it. For as needed medications, indicate how often you usually take it

  • Examples:

    • Lisinopril 10 mg, 1 tablet daily

    • Metformin ER 500, two tablets daily (vs. one tablet twice a day)

    • Tresiba insulin 10 units daily in the AM (vs. PM)

    • Aleve, 1-2 tablets twice a day, as needed for arthritis, usually 4 to 5 times a week.

    • Effexor 75 two tablets daily

    • Sumatriptan 100 mg, as needed, limit one per day in the even of a migraine

    • Etc.

  • Alert your doctor’s staff about any new medications or medication changes during the check in process.

• Resources:

  • (links to medication list templates coming soon...)

Routine Labs

Your doctor knows what labs are needed for monitoring your chronic conditions, and for a general health checkup. Making arrangements to have these collected prior to your visit will give you a chance to review the results with your doctor during the visit, rather than waiting on a lab letter or phone call after the appointment.

• What can you do?

  • Call your doctor’s office 1-2 weeks before your appointment to ask about giving a lab specimen prior to the appointment.

  • Alert the staff to any new symptoms or medication changes that may affect your doctor’s decision about what labs to draw.

  • Avoid food for 4 to 6 hours prior to the time your blood sample is collected. (Lab results for your blood sugar and cholesterol levels are more accurate when you have not eaten anything within 4 to 6 hours of your blood sample collection.

  • Drink half to one liter of water before you go to give a specimen (being dehydrated from fasting can also negatively affect your lab results). Black coffee +/- artificial sweetener is usually fine too, but skip the creamer.

Forms

Most doctors have a new patient questionnaire with space to write answers about your health history, and most annual exams include some standardized questions that can be completed prior to the appointment.

• What can you do?

  • For your first time to a clinic, call the office 1-2 weeks before your appointment to inquire about any forms that are required for the visit.

  • Ask if the form can be obtained online or mailed to you.

  • Bring any completed forms with you on the day of your appointment.

The format refers to how you meet with your doctor. Traditionally, you meet with your doctor in person at his or her office for primary care visits. However, insurance companies started providing coverage for new types of visits known as virtual visits during the Coronavirus 2019 Pandemic. These new visit types are helping doctors improve the way they practice medicine and are making the meeting experience safer and more flexible.

Traditional Office Visits

You communicate with your doctor’s office to schedule an appointment, and then arrive at the specified date and time to meet face to face.

Virtual Visits

You communicate with your doctor’s office to schedule a date and approximate time when you would like to connect to your doctor on a video conference or telephone call. Technically e-mail is included in this category, but most doctors use a secure web portal system for communication instead of e-mail in order to protect your privacy.

Most doctors offer appointments with different lengths of time depending on the anticipated agenda. A wellness exam for a healthy 20 year old who does not take any medications or have any active health problems is not expected to last as long as an appointment for an 85 year old with multiple active problems and over 10 medications.

New Patient (Initial Visit)

This is your first visit with the doctor.

• You will likely need to complete a new patient form prior to the start of the visit.

• Labs are not usually ordered prior to an initial visit

• An up to date medication list is very helpful.

Annual Exam

This is the time to check in with your doctor to maintain your relationship and review whether any preventive health services are indicated.

• For people with no medications and no active health problems, this is called a “wellness exam.” This is when you will be checked for common problems that may not yet have gotten severe enough for you to notice (like asymptomatic hypertension, high cholesterol, diabetes, or kidney or liver problems).

• For people with known chronic conditions that require routine monitoring, this is usually the time you get any tests that are indicated just once a year (like the diabetic foot exam or urine protein screening). Most insurance companies require a copay for evaluation and management of chronic problems, so you will likely have to pay one unless you and your doctor agree that you aren’t going to address anything at the visit except for preventive services.

• Is there a copay?

  • Most insurance companies reimburse a wellness exam at 100% with no cost to the patient and no copay because they want you to go see your doctor to find out if you have any significant health problems. Most health conditions are more costly to manage if they are not identified and treated in the earlier stages, so both you and your insurance company are financially incentivised to make sure you get regular checkups

  • Insurance companies do require a copay for any evaluation and management (E&M) services. So if your doctor is going to address any of your chronic problems during the visit, expect a copay.

  • Because the overall cost to you will be the same whether you address the wellness and E&M visits separately or on the same day, it is generally more efficient to do them together in a longer visit on the same day, rather than breaking them up into two separate visits on different days.

Routine Checkup

Some health conditions require more frequent monitoring. Diabetes, for example, is usually monitored by blood work every 3 to 6 months, even if a person is well controlled. Those planned visits that are in addition to your annual exam each year are called routine checkup or followup appointments.

• You may want to check in with your office 1-2 weeks ahead of time to prepare for the visit as above

• Alert your office ahead of time, or early into the checkin process on the day of your appointment if you have new problems or symptoms that need to be evaluated, as that may affect the logistics of your appointment.

  • For example, if you have chest pain, shortness of breath, or feel dizzy or lightheaded like you might pass out, we want to know that right away. These kinds of symptoms may expedite your evaluation, by prompting additional testing like ECGs, or chest x-rays.

Problem Visits

This is when you have a new problem that can’t wait until your next routine checkup or annual exam to address

• Talk to the nurse ahead of time to explain your symptoms and identify if there are any relevant tests that can be lined up to make your visit more efficient.

• For example, if you think you have a urinary tract infection (UTI), tell the staff so you can get a urine sample collected right away (results take just a few minutes to come back) and then your doctor can decide with you about treatment.

• Another example, if you have fever, or other acute viral symptoms, your doctor may arrange for Coronavirus and/or influenza screening prior to your arrival to the office via a drive through lab.