You have taken the important step of making that doctor's appointment you've put off for too long. Perhaps you've even scheduled it out a few weeks, hoping that something will come up and you'll be able to put it off a bit longer still. For many, even a routine visit to the doctor causes anxiety. But we all know that ignoring symptoms and avoiding needed care can lead to more serious health issues.

These tips for opening up a two-way conversation with your doctor may be the prescription for raising your comfort and confidence. Your doctor will want to know:

1. Your questions. Its a good idea to spend a few minutes before a visit to jot down all of your questions, symptoms and concerns in a notebook reserved exclusively for medical visits. Take the notebook with you and write down the answers as you are talking things over with your doctor. (The tech-savvy among us can gather and keep medical records right on their favorite hand-held device, making it especially easy to keep everything up to date — and in one place.) Ask your doctor for advice about resources you may find helpful, such as books, audio, video and websites. Ask your doctor for advice about resources you may find helpful, such as books, audio, video and websites. Discuss with your doctor the latest results of your online health assessment. Take the most recent printout with you.
2. Your medications. Let your doctor know about all the medications that you are taking. This includes medicine prescribed by other doctors, as well as all over-the-counter medications (including vitamins and herbal supplements).
   If you are on a complicated regimen, consider making a wallet card that includes the names of all your medication, including dosage and quantity taken each day. At least once a year, take all of your medications with you to the doctor for an assessment.
3. Your allergies. Tell your doctor if you have ever had a reaction to a prescription medication or over-the-counter product. Also share information about significant food, insect bite, or other allergies.
4. Your family history. Your doctor will want to know specific information about medical problems that affect blood relatives, especially your parents, brothers and sisters, and children. Medical problems in grandparents and cousins are also important, though slightly less so.
5. Your health habits and exposures. Your doctor will want to know about other factors that affect your health. Common areas of concern include:
   • Tobacco use, including cigarettes, cigars, snuff and chewing tobacco
   • Alcohol and drug use
   • Sexual practices, especially those that increase your risk for HIV and other sexually transmitted diseases
   • Exercise and pattern of physical activity
   • Diet — what you do and don't eat
   • Occupational exposures, e.g., asbestos, solvents, lead paint
   • Accident prevention — whether you wear your seat belt in the car, or wear protective equipment when you ride a bike or skate
6. Your body's functions. To gather more information, your doctor may ask a series of questions about your bodily functions. This may include whether you've experienced problems with joint pains, bowel habits, or sexual function or experienced headaches, chest pains, shortness of breath, indigestion, etc.
7. Your vaccinations. Depending on your age, medical problems and occupation, your doctor may recommend a variety of vaccinations including tetanus, influenza, pneumococcal pneumonia, and hepatitis B. Travelers to developing countries may require additional special vaccinations.

What to Expect during a Physical Examination

At almost every visit your doctor will want to examine you. Sometimes this can be as simple as measuring your blood pressure or looking in your ears. On other occasions this may be a complete "head-to-toe" exam. Depending on your age and symptoms, your doctor may choose to perform only selected parts of this examination:

• Measuring your height and weight (which can be used to calculate your body mass index, or BMI)
• Checking your blood pressure and pulse
• Examining your skin for moles and rashes
• Checking the lymph nodes ("glands") around your neck and under your arms
• Looking in your ears
• Checking your vision and looking in your eyes
• Checking your teeth, gums and throat
• Feeling your thyroid gland (at the base of your neck)
• Listening to the blood vessels in your neck
• Listening to your lungs
• Listening to your heart for murmurs or irregular beats
• Feeling your abdomen for lumps, areas of tenderness or enlargement of internal organs
• Examining your joints
• Checking the alignment of the spine
• Checking your reflexes and sensation
• Checking your reproductive system
• Assessing your memory and mood

Are Screening Tests Routine?

Many people expect that a routine visit will include blood or urine tests or other examinations such as an electrocardiogram (EKG), stress test, or chest X-ray. While your doctor may recommend such tests, they certainly are not necessary for every person or at every visit. If you've had X-rays, tests or medical procedures performed elsewhere, you can ask that copies of your films and results be sent to your primary care office so your medical records are complete.

Your Doctor's Sage Advice

Even if you feel healthy and your examination is normal, your doctor may make lifestyle improvement recommendations to help lower or manage your risk factors. Your doctor should be a trusted advisor in your life. Talking openly about topics you may consider to be embarrassing or uncomfortable is never easy, but it can lead to better health — and a healthy relationship with your doctor. Anything you tell your doctor is confidential.

It's Your Responsibility to Follow Up

If a prescription isn't working as it should, if you aren't improving as expected — or are getting worse — if you had tests but weren't contacted with the results, if you find you really didn't understand what you were told, call the doctor. If you are expected to make an appointment with a specialist or a lab, do it right away so you don't forget. (Avoid a costly surprise by calling the toll-free number on your health plan member ID card or reviewing your summary plan description before you go to be sure you will receive coverage.)

You may be counting on your doctor to keep you healthy, but your doctor is also counting on you to provide all the information necessary to treat your physical, emotional and mental health needs. Learning to talk openly with your doctor is an easy way to open a world of better health for you and your family.

More and more, health care in the U.S. is defined by specialty care and high-tech procedures focused on curing, rather than preventing, disease. According to many health care experts, however, the focus should shift back to primary care doctors, who serve as the first line of defense against serious illness and disease. By allowing your doctor to know you well, he or she can practice preventive medicine that may help you better manage your risk factors.

For more ideas about communicating well with your doctor:

Visit www.intelihealth.com to Ask the Expert, and read up on the very latest in health news. This includes consumer information from Harvard Medical School.

U.S. Agency for Healthcare Policy and Research
2101 E. Jefferson St., Suite 501
Rockville, MD 20852
Telephone: (301) 594-1364
www.ahrq.gov/ppip/adguide/

American Academy of Family Physicians
11400 Tomahawk Creek Parkway
Leawood, KS 66211-2672
913-906-6000
www.familydoctor.org

American College of Physicians –
American Society of Internal Medicine
190 N Independence Mall West
Philadelphia, PA 19106-1572
800-523-1546, x2600
215-351-2600
www.doctorsforadults.com

As part of your UPS-sponsored health plan benefits, UPSer’s and their spouses covered by the medical benefits plan can take a health assessment that offers an in-depth assessment of your lifestyle and factors that impact your health status. This will give you an opportunity to see your health in a big picture. Doing so can help you prioritize the kinds of health changes you may need to consider, and which health changes you may be ready and confident to make.

Click here for more information on the Health Assessment.

Source: Institute of Medicine, "To Err Is Human: Building a Safer Health System," 1999