Avoid bringing long lists to your GP, says Lucy O'Hagan. Photo: lucyohagan.com
You only get 15 minutes at the GP, so how do you make the most of it? Write a list, save up your ailments, do a quick Google beforehand?
Sunday Morning spoke to GP, medical educator and writer Dr Lucy O'Hagan to find out how to get the most out of your doctor appointment.
O'Hagan trains student general practitioners in consultation and communication skills, which is a "fascinating job".
"I get to watch about 100 to 150 consultations a year. Some of them are live, some of them are videos, some of them are role play or consultations with actors."
A 15-minute GP appointment can be challenging, both for the doctor and the patient, she says.
"We don't actually have a sense of the sea of humanity that walks through the doctor's room and how different patients are and where they are in their life and and how they're gonna manage that."
The question of how to get the most out of an appointment "assumes the patient is comfortable in the health service, they have a sense of capacity, they're feeling pretty well and can articulate things, they feel safe and trust the doctor and have a relationship with them".
"If I do a consultation with a 70-year-old farmer's wife from Tarras, that's a very different consultation to a 70-year-old Tokelauan woman who speaks English as a second language. So it's a complicated business."
It was vital that GPs did not judge their patients for anything disclosed, she said, and be aware of their more powerful position.
"We talk about using that power wisely and kindly because it has a therapeutic power as well, but ... we also have the power to humiliate and judge people. And I think sometimes those are the things that can go wrong."
Don't bring a long list
Before you go to your appointment O'Hagan recommends thinking carefully about what a doctor can help with.
"People often have a list and it's quite problematic for the GP because you have to then prioritise which one you're gonna put the most energy into, and then the other [items] only get a limited amount of time.
"You often get to the end and the person feels like they're a bit confused and they haven't quite got an answer to everything."
Don't leave the real problem to the last minute
If patients do bring a list of issues, O'Hagan tells trainees to get it out of the way early, so that they can triage what is most important.
"When people present their list, they present the less concerning, less shameful things first, so we've got to get to the bottom of the list in order to work out how you're going to spend your time."
Do know what you expect out of the consultation
"You might have been on Doctor Google, so you've got a whole lot of ideas about what might be wrong, or you've talked to Auntie Mary, or your wife's worried about something.
"So you might be expecting to get an X-ray and you don't get it because you haven't actually said so.
"It's much easier for the doctor - and the consultation goes much better - if you actually state those things."
Do change doctors if they're not working for you
Although O'Hagan acknowledges it can be difficult to register with a GP practice in the first place, she encourages patients to switch doctors if you feel you're not getting what you want.
"Doctors are all different, as well as patients being different. So if you have a doctor that you don't really relate to and you're not getting what you want, then you can usually change within the practice. I think it is really important that you resonate with the doctor that you see."
Do prepare for GPs to ask you lots of questions
GPs go into "doctor mode", O'Hagan says, and start asking closed questions to get a diagnosis.
"You can almost anticipate what they're going to be. They're gonna ask you how long have you had that symptom? When did it start? Does anything make it better or worse? Have you tried anything for it? Are there any other associated symptoms? So it's quite useful if you've thought that through ... because you can get a bit flummoxed.
"It's actually quite useful to write a timeline [of symptoms] down. We don't want a 50-page essay but if you've got some bullet points ... you could hand them to me and then, when you've gone and I'm writing up the notes, I've actually got it clear in my head about what happened when."
Do summarise your visit at the end
At the end, it can be helpful for patients to state what they understand is happening next.
"Sometimes if the plan is really complicated, I actually text it to the patient because if you're gonna have a blood test and then someone's gonna call you about an x-ray, and this is your follow-up appointment and I want you to stop this pill and start that pill - that's quite a complicated plan. It would be very easy for that to get very confusing."
Do bring a friend or whānau
The above point is why O'Hagan thinks it's "magic" when a patient brings along a trusted friend or family member, "because you've got two people to ask questions and to listen, and for the doctor you've got collateral information.
"So the guy who says he has the odd pie for lunch, his wife rolls her eyes and say, 'He eats two pies a day.'
"Or the person who comes in and says they're a bit stressed at work, when they come in the next week with their wife, the wife goes, 'Oh my God, he's in such a bad way, he can't go to work', that is really useful."
Don't forget about other healthcare providers
Not everything on a list of ailments needs the attention of a doctor, she says.
A STI check or cervical smear could be done with the GP practice nurse, and you could see a podiatrist for ingrown toenails, for example, or go directly to an optometrist or physiotherapist.
Pharmacists could help with a range of issues, too - especially if people are struggling to get into their GP.
"I was speaking recently to a pharmacist in Upper Hutt who's employed two nurses in her pharmacy. They do an initial assessment then [if necessary] they go into a virtual consultation with a doctor.
"Primary healthcare is changing rapidly and you have a lot of options. So I think my GP colleagues would say please don't bring the long list."
Do use online tools
A call to Healthline on 0800 611 116 can help you decide whether you actually need to see a GP, and Healthify - formerly Health Navigator NZ - is also useful "because GPs use it all day, every day", she says.
