I suspect there’s few people with chronic illness of any sort, in fact, probably few people in general, who haven’t had an experience of attending a doctor’s appointment and walking away feeling heavier, frustrated, with more questions than answers, or even like it was a waste of time.  I think that feeling has grown as we have entered an era of predominantly telephone and telehealth appointments. But just how can you make the most of your attendance – and have you ever considered it from the doctor’s point of view?

Even before the pandemic, telehealth was being used and research around it showed that it was a beneficial piece in the management of chronic illness . Improved quality of life, better disease management and reduced hospital admissions recognised as key benefits. Though I am unsure if these studies covered models of “hybrid” care where telehealth and face to face appointments intertwined, or if there was a sole telehealth scenario occurring.    During the pandemic there have been some studies on telehealth, though the ones I could find were more looking at who accesses these rather than their effectiveness.

The reality is, a face to face, telephone or video telehealth appointment can all be valuable.  And the preparation is similar in each scenario.  The face-to-face appointments bring you into a physical space with much less likelihood of distraction, though always allow additional time so you don’t feel like you need to rush off from the appointment.  If you have a video or phone consultation, be sure you can step away from what you are doing to adequately talk with the doctor.  Taking a call in the car while distracted with the kids won’t leave you focused on the conversation you are having.  Pull over if necessary or have someone else pick up the kids. If you can’t take calls at work you may need to take some time off, just as you would have needed to if you were attending in person.  You can still get an attendance certificate for these.  I’m a big fan of taking an advocate, or friend, or simply a second pair of ears to appointments.  Unfortunately, in covid times this isn’t always allowed – but if you are concerned about attending an appointment on your own reach out to the relevant people (maybe nurses attached to the clinic you attend, or otherwise the admin team) and ask if you can bring someone and outline your reasons why you would like to.  They may be able to make an exception.

But what about before your appointment?  What do you need to do?  About 2 to 3 weeks before your appointment double check if you were meant to have any blood tests or scans before you see the doctor.  Prioritise getting those done-  it will be inconvenient, but having PSC or IBD is inconvenient.  Being unwell with them even more so –  yep, I get it frustrating, but necessary.

At the same time begin considering any questions you might have for the doctor.  Remember that the time your doctor has allocated to you will be small – did you know that your doctor may be seeing anywhere between 10 and 30 patients in that session alone!  On the whole they want to spend time answering your questions and providing education, but if you have a lot of questions be sure to prioritise the ones you need answered first, and what ones can wait.  It is fair if the doctor needs to wrap things up and you have more questions to ask, that you request a review a little sooner so you can continue your questions.

 Some examples of questions can be found on our friends site https://pscpartners.org/about/treatment-options/questions-for-your-doctor.html by following this link.  Depending on the stage you are at and what, if any, complications you are experiencing, you need to adjust what you need to ask.  Sometimes questions come up during an appointment, for example, as they unpack your MRCP results you may have more questions on understanding that than you knew you would before. 

Don’t shy away from asking questions about reading you’ve been doing either.  I do recommend you don’t try telling your specialist you know more than they do….but having a dialogue where you learn together can be very beneficial.  Whether you’ve heard something on facebook, a webpage or a research article, it can be an enlightening conversation when approached well.

Some people find it helpful to go to an appointment with a list of questions.  Personally, I’ve rarely done that, but prefer to come with considered options and go with what feels the most helpful once in there.  That does catch me out sometimes as I am a person who likes the pause……you know, stop and think before speaking……but often that means the doctor has moved on while I’m pausing, and I have to try to remember to circle back.

Your appointments are about your care. When both you and your doctor really “show up”, you will hopefully come away feeling a little lighter, satisfied, and with some kind of plan to follow until your next appointment.  Some appointments are simply required for ongoing care to keep things running smoothly, show up, have a chat, and accept there didn’t need to be any massive “aha” moment this time.  Those appontments help maintain connection in readiness for things not being so smooth. Having a good working relationship with your medical team(s) can definitely help lighten the drudgery of appointments and give better outcomes – so both you and your doctor will see them in a more positive light.