Chapter 7: Top Five Things To Do Before You See Your Doctor
We want to be healed. We want to be heard. We want our doctors to care about doing both. We deserve it.
But healthcare in America can make that challenging for all parties. It’s designed to treat both the patients and the practitioners like nameless cogs in a factory. Intake forms, tests, and preventative screenings take up most of an adult’s annual visit. Doctors have computer screens with lists they need to run through and check off. One of my former primary care physicians (PCP) used to say, “Let’s just get through this BS and then we can talk.”
There’s a saying among patient safety and quality improvement folks: “Every system is perfectly designed to get the results it gets.” American healthcare wasn’t originally mostly about money but it is, now. The corporatization of healthcare, aka the profit motive, has changed the power balance for all of us. Because of this, most PCPs have limited time in the day to examine each patient. Physicians spend 12 to 24 minutes with each patient and another 16 minutes on the computer per patient entering data. So, what does this mean for us?
It means the patient is responsible for helping make the visit as productive as possible. Here’s a list of five things you can do before you see your doctor to help improve your chances of getting an accurate and timely diagnosis. These five steps are simple and practical and work for every body.
Step One: Pay Attention To Your Body
It begins when you recognize you have a health issue. Whatever is bothering you, you know your own body and if something is off. Take charge of your care by bringing your concerns to a professional. In Chapter 3, I shared a Diagnostic Process Map. The very first two parts of that map are titled:
1. Patient experiences a health problem
2. Patient engages with the health care system
Nothing happens until you begin the process. The first move is yours.
Step Two: Keep Your Medical Info Digital And Use It
Chapter 2: The Very First Thing You Should Do, Today details what information you should keep readily available on your phone’s Medical ID or Safety app. Do it. Seriously. Now when you’re healthy and keep it updated. It’s harder to do when you’re feeling lousy.
When you make a doctor’s appointment, ask if they provide their intake forms online. An intake form is what the receptionist hands you; those four to six pages with tiny spaces on both sides, stuck on a clipboard with a million questions to answer. I have Reynaud’s which makes my hands hurt and my handwriting degenerate as I try to cram essential medical background info into those impossibly small spaces. I end up writing around the margins. That’s always a recipe for error, mine and theirs.
Don’t wait until you’re there to fill that out. Copy and paste the data from your phone’s Medical ID and fill it out online. I print those pages in case the forms I filled out online didn’t make it to the medical practice or the receptionist. It happens. If you have a smart watch that tracks health data, like your heart rate, print that info out, too. This way the only thing you have to do in the waiting room is sign the federally required HIPAA form.
Step Three: Record Your Symptoms
While your doctor may be an expert on diagnosing and treating your health conditions, only you are an expert on what your symptoms feel like and what your body is telling you. The list may be brief and easy to explain to a doctor. However, for most patients I meet, the list of symptoms feels hard to untangle.
Start broadly by writing your symptoms down and what’s important about them. See if your symptoms can be grouped by location. Head, back, chest, stomach, arms, etc. Think about when each began.
I admire the work of John Ely, MD, MSPH, Professor Emeritus of Family Medicine at Carver College of Medicine. He taught medical students to ask patients eight important questions about their symptoms, in a Who, What, Where, When format. With his permission, I’ve adapted it into a simple tool that you can download and use.
It asks for brief answers to essential questions like:
Where is the problem? Does it stay in one place or move?
When did it start? How long does it last? How often does it happen?
Is it changing? Has it been getting worse or better or is it about the same?
How severe is the symptom? On a scale of 1 to 10.
What makes it better? What makes it worse?
The answers will help your healthcare provider narrow down what could be causing your concern. Write them down in the spaces provided. The boxes are small to help you keep it brief (see Step 5). Then print it out and bring it with you to your appointment. Hand it to your doctor or use it as an outline for discussion.
Step Four: Learn More About Your Symptoms
It’s not unusual to have to wait days, if not weeks or longer, for a doctor’s appointment. Use your time wisely by learning more. Many of us turn first to “Dr. Google:” looking up our symptoms online or finding information on social media. Nearly 59% of Americans have conducted health searches online.
Some doctors scoff but learning more about your symptoms can help you better describe them, put what you’re experiencing into context and prepare a list of questions to ask the doctor after she has examined you.
Of course, checking your symptoms online can be very helpful or terrifying, depending on how and where you do it. Type in “headache” on your browser of choice and the top three conditions that will show up are brain tumor, aneurysm, and cancer. That’s enough to cause a headache.
Instead, search reliable, informative websites. There are many to choose from. Start with top healthcare websites like Healthline, WebMD, Johns Hopkins Medicine –– which is organized by body part and condition –– and the Mayo Clinic –– which has a health library organized by symptoms or conditions. For parents, the top websites are Baby Center, Kids Health (plus Teens Health for your older children to visit on their own), and the American Academy of Pediatrics’ site Healthy Children. Normally, I would recommend federal government healthcare websites as reliable resources but they’re all undergoing radical revisions. I’m putting a pin in them for now.
Step Five: Prepare To Tell Your Story In 3 Minutes
This is the hardest step! You’ve written up your symptoms, you have your medical history on hand, and a list of questions. Your doctor will ask, “Why have you come today?” What will you say?
A patient advocate I admire recently told me she has been rejected by several primary care doctors because her issues were “too complex.” Perhaps her presentation was too complex, I suggested. Limit your list of symptoms to what is most worrisome and reframe it. What did you feel like before any symptoms began? How are you now? How does it affect you?
Editors always tell writers, “Don’t bury the lede.” The same goes for your personal health story. What is your headline? What is your opening sentence? Put it into context. Dr. Ely says give them a short paragraph, not a novel. Here’s a motivating statistic: The average patient is interrupted by the doctor in just 11 seconds. So make the most of your time.
A parent might say, “My daughter usually is very energetic, but for the past week she is quiet and complains of back pain.” An adult child of a senior might advocate by saying, “Until a few weeks ago, Mom was independent, driving, and handling her finances. Now she is suddenly confused and having memory issues.” If your story covers months or more, create a timeline story to show progression or spread. For example: “I began having headaches in November. Perhaps weekly, then daily by December. The pain level has grown from a 2 to a 6 [out of 10 on the pain scale]. By January, the pain interfered with my ability to work and read. Evenings were worse. Now, I wake up in the middle of the night with pain and can’t fall back to sleep.”
Many patient advocates will tell you to practice describing your symptoms. It might feel silly but grab a friend or a family member and run-through your story. Or do it in front of a mirror. Keep it brief; three minutes or less is a good goal. Emphasize why you are concerned and how is this affecting you.
Once the doctor gets the gist of your situation, she’ll ask you questions, suggest tests and/or treatments. The idea is to start a dialogue that leads to an accurate diagnosis and effective treatment.
Next Up, Chapter 8: Specialists Have Blind Spots. How To Avoid Being Harmed By Them.
© Helene M. Epstein 2025
By far the hardest step will be keeping things within 3 minutes. But I can completely see what it's so important. Thank you for this, Helene. I hope more people are conscientious enough to take charge of their healthcare (to the extent they can) long before there's a crisis.