"Help me ... help you. Help me, help you."
That famous line from the film Jerry Maguire may be the best advice a doctor could give his or her patient.
"Some patients have the attitude, 'I'm putting myself in the hands of a professional,'" says Stephen Permut, MD, chairman of family and community medicine at Temple University School of Medicine in Philadelphia. "They want you to make all their decisions for them."
Permut prefers to have patients get involved in their own care and engage the doctor in a cooperative effort to determine the best course of action.
So if you want to help your doctor help you, you need to help your doctor. Here's how.
1. Prepare for your doctor visit in advance.
A recent review of 33 studies showed that patients who filled out a detailed checklist before an office visit, or received in-office coaching that focused on their health status, asked more questions during their doctor visit and got more satisfaction from the visit.
"Keep a symptom diary," advises Terrie Wurzbacher, MD, a Navy physician for more than three decades and author of a book titled Your Doctor Said What? Exposing the Communication Gap.
"You may think you can remember everything," says Wurzbacher, "but by the time you get to see the doctor you will have forgotten the majority of what you wanted to tell the doctor, and it's important for the doctor to know the progression of the problem. Be specific. Explain that it all began with belly pain, and then you developed diarrhea, and so on."
Write down all of your medical problems, and also the names and the dosages of the medications you're taking. Once you've written it all down, make a copy and give it to the nurse when you arrive for your doctor visit. She'll add it to your medical records.
"You know the doctor is going to look at that before seeing you," says Wurzbacher.
2. Explain how you're feeling.
You know better than anyone else how you feel, and that information is vital to your doctor. That's why Permut prefers to take a patient's medical history himself.
Has your appetite increased or decreased? Are you having trouble sleeping? Do you have any pains? How's your mood? Your sex drive? Are you feeling unusually tired?
"I prefer to see the reaction on their face when I ask the questions," he says. "A bunch of studies show that 85 to 95 percent of diagnoses can be made by the medical history alone. Listening is what being a physician is all about. It's amazing what you can accomplish in 10 to 15 minutes."
3. Know what medications you're taking.
Are you taking any prescription drugs? If so, make sure you know the name of each drug, the dosage you're taking, and the number of times a day you take it. "That includes herbal remedies and over-the-counter drugs, too - even multivitamins," says Permut.
Also let the doctor know about medications you have tried that caused side effects or didn't work.
"The patients who frustrate me the most are the ones who talk to me about their little white pill, or the triangular pill," Wurzbacher says. "They don't know what their medications are or what they're for."
4. Be honest, and don't leave out details.
"I want to know everything medical that has happened to a patient," says Permut. That includes the removal of any organs. That may not seem like something a patient could forget, but outpatient surgery makes some procedures so simple that patients do forget.
"Gallbladder surgery, for example, used to be a big deal that required a lengthy hospital stay and left you with large scars," Permut says. "Now you wind up with three or four half-inch scars and go home from the hospital the same day. You might forget to tell doctor you had your gallbladder out."
Also tell the doctor everything that you're doing that could affect your health. Are you taking laxatives? Are you on a diet? How much exercise do you get? Are you using a sleep aid? How much alcohol do you drink? "If you're using illegal drugs, I need to know that also. A visit to the physician is totally confidential," emphasizes Permut.
Are you under stress? Have you ever endured extraordinary stress?
"I want to know about any emotional stresses that may have changed people's lives -- the loss of a child or a spouse, job setbacks," Permut says. "I want to know about anything that might have had a powerful effect on the patient."
5. Don't be embarrassed -- your doctor has heard it all.
If you're planning to discuss a personal topic, one way to avoid nerves is to practice what you plan to say in advance.
"It's like public speaking, once you get it out of your mouth it's easier to say," says Wurzbacher.
"Once you've said it to your mirror a few times, it's easier to say, 'I've had this vaginal bleeding.' Rest assured," says Wurzbacher, "the doctor probably has heard everything you're going to say at least 10 times before."
6. Keep an open mind.
The patients Permut finds most troubling are those who come in with a fixed idea about the treatment they should receive.
"They'll say, 'I'm having headaches, and I want an MRI,' and they won't be happy unless you arrange that for them," Permut says. "But if you take the medical history and conclude that they're almost certainly tension headaches, an MRI would be a waste of resources. One of my colleagues used to say that it takes 5 seconds to say yes and 15 minutes to say no, but I think you have to take the time to educate patients about what the issue is and what your plans are for ordering tests down the line."
7. Write it down.
Once you're with the doctor, take notes in case you want to look something up, or bring someone with you to provide a second set of ears. Write down the names of any medications the doctor prescribes. And don't hesitate to ask questions.
