Do you struggle to ask your doctor the right questions? Do you find it confusing and are unsure what questions are important? Dr. Kimberly Bates, the Medical Director of FACES at Nationwide Children’s Hospital in Columbus, OH and academic internist and pediatrician at OSU Internal Medicine and Pediatrics Grandview, shares her recommendations for the most important questions to ask your doctor. Do you have any other suggestions? Tell us by commenting below!
10. Body Mass Index: The body mass index, or BMI, is a measure of weight for height, and lets you know if your weight is appropriate for you. A normal BMI is between 19 and 25. Below 19 typically means you are underweight, and this should lead to a discussion of your dietary intake and any medical problems that could lead to poor weight gain, including eating disorders. A BMI between 25 and 30 means you are overweight and a BMI over 30 is obese. If your BMI is above 30, you and your doctor should talk about healthy diet and exercise modifications to help you lose weight safely.
9. Medication Side Effects: Every medication has side effects, and some can be worse than others. In order to make an informed decision about a particular medication, you need to weigh the risks and benefits of the medication compared to the condition it will treat. For example, an antibiotic may cause diarrhea and vomiting but not treating your pneumonia could lead to hospitalization, a blood infection or death. Most cases are not this simple, however, you and your doctor should discuss side effects to find the proper treatment.
8. Cost of Treatment: Every year, thousands of people defer recommended health care due to cost. Most of these people do not talk to their physician about the affordability of medication and other treatments. Each person’s insurance will differ in what they cover but you can call your insurance company to obtain information about your coverage. You should bring this to your doctor’s appointment so that your doctor can help you find affordable, effective treatment. Increasingly, hospitals are posting the cost of common procedures so that patients can make cost effective decisions. You and your doctor can use that information to decide on care that you can actually afford. Remember, generally your doctor will have patients with multiple types of insurance, so it will ultimately be your job to find out the cost of care for your coverage, and to bring that information to your appointment to find out what works best .
7. Patient Centered Medical Home Certification: The National Center for Quality Assurance (NCQA) certifies a physician practice as a Patient Centered Medical Home (PCMH) if they meet certain quality criteria for the management of several chronic medical conditions. If your physician has been certified as a PCMH provider, that means they must offer a variety of services, or access to services by definition. These can include electronic medication prescribing, secure communications with your physician, care coordination, referral tracking, among other qualifications. The purpose of PCMH certification is to standardize quality among various medical providers and could be an indication that your physician is willing to go the extra mile for quality care.
6. Follow Up: Probably one of the most important questions that you can ask your doctor is “When do you want me to come back?” Follow up, particularly when chronic conditions are concerned, is vital to the maintenance of health in patients with chronic conditions. For these patients, routine health care allows you to catch progression of disease early, as well as to focus on prevention.
5. Second Opinions: If you and your doctor are not in agreement on a particular course of action, you should be encouraged to seek a second opinion. Your doctor should be willing to refer you for a second opinion without any hesitation. It is rare that there isn’t enough time to seek the advice of other providers in the field to give you a complete view of your options. If your doctor is confident in his or her skills as a provider, they will see your request as an opportunity for you to have the most information available to you, not as a slight against them.
4. Time for Discussion: Most patients don’t realize that out of a 15 minute appointment, only about five to seven minutes of that time is actually designed to be scheduled with the doctor. The rest of the time is for registration and the initial assessment by the nurse or medical assistant. So it’s important to know how much time you have for a particular discussion. If you’ve been saving up all of your questions for this one appointment, it may be necessary to request an extended appointment time when you set up the appointment, or to rank your questions so that the most important receive the most attention. Your doctor can most appropriately respond to your questions if he or she knows how many you have and the complexity. This can also be the difference between your doctor being on time to see you or being delayed (by the patient who did not read this list of 10 important questions to ask your doctor!)
3. Evidence based medicine: There are many decisions that we make in medicine that are based on lots of evidence, and some that are based on experience, or trial and error. In order to make informed decisions, it is important for you to know which decisions are based in evidence and which are not. A great way to ask this question is “How did you come up with this treatment plan?” or “Are there studies that have shown this to be a good strategy?” There is not always evidence for a particular treatment or action, but this is a good discussion for you and your doctor. Your doctor may say, “Well, there are not any studies of this but in the patients that I treat with this condition, this has been an effective method.” That is completely acceptable but should be stated clearly.
2. Experience with your condition: Particularly if you have a chronic condition, you should ask if your doctor has experience caring for patients with your condition. Now, if you have a rare medical condition, you are unlikely to find a provider who has this experience. However, your doctor should at least be able to connect you with someone (either in or out of your area) who has this expertise. If your doctor doesn’t have any experience with patients like you, then you know that you’ll need to educate each other about your condition. It’s important to get their agreement to learn with you and to give you access to what you need to improve or maintain your health.
1. Complementary and Alternative Health Care: Millions of patients use some form of complementary or alternative medicine (CAM), including supplements, acupuncture and other strategies. This is a discussion that all patients need to have with their doctor. You need to know if your doctor is open to using CAM and how these may interact with your doctor’s traditional treatments. If you use CAM and it is helpful to have a provider who is supportive of your choices.
Dr. Bates is the Medical Director of FACES (a family-centered HIV program) at Nationwide Children’s Hospital in Columbus, OH and academic internist and pediatrician at OSU Internal Medicine and Pediatrics at Grandview. She obtained her medical degree at The Ohio State University College of Medicine and her residency in combined Internal Medicine and Pediatrics at Christiana Care Health Systems in Newark, DE. Dr. Bates is also a faculty member of the departments of Pediatrics and Internal Medicine at Ohio State University College of Medicine and is active in medical student and residency education. Her professional interests include the care of young adults with chronic medical conditions, health care transitions, HIV and family centered health care delivery.