How to Get the Most From Your Doctor's Visit with Dr. Matthew Goldman

Podcast Transcript

Nada Youssef:  Hi, thank you for joining us. I'm your host, Nada Youssef, and you're listening to the Health Essentials Podcast brought to you by Cleveland Clinic. When you make an appointment, whether it's virtual or in person, your doctor will usually ask you some questions about your health. Well, we're here to tell you that you need to ask some questions, too. Together, you and your doctor can make the best decisions about your health care and any treatment you may need. To get the attention and care you need and deserve, that encounter with your doctor needs to be as efficient as possible. So, to help us navigate through this conversation we have with us, Dr. Matthew Goldman. Dr. Goldman is a board-certified family physician at Cleveland Clinic. Thank you so much for being here with us today.

Dr. Matthew Goldman:  Thank you for having me, Nada.

Nada Youssef:  Dr. Goldman is a board-certified family physician at Cleveland Clinic, and today he's here with us to talk about getting the most out of your doctor's visit. And before we begin, please remember this is for informational purposes only, and it's not intended to replace your own physician's advice.

So, to start off, I want to kind of talk about virtual visits right now on the rise. How do I know if I should go into the doctor's office in person or if I can just do it over an iPad or a phone?

Dr. Matthew Goldman:  So, a virtual visit is a convenient way to talk to a provider when a physical exam may not be necessary. It's also a convenient way to speak to your provider without having to commute. With the recent pandemic, it's one way to remain isolated, especially if you're high risk and need to talk to a provider. It's also for circumstances where you may want to talk about things that, again, don't require a physical exam, like mental health, a simple follow-up, or if you're out of town and just need to get in touch with your provider.

Nada Youssef:  Great. So, I want to talk a little bit about preparing for a doctor's visit, basically how to set ourselves up for success, maybe before going the appointments and then during the appointment, and then after the appointments, maybe like in three parts.

Dr. Matthew Goldman:  Okay. Sure. So, talking about before the appointment, I have some main points that I'd like to talk about, and then maybe just elaborate a little bit. So, some of the main points include looking into the potential provider and doing some research online, or talking to friends and family, and then getting in touch with office staff and getting information, as well as giving information, touching base with the insurance company and considering some of the things that you want to get out of the visit.

So I'll go a little bit more into detail about each one of those. When you're doing homework or research about a provider that you're considering, talk to trusted friends and family, see what kind of things they have to say about their experiences with the provider? Go online, read reviews, see the feedback that the provider has received, look into whether or not they're certified. See if they're engaging in academic medicine. See if they've written any publications or articles. You can also find out the size of the practice and how many other providers might be sharing the care of patients within the practice. You might also want to consider your own schedule with the provider schedule.

Also, another main point was talk to office staff, get information as well as get information. You might want to contact the office and ask will you need lab work done before the appointment or after the appointment. Ask about schedule for evenings and weekends, especially if you work nine to five. Ask about forms or records that might need to be sent in. Ask what kind of things they might need, whether it's insurance information, identification, an interpreter, etc. If you think you're going to need extra time for your appointment, let them know. If you have more than just a few concerns, they may be able to accommodate you by giving you more time. If getting around and walking is an issue, maybe they can put you in a room that's closer to the waiting room.

Talk to your insurance company before you go in, find out what's covered under your plan. That way, when you're having a discussion with your provider, and they're talking to you about which blood work or studies might be needed, you'll know whether or not they'll be covered. If you're a parent, if you have pets, consider talking to somebody before the appointment to see if maybe they can look after those that you're caring for that way. That way, there's less distractions during the appointment.

Make a list about some of the things that you want to talk about. I would prioritize that list from what's most pressing to you from top to bottom. Keep a log of your symptoms. Talk about what's helped, what hasn't helped whenever possible. Take medications, supplements, vitamins, et cetera, with you to the appointment. And if you can't, take pictures or make a list of those items. If something's difficult to talk about, consider bringing a trusted companion who may already be aware of what's going on. That way during the visit, if it's tough to talk about, they can help convey some of that information.

One thing I would like to emphasize is trying to arrive early. I usually encourage people to arrive maybe 15 to 30 minutes before the appointment. That way there's plenty of time to take care of forms or checking in or handling traffic or any other potential issues that might arise last minute.

Nada Youssef:  Now, amid this pandemic, how about if it's a virtual appointment? Is there anything else that we should be doing to prepare for our visits?

Dr. Matthew Goldman:  Yeah. Great question. So, just like an in-person visit, one thing I would encourage people to do is keep their medications, their supplements, their documents, their meters, etc., Nearby and handy. That way during the virtual visit, if the prior asks you a question about one of those things, you can just reach over and take a look at it. Try to find a quiet, well lit environment. Try to avoid having light behind you, because that can potentially make it difficult to see something that you're trying to show to your provider. Sometimes there's a brief questionnaire before the visit begins, when it's virtual, that you need to fill out. So give yourself plenty of time, maybe days ahead, to do that. Make sure that your online connection is working and make sure that you're able to log in. If for any reason, you're trying to connect at the time of the visit and you can't, call the office and let them know. Maybe the visit can be conducted on the phone.

Nada Youssef:  Excellent. Now for a physician, there's a significant difference between a well visit, which is preventative, or a problem visit. Can you describe the two kinds of visits, how they're different from each other and how to prepare for each?

Dr. Matthew Goldman:  Yeah, absolutely. Typically, a preventive visit is the kind of visit where the patient is coming in for routine care, ensuring lab work, vaccines, health screenings, etc., are up to date. This is the kind of visit that's usually a little bit longer. The provider will sit down with the patient, find out what's been going on lately, talk about family history, surgical history, do a head to toe exam, make sure the patient's caught up on all the routine stuff that they might need.

A problem visit, on the other hand, is focused on one or two main issues, a rash, a cough, concerns about blood pressure or blood sugar, for example. During this kind of visit, the provider might do a physical exam that's specifically geared towards what the patient's concerned about and they might do testing that is specific for that concern as well.

Nada Youssef:  So, if we take this back to even before coming to our appointments, when we call the appointment line, are there certain questions we should be asking the scheduler that can help us for a successful visit?

Dr. Matthew Goldman:  Yeah, absolutely. So let the office know that you might need ... Again, this is sort of going back to what we talked about earlier. Just let them know that you might need extra time. You might need an interpreter. You might need accommodations if you're having trouble getting around or getting in and out of your car. Try to bring copies of records, whether it's medical records, blood pressure records, blood sugar records, etc. with you to the visit. Ask about lab work and whether or not it might need to be before the visit or after the visit. And also consider talking to the staff about an emergency contact in case there was an issue taking place during the visit.

Nada Youssef:  Excellent. So, earlier you mentioned some of the things that we need to bring up to the doctor. How important is it to know my family history when it comes to diseases and why?

Dr. Matthew Goldman:  Family history is very important. There are some diseases that people are more likely to potentially get if it runs in the family. Some diseases are passed down by generations and having that kind of information, having the whole family information, can really help the provider figure out what's going on and who might potentially be affected and what testing to do for that person.

Nada Youssef:  So does this apply to one direct family member or the whole family tree when it comes to family history?

Dr. Matthew Goldman:  So, this applies to the whole family tree. It's not just mom and dad that you want to know about, but also mom's parents and siblings, dad's parents and siblings. The more information that the provider has, the better off they'll be able to help you.

Nada Youssef:  Excellent. So, you touched on this before, but I wanted to talk about it a little bit more. Being honest with your doctor is probably one of the most important things you want to do, but opening up sometimes could be awkward, especially for certain people or after certain experiences. What tips or advice do you have for patients who are reluctant to tell their doctor personal or private information? I am aware you mentioned bringing maybe a loved one with you, but if it is kind of like a one on one conversation?

Dr. Matthew Goldman:  Yeah, so this is something we see a lot. There are a lot of people who are reluctant to talk about some of the concerns they have. They might be a bit embarrassed about some of the concerns they have. They may even feel just anxious about some of the concerns they have. Some of the advice that I give is, one, when you're in the room and maybe before, even while the provider is in the room, take a couple deep breaths, try to relax. Keep in mind that the provider is probably going to ask you some very personal questions. Don't be surprised. These questions are meant to try to help you and them figure out what exactly is going on and what to do about it.

It certainly can be a bit embarrassing, uncomfortable when somebody is taking a look at a part of your body or touching a part of your body that maybe you're not used to having people touch or look at, but ultimately this is meant, again, just to help you and then figure out what exactly is going on. And one last emotion that I would like to talk about is frustration. A lot of patients might feel frustrated seeing their provider looking at the computer screen during the encounter, but keep in mind that they're looking at your chart. They're trying to help you figure out if your medications might be the culprit, or if there's a family member who has a disease that might be related to what is going on in your situation, etc. So they are listening, but they're also trying to gather information, put it all together at the same time.

Nada Youssef:  That's a very good point. And to add to that, these private conversations that we have with our doctors stay private. This doesn't go anywhere, no matter how much detailed personal information or family information you're giving. Correct?

Dr. Matthew Goldman:  Exactly.

Nada Youssef:  Great. So, amid the current pandemic situation, many patients maybe wondering what to expect when they go into any Cleveland Clinic facility. Can you kind of explain what kind of changes we should expect walking into a Cleveland clinic facility today? And is it safe?

Dr. Matthew Goldman:  Okay. Yeah. Great question. The Cleveland Clinic is doing a great job in trying to keep both staff and patients safe. There are changes during the pandemic that are constantly occurring, and so the policies are constantly changing as the situation evolves. There's temperature checks happening. They're asking about symptoms as people walk in. They're limiting the number of people that enter the buildings. They're asking about travel history. All visitors required to wear a mask unless there's a health or behavioral condition that might be preventing them from doing so. There's also hand sanitizer stations. These guidelines and policies that are in place are being monitored along with the rates of COVID-19 and being adjusted as a result. You may want to contact your provider for any specific questions or concerns that are related to visiting a Cleveland Clinic center. And to answer that last question, I think it's as safe as it can be given the circumstances.

Nada Youssef:  Thank you. Thank you for that. So, a doctor's appointment isn't usually a onetime thing. It's part of an ongoing relationship. If you realize that maybe I overlooked a very important question or have trouble following up my doctor's advice, is it okay to call the office and follow up? Or would I need to make a follow-up appointment? And I ask that because I see many people maybe are a little flustered when they're talking to the physician, especially as you mentioned if it's something personal, and then as soon as you leave, you're like, I didn't ask the important question. Is it okay to follow up with a phone call or should I make another appointment?

Dr. Matthew Goldman:  Yeah, that's a great question. How many times do we leave the doctor's office or the provider's office and realize that we forgot a question or concern? We hear it all the time and I think it's absolutely okay to reach out, whether it's online or through a phone call, and just say, "Hey, I forgot to ask you this." Or, "Hey, I wanted to mention this." All of the information that the provider gets is useful in potentially helping you figure out what the next best step is.

Nada Youssef:  Excellent. And that's all the time that we actually have for today. Is there anything else you would like to add?

Dr. Matthew Goldman:  The last two things I'd like to add is, in general, I think it's really important to remember that the office staff is there to help you. So, treating them with courtesy and respect is very important. Having cooperation between the patient and the staff that helps the provider goes a long way. And the last thing is I just want to thank the Cleveland Clinic and you guys for helping me put this together.

Nada Youssef:  Thank you so much, Dr. Goldman, for all this information. It's been great. Thank you.

If you've never done a telehealth visit before, now might be the perfect time for you. It's a great option to get the care that you need while taking the steps to keep yourself and your community safe. You can make a virtual appointment by going to clevelandclinic.org/expresscare or for an in-person appointment, you can call (216) 444-2273.

For the latest health news and information from Cleveland Clinic, make sure you're following us on Facebook, Instagram and Twitter, username @clevelandclinic, just one word. Thank you so much for tuning in and we'll see you again next time.