As usual, Dr. McBride, you are right on, inviting,encouraging and engaging as well as informative. I would like to add one more way to enhance one's medical appointment.
Go with an open mind, be curious and want to learn in order to enrich your own life. Essentially you are in charge of your own health and the more you know, intellectually and emotionally, the better prepared you are enhance your health and healthy behaviors and attitudes. ellen sirkis
Yes, open mindedness is key! I think it's easy to think that we already know everything we need to know about health.. that we already have all the answers, and that we just need the doctor to execute on OUR plan.. But hopefully our doctors are able to think more broadly about our health than we can - and push us in ways we didn't even know we needed to be pushed ... stretching our definitions of health is step 1 in health "optimization." Thank you for this, Ellen! You always make me think :)
I appreciate the post. My primary care physician retired and I have a new doctor. The first meeting went very well, I likee him, but he was leery of refilling my PRN Klonopin prescription for acute stress. I didn’t push the issue -- I still had plenty and I use them sparingly (1 - 3 tablets per month, depending on how work is going in cybersecurity). However, I’m girding myself for my next follow up appointment. My refill record should be adequate proof that i am not abusing it. I don’t want to have to establish a relationship with a psychiatrist simply to get an anxiolytic prescription refilled twice a year. I’m going with kindly request that he refill my prescription, and if he refuses, express my displeasure with kindness. The question though for me is whether I will continue with this doctor. The drug is legal, and I’ve been using it for years, I know the risks, and it works for me. I’m already ticked off that I’m worried about having to gird up for this conversation.
I think it's important for you to understand each other first and foremost. Whether it's about prescribing medication or making any other medical recommendation, doctors take an oath to first do no harm.. and while it's easy to assume that doctor are gatekeepers, a good physician is someone who understands the problem you are trying to solve in the first place. If it's acute stress, he may want to discuss a broader set of tools to help manage the issue. Indeed, medications are only a small piece of a larger arsenal of tools we can offer patients to manage acute stress. That said, no one wants to deprive patients of things that they *know* works well for them! Our job is to meet people where they are but also to zoom out on complex problems and to avoid the easy trap of thinking that medication is necessary *and* sufficient for complex problems... cultivating a relationship w your doctor where you trust each other is the key to getting what you need.. which is more than just a prescription :)
Follow up. My appointment went fine. I shared my concerns including that my cybersecurity job is at times very stressful, and that I have habits in place to manage anxiety. Also, that my prescription will last me for months. He agreed to manage it, he was great! I got worked up over nothing.
I'd love a tip on finding a good doctor in the first place! We don't have a regular GP, and while we're fortunate to be healthy enough not to need regular care, it would be nice to have a consistent health care provider.
Yes you def need a good GP! We all do. This is something I plan to write about soon - what to look for in a GP and how to get more of what you need out of the experience - stay tuned!
Your perspective on visits with my PCP and cardiologist came at just right time. It’s most recent that I am now dependent on cardiologist to help map out my health progress. Immense thanks to you.
As a person who lives in a state/province that has recently passed laws forbidding medical professionals from practicing medicine, what advice would you offer? How is it possible to have any trust in medical professionals who are now subject to fines, incarceration and the loss of their license/certification should they say or do anything that’s in conflict with the current administration/political ideology?
Ooooof. I have lots to say about this. The health care systems in the US and Canada are broken. We are living in a trust DESERT. There are no easy answers. This is (in part) what I am writing about in my forthcoming book... :)
Also, when you suggested people could say “thank you” at the end of the appointment to their doctor I almost laughed...you mean some people DON’T?!?” I can’t imagine this. But, I am Canadian. We say thank you all the time.
Thank you for this message with great advice! One year ago we (both retired) moved to Dover, DE where there's a huge influx of seniors and health systems struggling to keep up. Hubs has hypertension and my recent labs showed a FBG of 99 (not the first time) and slightly elevated lipids. My K was 5.8. We are very motivated for healthy longevity but the provider we ended up with (part of the largest system) stated he's "hyperfocused on his numbers", after changing his dose, and did not suggest follow-up. And after I explained my mother's history of hypertension, diabetes and cancer, I was told to just relax because I'm fine. It took her 2 weeks to message me about having the K repeated. There's more but you get the idea. I came down with a cough and due to lack of response from that provider, ended up with pneumonia. We are now with a PA, not connected to that System. So far so good. She's been on top of treating me!
I agree with what Jill wrote! Thank you for a straight forward piece with great advice. I’ve always taken a list because I sometimes feel nervous and worry I’ll forget something and also my doctors seem to appreciate that we can move efficiently through the appointment.
Thank you! I really appreciate this post! I really enjoy your authenticity and willingness to show your own vulnerabilities. As a recovering people-pleaser myself, I find myself sometimes working hard to appear ok when I am not. Hearing it’s ok not to be ok helps me a lot!
Great post! I really appreciate your perspective. It’s so helpful to know you feel the same when you’re at your appointments. It’s nice that you mentioned it’s okay to be vulnerable etc., sometimes life gets a little rough around the edges. You sound like an awesome physician and your patients are lucky to have you!
This was very nice. My PCP is wonderful but I had to find a new cardiologist to feel more understood. Your writing is so uplifting. Please, do not forget the seniors!
Great comments. I was 20 minutes late for my annual physical last year. He was busy. It was a ten minute appointment plus time for drawing blood. I will get there half a hour early this year. I will make it tomorrow
As usual, Dr. McBride, you are right on, inviting,encouraging and engaging as well as informative. I would like to add one more way to enhance one's medical appointment.
Go with an open mind, be curious and want to learn in order to enrich your own life. Essentially you are in charge of your own health and the more you know, intellectually and emotionally, the better prepared you are enhance your health and healthy behaviors and attitudes. ellen sirkis
Yes, open mindedness is key! I think it's easy to think that we already know everything we need to know about health.. that we already have all the answers, and that we just need the doctor to execute on OUR plan.. But hopefully our doctors are able to think more broadly about our health than we can - and push us in ways we didn't even know we needed to be pushed ... stretching our definitions of health is step 1 in health "optimization." Thank you for this, Ellen! You always make me think :)
We are on the same team!
I appreciate the post. My primary care physician retired and I have a new doctor. The first meeting went very well, I likee him, but he was leery of refilling my PRN Klonopin prescription for acute stress. I didn’t push the issue -- I still had plenty and I use them sparingly (1 - 3 tablets per month, depending on how work is going in cybersecurity). However, I’m girding myself for my next follow up appointment. My refill record should be adequate proof that i am not abusing it. I don’t want to have to establish a relationship with a psychiatrist simply to get an anxiolytic prescription refilled twice a year. I’m going with kindly request that he refill my prescription, and if he refuses, express my displeasure with kindness. The question though for me is whether I will continue with this doctor. The drug is legal, and I’ve been using it for years, I know the risks, and it works for me. I’m already ticked off that I’m worried about having to gird up for this conversation.
I think it's important for you to understand each other first and foremost. Whether it's about prescribing medication or making any other medical recommendation, doctors take an oath to first do no harm.. and while it's easy to assume that doctor are gatekeepers, a good physician is someone who understands the problem you are trying to solve in the first place. If it's acute stress, he may want to discuss a broader set of tools to help manage the issue. Indeed, medications are only a small piece of a larger arsenal of tools we can offer patients to manage acute stress. That said, no one wants to deprive patients of things that they *know* works well for them! Our job is to meet people where they are but also to zoom out on complex problems and to avoid the easy trap of thinking that medication is necessary *and* sufficient for complex problems... cultivating a relationship w your doctor where you trust each other is the key to getting what you need.. which is more than just a prescription :)
Follow up. My appointment went fine. I shared my concerns including that my cybersecurity job is at times very stressful, and that I have habits in place to manage anxiety. Also, that my prescription will last me for months. He agreed to manage it, he was great! I got worked up over nothing.
So good to hear! Thanks for the follow up :)
I'd love a tip on finding a good doctor in the first place! We don't have a regular GP, and while we're fortunate to be healthy enough not to need regular care, it would be nice to have a consistent health care provider.
Yes you def need a good GP! We all do. This is something I plan to write about soon - what to look for in a GP and how to get more of what you need out of the experience - stay tuned!
This sounds like a great topic to write about in the future! Since the pandemic, it seems harder to find a GP who is taking new patients.
This was helpful! Thank you for sharing!
Great tips! Thanks!
Your perspective on visits with my PCP and cardiologist came at just right time. It’s most recent that I am now dependent on cardiologist to help map out my health progress. Immense thanks to you.
Glad it resonated!
Love this Dr. McBride. That’s why I’m so glad you’re my doc.
As a person who lives in a state/province that has recently passed laws forbidding medical professionals from practicing medicine, what advice would you offer? How is it possible to have any trust in medical professionals who are now subject to fines, incarceration and the loss of their license/certification should they say or do anything that’s in conflict with the current administration/political ideology?
Ooooof. I have lots to say about this. The health care systems in the US and Canada are broken. We are living in a trust DESERT. There are no easy answers. This is (in part) what I am writing about in my forthcoming book... :)
Good advice, thank you.
Also, when you suggested people could say “thank you” at the end of the appointment to their doctor I almost laughed...you mean some people DON’T?!?” I can’t imagine this. But, I am Canadian. We say thank you all the time.
So nice. Yes, saying thank you is so easy and FREE!!!
Thank you for this message with great advice! One year ago we (both retired) moved to Dover, DE where there's a huge influx of seniors and health systems struggling to keep up. Hubs has hypertension and my recent labs showed a FBG of 99 (not the first time) and slightly elevated lipids. My K was 5.8. We are very motivated for healthy longevity but the provider we ended up with (part of the largest system) stated he's "hyperfocused on his numbers", after changing his dose, and did not suggest follow-up. And after I explained my mother's history of hypertension, diabetes and cancer, I was told to just relax because I'm fine. It took her 2 weeks to message me about having the K repeated. There's more but you get the idea. I came down with a cough and due to lack of response from that provider, ended up with pneumonia. We are now with a PA, not connected to that System. So far so good. She's been on top of treating me!
I agree with what Jill wrote! Thank you for a straight forward piece with great advice. I’ve always taken a list because I sometimes feel nervous and worry I’ll forget something and also my doctors seem to appreciate that we can move efficiently through the appointment.
Thank you! I really appreciate this post! I really enjoy your authenticity and willingness to show your own vulnerabilities. As a recovering people-pleaser myself, I find myself sometimes working hard to appear ok when I am not. Hearing it’s ok not to be ok helps me a lot!
Great post! I really appreciate your perspective. It’s so helpful to know you feel the same when you’re at your appointments. It’s nice that you mentioned it’s okay to be vulnerable etc., sometimes life gets a little rough around the edges. You sound like an awesome physician and your patients are lucky to have you!
This was very nice. My PCP is wonderful but I had to find a new cardiologist to feel more understood. Your writing is so uplifting. Please, do not forget the seniors!
Great comments. I was 20 minutes late for my annual physical last year. He was busy. It was a ten minute appointment plus time for drawing blood. I will get there half a hour early this year. I will make it tomorrow
I love your list.
I "always" work best with things laid out in an orderly manner.
I also am HaPpY to say that I have a doctor who I have been able to just be ME with.
I even argue with him, if I feel differently and he listens.
Also, my gynecologist is the same way.
I can talk to her about anything...and I mean anything and know that I am not judged.