For some patients, going to the doctor results in getting the "white coat syndrome," in which blood pressure and heart rates go up just from being in a clinical setting. Likewise, many patients can find themselves being less self-advocating than they might normally be, especially if they don't quite understand everything the doctor is saying.
"There's a great deal of stigma surrounding any kind of illiteracy," said Bronwyn Pughe, a doctorate of educational leadership student who is in a practicum at Madigan Army Medical Center and a leader in the hospital's Health Education and Promotion Committee.
Pughe explained that this stigma around illiteracy includes health illiteracy, which can directly affect patients' well-being if they do not fully understand their medical conditions, their medications or their treatments. In addition, for many medical appointments patients may only get 20 minutes with their doctors, so the need for patients to speak up and be fully engaged in their care becomes even greater.
Patients can take steps before, during, and after doctor visits, though, to get the most out of their time. First, Pughe encourages them to review the purpose of their appointments.
"It helps you to manage your expectations and remember 'Why am I going in', so the doctor can actually serve you," she said, noting that focusing on the medical issue being addressed that day can be more effective than bringing up unrelated concerns.
For patients who want to research their medical conditions beforehand, Pughe encourages them to visit the Centers for Disease Control and Prevention website, which is written in lay-person's language and is well-researched. When visiting other websites, she advises that patients consider if the information is current and accurate, if the author is credible, and if they understand the language used on the site.
It's also important to consider before appointments what patients want to cover, and to write down specific questions as well as all medications, vitamins, and supplements used, to include how much they are taking, whether they work or not, and any side effects experienced.
Patients with ongoing medical concerns, such as sleep issues, chronic pain, or headaches, may want to keep a log of how often they experience those conditions and the associated symptoms of each episode. Pughe especially encourages patients to log medical concerns that are interfering with their everyday lives, such as interference with daily tasks, or changes in appetite or concentration.
"If you bring data, there's a reality check for you and the doc and you can actually address what's going," she said.
In addition, patients should plan to mention if anything has changed with their medical conditions or in their lives in general, to include recent moves, family changes, and any other significant changes, since these can cause stress which can impact people's health. Likewise, patients should plan to bring up any changes in their family's health history, such as any serious illnesses family members recently experienced.
During appointments, Pughe encourages patients to not minimize their symptoms.
"A lot of times people minimize pain," she said, whether downplaying the amount of pain experienced or the frequency of it. But when patients downplay pain at medical appointments office, it can affect their doctors' full understanding of patients' symptoms and medical conditions.
Likewise, some patients are less than honest about symptoms they find embarrassing or about reporting how often they engage in healthy behaviors such as exercising.
"It's normal to want to reflect your best self, but the point is a doctor is there to help you become and then maintain your best self; it's normal to have fluctuations in that," said Pughe.
Pughe also encourages patients to bring a trusted friend or family member to medical appointments simply to "have two sets of ears" present to intake information; patients can also take notes to refer to later.
Patients may also want to write down questions they think of afterwards to ask at their next doctors' appointments. If they would like answers more quickly, patients can visit the RelayHealth website to ask their doctors questions online.
In addition to fully engaging in their medical appointments, Pughe encourages patients to listen to their bodies, to be aware of when there are problems, and to then make decisions of how they want to approach those problems.
"We want to empower people to use their awareness," she said.
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