family practice issues and general life events

The dreaded list

While all magazine articles recommend you write a list to bring into your doctor’s appointment with you, I can tell you as a physician, there are few things that cause panic in the doctor’s mind than the patient pulling out a list.  While most will admit that it is a useful memory tool, and probably preferable to the patient saying “I was going to ask about something, but don’t remember what it was.”  And then continue to try to remember.  It is a dreaded obstacle to trying to keep somewhat close to the schedule.
It is never a good sign when the nurse says, “She’s got a list.”  That means that means they are so concerned that they will forget something on that list that they want the nurse to tell you about their list.
The worst list I ever got from a patient was two pages single spaced.  Let’s be honest, there is no way I will ever get through that list in a 15 minute visit, much less 3 months worth of 15 minute visits.  At some point you have to say, “Let’s pick the three most important issues that you want addressed today, and then work on the rest of the list as we can.”  While this may seem cruel to the average individual, it helps to insure that the items can be managed effectively.   Sometimes addressing the most important items will help to take care of the rest of the issues that you have.
Lists are even worse on sick visits.  You know the visits for a sore throat or cough, and suddenly you want to address your erectile dysfunction, your ingrown toenail and the colonoscopy that you had at the specialist.  Sick visits are usually scheduled shorter periods of time, because they are specifically designed for your one chief complaint.  While sometimes it might be appropriate and even ok to take care of both issues at the same visit many times it is not.  And if you want to make sure that you don’t get worked in again, lie to the front and tell them you are running a 104 fever only to get to the back and say, “I need a refill on my pain medicine.”
The list can be useful as a memory tool, but it often causes panic through your doctor.  And it is not that they don’t want to help you, but sometimes less is more.  A list that is a couple items long is no problem, 2 pages front and back is ridiculous.

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