Going to the doctor like a Real Adult
February 6, 2013 7:52 AM   Subscribe

I've never really had a regular doctor as an adult and I'm thinking I should change that. Should I? How do I go about it?

As far as I know, I'm generally healthy. My achilles tendon (I think) has been sore/hurting off and on for the last week or so and it's getting to the point where I think maybe I should see a doctor on the off chance I should be concerned about it. My only other complaint is that I'm generally anxious and I've started to become ridiculously anxious about flying. Am I right in thinking adults have 'wellness visits' (as check-ups seem to have been renamed) in the absence of substantial health complaints?

I'm a grad student, so I have access to the university student health clinic, but I was not really impressed with them when I went about three years back. I have 'real' health insurance and am not obliged to go to the student health center (where I have to pay exactly the same co-pay as elsewhere). I got a recommendation of a GP from a friend. Let's assume I wish to make an appointment with this person. What do I say when I phone? "Is Dr So-and-so accepting new patients?" And then what? What do I say when they ask me why I want/need an appointment? When I go for the appointment, what information do I bring?
posted by hoyland to Health & Fitness (22 answers total) 15 users marked this as a favorite
YES, you are supposed to have a primary care doctor. It's how healthy people stay well.

Ask if they are accepting new patients and whether they take such-and-such insurance. For the appointment, mention that you want a wellness visit. When you get to the appointment, you'll have to fill out a long list of family history (stuff like heart disease, stroke, diabetes, etc.), surgeries, and concerns. Mention the anxiety when you see the doctor.

Good for you for doing this.
posted by mochapickle at 7:58 AM on February 6, 2013 [2 favorites]

Sure, adults go see doctors just for checkups. Yes, call up the office and say, "Is Dr. So-and-so accepting new patients?" Then say, "I'd like to become a new patient." They'll ask you for your health insurance information. Then you say, "Can I schedule an appointment for a physical?" They may ask you if you have any specific complaints and you can say you just need a checkup, but are also concerned about your achilles tendon and anxiety. Then they tell you when to come in. When you have your appointment, get there ten minutes early to fill out paperwork. A nurse will probably take your weight and blood pressure and have you pee in a cup. When the doctor is ready to see you, s/he will probably talk to you for a few minutes before examining you. This is the time to bring up the Achilles tendon and the anxiety.
posted by chickenmagazine at 8:00 AM on February 6, 2013 [1 favorite]

Any doctor worth their salt will appreciate the fact that you want to just have a checkup. That gives you and the doctor a chance to see if there are any little problems that you can catch and fix before they turn into big problems. And in the long run, that saves them work!
posted by EmpressCallipygos at 8:07 AM on February 6, 2013

What do I say when I phone? "Is Dr So-and-so accepting new patients?" And then what? What do I say when they ask me why I want/need an appointment? When I go for the appointment, what information do I bring?

1) Yes - ask when you call whether the dr. is accepting new patients. If not, ask if they can provide you with referrals to other doctors that accept your insurance.

2) If this doesn't work, look on your provider's web site - they should have a directory of physicians near you that take your insurance. It may take a few appointments with several doctors over a few years to find one that you like and trust.

3) For the initial appt., tell them that you want to come in for a general physical, and mention your specific concern about your Achilles tendon. As chickenmagazine points out, you'll be asked to fill out some paperwork at your first appt. w/your relevant medical history.

4) When picking a doctor, look for someone who isn't likely to retire for a while - this will keep you from having to repeat the process.
posted by ryanshepard at 8:09 AM on February 6, 2013

One of the other points to regular checkups is that the doctor gets to know you, and you get to know them. That way when you wake up with some sort of embarassing or gross condition, you're a lot more comfortable going to see them about it rather than putting it off because you don't want to show this embarassing/gross thing to a nearly-complete stranger.
posted by griphus at 8:10 AM on February 6, 2013 [3 favorites]

If you can, see if they have online forms that you can fill out with your family history in advance. If not, especially if you have some patterns of family illness, you might note them down ahead of time or bring in a typed sheet. They will ask about allergies and past illnesses. If you used to see a doctor regularly, bring their name, office information, and any other contact information-- that way they know where your old medical records are, in case you need to have any released to their office. They may ask for a vaccination history, and offer you an adult booster of tetanus/pertussis (or any other vaccine) if it's overdue. They also may ask if you have a preferred local pharmacy.

Some of this may seem like overkill for an achilles tendon and anxiety, but having this information on file and your vitals as a baseline will be really helpful if you do have a more serious injury or medical concern in the future, trust me.
posted by jetlagaddict at 8:12 AM on February 6, 2013

I'm not so sure that "wellness visits" are such a must. I never see my primary care guy, unless I'm actually sick. Your tendon is certainly a reason to have it checked out and if you need to see a specialist for the anxiety, you need to see the primary care MD first, to get the referral. But in general, I think that a yearly checkup is a thing of the past, unless you have some chronic condition.
posted by Ideefixe at 8:13 AM on February 6, 2013 [2 favorites]

High-five! You should definitely do this; if you have the resources to take advantage of it, regular doctor visits are a fundamental tenet of self-care. (I am saying this as someone who recently broke a 10+ year streak of not seeing a doctor simply because I was too scared to make an appointment.)

Adults certainly have 'wellness visits' without first suffering from substantial health complaints, usually once or twice a year. It's a good way to keep track of whether or not you are on the right path to a long, healthy life, and maintaining regular contact with someone who is familiar with your baseline maladies or lack thereof is incredibly useful.

What do I say when I phone? "Is Dr So-and-so accepting new patients?" And then what?
Yes, ask if they are accepting new patients. If they are, explain that you would like to become one; they will ask for your insurance info, SSN, etc. If they are not, ask if their office has any physicians they'd recommend, either at their current location or another one; if none of this works out, call your insurance and ask them for a list of referrals, or visit the insurance website for an even longer list.

What do I say when they ask me why I want/need an appointment?
Just say you would like a wellness visit/check-up/first doctor's appointment in ages. Any further/specific issues you have can/will be discussed during the 'getting to know you' portion of the actual in-person appointment. (You can certainly mention the specific issues you have to the receptionist who's making your appointment if you'd like, but I try to keep my medical information as private as possible, so I wait until I am with the doctor to mention it.)

When I go for the appointment, what information do I bring?
Make sure to bring your photo ID and insurance card(s) as well as the name/address of which pharmacy you'd like to fill any applicable prescriptions. When you get there, as mentioned above, you'll have to fill out a TON of paperwork with extensive questions about the health/wellness of your family of origin, so if you can quiz your relatives on that information before the appointment, all the better. If you know that information, great; if you don't/can't get access, just say as much -- don't hazard a guess.

I'm of the opinion that it's a great idea to get all of your blood tests out of the way ASAP, at that very first visit, so you have a baseline to measure against for years to come -- Vitamin D, B12, iron, cholesterol, all that fun stuff. This means you may want to fast for 12-24 hours beforehand. This process may involve drawing more vials of blood than you'd think/like, but you'll find out a lot of information about your current state of health that way, and you may get cookies and juice afterward. I've never had to pee in a cup at a regular wellness visit, but I suppose some doctors might want to check... whatever gets checked in there.

Good luck.
posted by divined by radio at 8:14 AM on February 6, 2013

Yeah, you want "a physical". This is a doctor visit/exam that adults have every year or every couple of years. At a physical, the doctor will probably:
-take your height and weight
-examine your eyes, ears, nose, and throat
-prod around your abdomen,
-listens to your heart and lungs
-takes your pulse and blood pressure
-ask you questions about your diet and exercise habits
-ask you if you have any concerns (regarding genetic risk for certain illnesses, symptoms you've had, etc.)
-inform you if s/he has any concerns you should follow up on

The doctor may draw some blood to establish baseline values for things like cholesterol, thyroid levels, various vitamins, etc. Doctor's discretion. This isn't what HAS to happen every time, I'm just trying to give you a sense of what normal adults do at a checkup.
posted by Cygnet at 8:16 AM on February 6, 2013

When I finally got a primary care doc, I had to have a initial visit where and then I had to schedule a checkup for later. That was annoying because the initial visit was 5 minutes long and could have been folded into the checkup.
posted by vespabelle at 8:21 AM on February 6, 2013 [1 favorite]

Am I right in thinking adults have 'wellness visits' (as check-ups seem to have been renamed) in the absence of substantial health complaints?

Some people do this, but it's really not necessary. They're useful for some people because some people aren't really good about being up front with their doctor about their problems, and being in front of the doctor will give the doctor a chance to ask specific questions, or even just to say, "are there any problems you're having you want to tell me about?"

If you are developing a problem you want to see a doctor about, just make an appointment with a doctor and say, "I have problems X, Y, and Z." I was in a similar position as you in my early 20s-- a problem I was having just wasn't going away. Finally, someone told me "see a doctor," which wasn't normally something I did. So I looked up a primary care doctor in my insurance directory, made an appointment, and got my problem treated.
posted by deanc at 8:22 AM on February 6, 2013

You have specific health concerns; you should see a doctor. If you don't, don't. There is plenty of evidence to show that checkups are useless and often lead to unnecessary, costly, and potentially harmful tests and treatments.

However, it can be hard to find a doctor when you're sick, so it's a good idea to sign up with someone, who will probably want to meet you and give you a basic physical, but that shouldn't be very indepth. (If the doctor wanted to do a very detailed exam and do a lot of tests, I'd find a new doctor.)

Are general physicals pretty much useless?

Full article: General Health Checks in Adults for Reducing Morbidity and Mortality From Disease

See also Violet Blue's response to this question and her many citations.
posted by Mr.Know-it-some at 8:25 AM on February 6, 2013 [3 favorites]

First of all, go to your health insurance's website and do a search for the GP you want to go to. If they don't work with your insurance it will be much more annoying and/or costly for you to get the costs paid for.

I got a recommendation of a GP from a friend. Let's assume I wish to make an appointment with this person. What do I say when I phone? "Is Dr So-and-so accepting new patients?"

Yeah my exact line is usually something like "Hi, I'd like to make an appointment as a new patient." Other than that they will ask you for all of the information they need. Make sure you have your insurance card in case they need your member ID or anything.

And then what? What do I say when they ask me why I want/need an appointment?

Just say that you haven't had a checkup in a long time and also you've been having some minor achilles tendon pain lately or whatever. They don't really need to know much in advance, you can bring up whatever you want with the doctor when you're there.

When I go for the appointment, what information do I bring?

Just your insurance card mostly. They will have a form for you to fill out when you get there to fill out any info they need, like if you are allergic to anything, are on any medication, what your family medical history is, etc. Also, ask whoever you are making the appointment with this question, because they will know the exact details. In general if you don't know what to do just clarify with them.
posted by burnmp3s at 8:56 AM on February 6, 2013

The best way I've found to find a good GP has been to talk to people I trust and respect and who think similarly and ask who they would recommend (or who they would avoid).

The worst way I've found to find a good GP was to go through the HMO book and select a few that were conveniently located and call and ask if they were taking new patients.

Anecdote - using the latter method, I was hooked up with a doctor who did only 1 thing: she wrote referrals. She would listen, nod then pull out the pad and refer to a crony for something that made sense but never seemed to pan out on the first try. It was apparent that she was trying to maximize HMO money and minimize effort.

Using the former method, I had a practice recommended for which all the MDs were completely awesome. In my first visit, the doc asked why I switched. I said, "my previous doctor was more interested in referring patients than practicing medicine." Without pausing, he said, "oh you had XXXX, did you?" I asked how he knew and he just smiled. I later found out that he sat on the local AMA review board (IIRC).

My current GP is awesome in that he doesn't treat me like an idiot and has never rushed an exam. He spends more time on why than what and involves me in the diagnostic process in as much of a Socratic method as you can imagine. The result is that I take much better care of myself. He also listens if I say a particular treatment won't work for me.
posted by plinth at 9:03 AM on February 6, 2013

I'm a doctor. I agree with the posters above that you don't necessarily need an annual physical if you feel fine. However...

If you don't have an established relationship with a doctor, you DO need one. Doctors are busy. You can't just wait until you really need one and then make an appointment in most cases. They need to have you as an established patient or you will typically have to make a longer "new patient appointment" where they can do a full history and physical on you before you can be seen for a shorter acute appointment focused on a new problem you are having. Some offices will let you around this rule but the idea is that they need to know the details of your health prior to evaluating you for a specific problem, and that is a good thing.

Also, there are reasons why seeing a doctor every few years can be quite useful for screening tests and so forth. When I see people in the ER who haven't seen a doctor in 10 or 20 years I do not believe them when they say they are "totally healthy". There isn't a sixth sense for knowing if you have high blood pressure or cholesterol or colon polyps. These aren't usually things grad students need to worry so much about, but I'm glad you're taking charge of your health.
posted by treehorn+bunny at 9:09 AM on February 6, 2013 [1 favorite]

My husband and I both get yearly check-ups, despite our relative youth and good health. We both have mild conditions that warrant a regular look-see. And our relationships with our primary care doctors have made our lives a lot easier, medically speaking. Roughly quoting my doctor:

"When you come in, we are picking up on an ongoing conversation. I know you, I know your particular health problems, and I know how to adjust for your anxiety issues. So we can figure out your current problem relatively efficiently. When I get a new patient, it takes a lot more work to figure all of that out." Not that my doctor minds new patients, although he's overloaded and not currently accepting any. But having an ongoing relationship with a trusted primary care doctor is good stuff.

ALSO: Because I'm a current patient of his, I have access to his nurse line. SO many potential visits were avoided because the nurse consulted with him, and they determined I could treat my problem at home. That is a truly marvelous resource.

And it's also pretty great to have the ability to call your doctor and say, "Um crap, my rescue inhaler is expired and I have a cold and I'm going to have an attack if this keeps up, could you please call in a refill?" Maybe not all doctors are like this, but my doctor calls in those prescriptions without charging me. Before I had a primary care doctor, I had to wheel into an urgent care or something and say, "Welp, can't breathe. Help me out here."

And my husband's (ridiculously sweet and kind) doctor doesn't let him get out the door without his flu shots or his tetanus booster, because she knows he's afraid of needles and will slipslide out of important vaccines if he can. I love that woman.

Okay, I'm done talking. Just wanted to encourage you to establish a relationship with a doc. Even if you don't need yearly check-ups, it's a great thing to do for yourself.
posted by Coatlicue at 10:07 AM on February 6, 2013

If you don't have an established relationship with a doctor, you DO need one. Doctors are busy. You can't just wait until you really need one and then make an appointment in most cases.

This is really important advice. I was recently very ill and had no regular primary care physician. If it hadn't been for a friend who got me in to see his (very good) internist, I would have been calling around to find one -- which I really had ZERO energy to do. But, yes, you call and ask if they are accepting new patients, if they accept your insurance, and can you come in for a physical (or new patient exam).
posted by bluefly at 10:19 AM on February 6, 2013

Yes! Go get yourself a doctor, for the reasons discussed above. It's good to have one, because:
- you can establish a relationship with someone who can see you when you're all OW OW OW or BARF BARF BARF, which is not a great time to start trying to find someone who is available.
- it's a good idea to check your health using screening tests
- it's nice to have a single practitioner to have all your records, especially if you have, or have had, multiple medications (for either chronic or temporary things). Are you going to remember every med you've taken, at what dose, and whether it worked?
- you can learn cool things about your body at the doctor's! Fun facts!
- if you are healthy and young, you can just have the initial appointment, and then do physicals every two years. That's what my doc has me doing.
- I am guessing you are a dude, as it seems like this hasn't come up, but: if you are a lady who has sex with people who can knock you up, you will probably want to have a doctor for birth control prescriptions/monitoring/changes
- and: they can catch things you would disregard. I went in to get a big, ugly mole checked. The doctor said it was totally normal and healthy, but hey, have I noticed this other little one over here (which to me looked really small and normal and innocuous?)...? Yep. That little one was the one that needed to be removed. Doctor's can be all helpful and junk, like that.
posted by vivid postcard at 10:39 AM on February 6, 2013

He will know what to ask regarding your general health. Relax on that part. However, keep the following in mind:

-- the nurse's job is to prepare. Don't try and ask her about your health, it will slow her down as well as the appointment.
-- doc will come in but don't expect him to be Mr. 20 questions - volunteer info about yourself that you feel might be important. Let him filter it.

Judge the comfort and professionalism of his office when you first talk to the front desk while making your appointment. Then, what is your first impression when you walk through his office door?

What is your impression of the nurse - was she helpful, intelligent, skillful, and professional?

And, did the doctor give you attention that was focused, undivided, or was he distracted and rushed? Finally, how was your exit? Did the front desk have the prescription ready, bid you a good day with pleasantry, or didn't even notice you leaving?
posted by Kruger5 at 10:47 AM on February 6, 2013

Primary care doctor here--while the value of an "annual physical" is probably not that great for a young person, as others have noted, establishing care with a primary doctor is a really good idea. Just as an example, a few years back I nagged my healthy spouse into going for a checkup. As expected, the doc told him to lose some weight and checked his cholesterol, which was fine. A year or so later, my spouse developed swelling in his leg and I insisted he go get checked out. Because he already had a relationship with a doctor, he was able to see his doc for a sick visit the next day and when the ultrasound showed a life-threatening blood clot in his leg, his doc coordinated everything by cell phone and he was able to get all his treatment as an outpatient. Folks with the same problem who don't have doctors already almost always end up in the hospital just to get everything organized. Similarly, for my own patients, I am always willing to overbook, come in early, make phone calls, write emergency refills, etc. I am not willing to do that for random Joe Schmo.
Call up the office, ask if the doc is accepting new patients, and ask for a new patient visit. Those are usually extended visits that include all the background info as well as whatever particular complaint you might have going on.

- Ahead of the visit, it would be great to make sure you know your own past medical history and any significant family history. So if you had a surgery once when you were a kid but you're not sure what it was, or your grandfather died of some kind of cancer at age 45 but you're not sure what kind, this is a good time to ask a parent.
- if you take any medications, it is helpful to know what they are and what doses.
- Same for allergies. I get a lot of patients who think their mother told them they were maybe allergic to penicillin, but they don't know if the allergy was a mild rash or severe anaphylaxis.

You will probably fill out some kind of form ahead of the visit where you describe your family history and do some basic screening questions about lifestyle (exercise, etc.)

Achilles tendon pain and anxiety about flying are perfectly reasonable things to ask about during a visit.
posted by The Elusive Architeuthis at 2:02 PM on February 6, 2013

If the recommendation you currently have doesn't pan out, other Primary Care Physicians are pretty good places to get a recommendation. As a hint. If you just happen to know one. They might be able to help you with other questions, too.

You can totally just list the ankle or anxiety as a reason for the visit. A physical also works, but if you're going to bring it up, well, it's kind of the reason for the visit, right? Should you go in for any other reason, they'll also probably do the physical, just because it's been so long.

Remember when you got your shots as a kid and any hereditary diseases that run in your family. For the ankle thing, try to remember when it started and when it happens. From my experience, going into the doctor's office for anxiety means worksheets, but that's more of a generalized anxiety. I'd still suspect that they'll ask you to describe and attempt to quantify the anxiety.
posted by dinty_moore at 5:30 PM on February 6, 2013

I'd encourage you to get a physical. It's helpful to have a baseline for things like your cholesterol, blood pressure, etc. Getting an annual physical, for me, is also an occasional wake-up call, like, HEY, you gained weight and you should think about that.

I think I have a good relationship with my PCP. I called a few weeks ago and said, I feel sick, can I just get some cough syrup or something, and he called in a prescription for me. He's called me late-ish with test results. I've called him on weekends when I was traveling and forgot my prescription; he called it in to a local pharmacy. He's my first stop when I have a problem - broken finger from softball led to a referral to a fancy hand specialist.

Our relationship isn't perfect - his office staff is good in that they are gate keepers so he doesn't get overwhelmed or very off schedule. They mean business, so I don't always get to talk to him on the phone. But when I have needed to see him, I have gotten in.

I think having a relationship with a PCP is helpful because it's not ideal to be in a position where, when you get sick, you are seeing your doctor for the first time, or the first time in more than a year. My PCP has treated my acid reflux, seasonal allergies, sore throats, etc. He knows what things to look for and what my background is. He doesn't have to ask me two million questions when we meet because we've met before. So I'd encourage you to work on building a similar relationship with a medical professional.
posted by kat518 at 8:08 PM on February 6, 2013

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