How to Prepare for Your Appointment: a long winded narrative by Dr. Dionne

So there you are, sitting in the doctor’s office.  

Waiting.  And waiting.  And waiting some more.

They should call the whole building a waiting room. The exam room, the nurses station and *wait for it* the waiting room.  

Thinking to yourself: I got here on time. My appointment was at 9:00 and I showed up at 8:59.  PERFECT. Why did I have to sit in the waiting room? Why did that nurse need to take my blood pressure and weight today (we just did that last week) and WHERE is my doctor?

And then she rushes in. 

Head down, hands full of stuff.  Phone, pen, stethoscope.  Crash!  All falling to the floor after trying to set them on the printer.  Why are those desks so small?
Smiles, apologizes about the time, and then gently muttering under her breath (was she swearing?) puts in two separate passwords (twice) to finally get to your chart.  

“So, What brings you in today?”
“Here's my list” as you reveal your three pages of scribbled post it notes. 
Your doc’s face falls. “I see, I thought we had booked this as a follow up for your blood pressure and fluid control.”
“I know doc, but it takes forever to see you, and I want to talk about my big toe, this rash and my thinning hair. My blood pressure doesn’t matter”  
​
This is often how an appointment will start, well my appointments anyway.  
Feeling like I am running behind, trying to cram as much into 15 minutes as I can.  

Wait! You say, 15 MINUTES, what do you mean, 15 MINUTES! My appointments aren’t that short.  You’ve got this wrong!
Hmmm…  maybe this is part of the problem,  I have 15 minutes on the schedule and you think we have longer. 
​

So how much time do you get with your doctor? Or your Nurse Practitioner ? or your Physician Assistant? 
Most appointments are booked for 15 minutes.   This time limit really only allows us to address a couple of things properly.  Maybe three if there are simpler issues. 

Exceptions for this are: 
Your Periodic Health Exam (PHE) which may be for 30-45 minutes depending upon your age and complexity.  
Counselling appointments are usually 20 minutes.  
Urgent care and same-day appointments booked through triage are allocated only 10 minutes as they are to be one issue only. 
So knowing how long your appointment is, is important because only so many things can be taken care of in 15 or 20 minutes.  

“Sigh… great Doc, 15 minutes, got it.  But you were still late!”

But… so were you.  

“NO, I was not, I got here at 8:59, my appointment was at 9:00”

Weeeell sorta kinda.  If you look at the email confirmation you receive (I know, does anyone actually read that stuff?)  It does ask that you arrive 15 minutes before your scheduled appointment time.  
“Yeah, I know it says that,  I ignore it because I am busy,  and I really don’t want to sit there another 15 minutes. You know, in the WAITING room.”

But there is a reason we ask this. 

Step 1.  Reception will need to check you in. 

They need to make sure that your health card information is up to date. Make sure we have the correct email and phone number. The correct address. Clarify who you are seeing and mark in the computer that you are here so nursing can see it 
These things all take a minute or two.  And there may be someone (or three) in front of you.  

Again, time.

So now you are checked in with reception. (5 minutes have gone by)
Back to a chair in the (drum roll please) Waiting Room.

You win the Waiting Room Lotto,  The nurse has called Your Name!!

Step 2. Do you need something done by our nursing staff before you see your doctor (or NP or PA)?  

Often there will be a note on your booking to indicate if you need any of the following: 
A weight check?  Blood pressure?  Does your temperature need to be taken?  Should they be checking your oxygen or glucose level?

All of these things can take several minutes or longer.  If you arrive right on the dot of your appointment time these can eat into your appointment time. 

Your appointment states this is a blood pressure and fluid check.  So you will need a weight done and up to three blood pressures, at least 10 minutes of time. 

At this time the lovely nursing staff will escort you to a waiting *cough* Exam room.  
After they walk around the loop peering into each room to see if it is available.  We have 24 exam rooms.  How can they ALL be full ALL the time?

Step 3.  At this time a notification will be on the doctor’s schedule that you are in a room ready to go. 

Back to the beginning of the story: Hi Doc, Here is my list…


Seriously though.  We are all busy,  Nurses, doctors, reception, NPs, admin, PAs, allied health and YOU, the patient.  I am well aware that you have a crazy busy life too, and it took weeks to get this bit of time to see your health care practitioner.  
We all are just trying to get through our days and do the best we can. 

As my little scenario said, arriving early is always better (just a little early, 15 minutes is usually perfect). There are many behind the scenes things that happen in any workplace and those things all take time.  It does warm my little grinchy heart when people are early for appointments and nursing can do all the things I have requested (I can be demanding, just ask them).  

Below I am going to have a LIST (I love lists) of things that will hopefully help with your future visits.  As my own patients know, I love to give homework.  

And (if Sarah lets me back in the newsletter again) this hopefully will become a short series about how things work in the office and how YOU can get the most out of YOUR office visit.


How to get the most out of your office visit.

Please arrive 15 minutes before the BOOKED scheduled time on your confirmation. 

Bring all of your medications WITH you.  This includes supplements and over the counter products.  I want the bottles, not a list.  Seeing that bag full of medications fills my heart with joy.  Then we know exactly what you take and what you will need. Or need to get rid of.

Know how long your visit is scheduled for. Unfortunately this is not on the reminder email (we are working on it, you know: computers, tech guys, etc)  Ask reception at the time of your booking and note it on your appointment sheet or in your phone. Or write it on your hand, but I really hope you are going to wash it in the meantime, so that may not be the best choice.

The amount of time allocated for your appointment is important:
  

• Regular office visits are 15 minutes.  
• Urgent care and same day appointments are 10 minutes.
• Counselling appointments are 20 minutes.
• Periodic Health Exams (the new lingo for your physical) can range from 30-60 minutes. 

If you feel you need more time, ask reception if this is possible. Sometimes it is not possible to lengthen the appointment.  Time after your appointment may be full with other bookings. 


Understand we are a team.  Docs, Nurses, NPs, PAs, Reception, Admin. 
As your clinical caregivers,  we all work together and chat all the time.  Sometimes your own person is not available and you will need to see someone else.  If you are worried about keeping them in the loop just ask the provider who you are seeing, to send your person a quick FYI message to review today’s note.  

What is Urgent.  Or not. 
We all will have things in our lives that require urgent care.  Some days the office is full to the rafters.  On an average day we have about 40 short urgent appointment spots available (these are the 10 minute ones, one problem only).  The providers all take turns providing this same-day care.  The odds are not in your favour to see your own Doc but you will see someone. 

Sometimes these spots will fill up within 30 minutes of the phones being open at 8am.
Our staff try very hard to get people in to be seen.  If I could clone myself, I would, but even that would not solve the problem. (Might create more, but we won’t go there).  
Discussing your issue with the Triage Nurse can often determine the urgency of the situation and help with decision making. 

Routine visits may be weeks out.  This is frustrating.  Please be assured our office looks at this on a regular basis and we are working on it. If you are fine with seeing a different practitioner (usually and NP or PA) you may be able to be seen sooner. 

Periodic Health Exams (aka physicals) are not urgent, by definition.  These are usually scheduled months in advance due to the long visit time.  Please plan ahead. If you need one for your travel, work etc etc book early! 

Dr. Jeanette Dionne

Dr Dionne has been working in Carp since 2006 (except for that year she ran away downunder to work).  The 10 years prior to that she had worked in Kingston, Ohio and Nova Scotia (didn't know she was that old didja??) 
Her Practice interests are a bit of everything.  In the past she did both some emerg and hospital care but now is firmly entrenched in her office. She often will have students trailing and loves having residents to do her work for her.  Outside of the office she is usually in disguise in jeans, and a bit dirty from her hobby farm.