Being a better patient will make your life a lot easier and will save you (and your doctor) time, frustration, and money. We spoke to Melanie Frank, Division Administrator at Duke University Medical Center, to put together a list of strategies that help you make the most of your appointments. Melanie has over ten years of experience working in some of the top medical centers in the world and has experienced appointments from a patient, administrator, and parent’s perspective.

1. Schedule the Right Appointment

Most offices offer a few standard appointment types that are scheduled in specific time blocks. Scheduling the right type of visit allows the doctor to allocate the right amount of time for your needs and helps with accurate billing. Depending on the type of doctor, usual appointment blocks generally include:

Preventive Visits

Ex. Annual Physical.

Often slightly longer than a diagnostic visit.

Designed to evaluate your current health to prevent future problems.

Tip: Read this article about medical billing to learn why you shouldn't mention your knee pain or your sore throat during your preventive visit.

Diagnostic/sick visits

Ex. Appointment to discuss pain or an illness.

Usually scheduled in 15 minute time slots and are billed with one of five diagnostic codes.

Tip: If you intend to talk about more than 1 or 2 different ailments, alert the scheduler in advance so they can schedule a longer visit.

Procedural visits

Ex. Mole removal, endoscopy, vasectomy, etc.

Usually longer appointment times, depending on the procedure

Tip: If you have a high deductible, try to have simple procedures done in-office rather than in a hospital. If they are performed and billed "in-office" the procedure often falls under your office visit co-pay (on a PPO plan) or you will only be charged for the doctor’s fee (on a HDHP plan). If the place of service is billed as a hospital or surgical center, it will likely apply to your deductible.

2. Be Prepared for Your Visit with the Doctor

Bring your relevant medical records and know your up-to-date medical history

If you don’t already have your medical records, you can call previous doctors to request that they send the records to your new doctor.

Provide concise and relevant information about your symptoms or needs

Providers are seeing many patients, so it is important to give them a brief recap of your situation. Be respectful of their time by getting right to the point and providing succinct information about your symptoms.

Have your questions ready for your provideR

This is especially important for complex diagnoses. Think about the questions you want to ask in advance, write them down, and recap the answers with your doctor before you leave.

Tip: You may want to bring a family member or friend with you, as they can help to take notes or ask follow-up questions.

3. Understand Who You are Talking to and What They Can and Cannot Do and Say

It takes a village to make a doctor's office function, and it takes a small army to keep a hospital moving. Below are some of the people you may encounter at your visit, along with notes about their “scope,” or what they can and cannot do:

Scheduler

Schedules your appointments, checks you in, and may collect your copay or deposit.

Tip: If they try to collect a different amount than you expected to pay, ask to speak to the billing office rather than arguing with the front desk. The billing office usually has a deeper understanding of the coding of your visit and how your insurance benefits will apply.

Medical Assistant

Brings you from the waiting room to the patient rooms, takes your vitals and asks questions about your medical history and current symptoms. They often document this in your chart for the doctor to review before they see you. Medical assistants cannot provide you with medical advice or a diagnosis.

Technicians (ex. Ultrasound Technician or Lab Technician)

Takes images of your body or takes your blood, for example. They do not provide you with an interpretation of what they see. They will provide the images or results to the doctor who will then provide the diagnosis.

Nurse

Administers medication and IVs, develops care plans, takes vitals, updates your documentation.

Note: Nurse scope varies significantly depending on your state’s laws and the nurse’s level of education.

Nurse practitioner

Evaluates your medical situation, prescribes medication, diagnosis illness, and provides treatment. They have similar responsibilities to a doctor with a narrower scope, which may also vary based on local laws.

Physician Assistant

Interns

Have completed medical school, and are in their first year of medical training. They always practice with supervision.

Residents

Have completed medical school and their internship year. While they can practice as a physician, they are supported by a doctor, so if you are not getting what you need from a resident, ask for their supervising physician.

Physicians or Attendings

Have completed their medical training and are fully-practicing, unsupervised physicians who are licensed to examine, diagnose, and treat patients.

Biller/Medical Coders

Billers usually have a solid understanding of medical coding and insurance benefits. They submit your claim to insurance and send bills once the EOB is returned.

Tip: Billers are helpful if you have questions about your costs, but they do not know the specifics of your plan until they call your insurance and ask about your specific plan. If you disagree about the amount they are trying to charge up front, you can often do a three-way call with your insurance company and the billers to clarify your patient responsibility.

4. Be understanding

We’ve all been to a doctor’s office where the doctor is running behind or seems rushed. While it may feel frustrating to be seen well beyond your appointment time, try to be understanding. Your doctor is trying to help as many patients as possible, and between patients showing up late and emergencies that arise, it is common for them to fall behind schedule. They may also encounter situations that are more urgent or require more sensitivity than yours. As Melanie put it, "understand that doctors are there to help as much as they can. You never know what news your doctor may have just delivered to the patient before you - they could have just given a cancer diagnosis to a family." A little bit of understanding goes a long way.

Tip: If you have repeated disappointing experiences with your provider, you can always switch to another one within the practice or within your network. Read this article on finding a new doctor to learn how to find someone new.

We hope these tips are helpful to you at your next appointment. If you have any to add, feel free to leave a comment!

Melanie Frank

Division Administrator
Duke University Medical Center