Published: February, 2018

You know the routine: you're waiting in the exam room, and your doctor comes in for what seems like a very quick visit before leaving to see the next person. You're left feeling that you didn't ask all of your questions or get a good understanding of your treatment plan. What happened?

"We're under incredible pressure, and we're scrutinized to be sure we're seeing enough patients," explains geriatrician Dr. Suzanne Salamon, an assistant professor at Harvard Medical School. "We don't have many minutes, and yet we have to go over each person's medical issues, medications, and even end-of-life issues. That doesn't leave a lot of time to talk."

The scenario is the new reality of medicine. Research suggests that the average length of a doctor visit ranges from 10 to 20 minutes. While that can be challenging for both you and your doctor, the way to make it work is to maximize every minute. You can do that by adopting as many of the following strategies as possible.

Create and bring a list of questions you have for the doctor, so you won't forget to ask them. Prioritize your list, with the most urgent questions at the top. "If you bring in a list of 10 questions, there may not be enough time to get through all 10, so start with the most important," Dr. Salamon advises. Your doctor may be able to plan some time for questions if you announce that you have a list at the beginning of the appointment.

When you see a new doctor (particularly a specialist), he or she will likely want to see prior medical records and tests related to your health condition. "It's most useful to have the actual test results when possible, above and beyond someone else's interpretation of those tests, so the physician has the opportunity to see and interpret those same studies personally as well," says Dr. Christopher DiGiovanni, an orthopedic surgeon and associate professor at Harvard Medical School. Ask about the best way to forward your records to the doctor when you make the appointment. In this day of electronic medical records, a specialist in the same medical group, hospital, or health care system will have computer access to medical records, but a specialist elsewhere may not. You should check with the doctor's office about this in advance.

It helps to have someone with you to serve as another set of ears. "Older patients may have hearing impairment and may not feel comfortable asking doctors to repeat themselves, or they may have undetected cognitive impairment and won't remember or understand what the doctor said," explains Dr. Gad Marshall, a neurologist and assistant professor at Harvard Medical School. Or you may be emotionally distressed and unable to take in everything the doctor is saying. It can help to have another person along to ask the doctor to clarify or repeat information, or at least take notes.

You may think you know your medications well, but do you know the names and dosages? "I suggest that you routinely bring in the bottles with your medications, both prescription and over-the-counter. This may reveal that you are not taking the medications your doctor thinks you should take. It also gives you the opportunity to understand what every medication is being used for," says Dr. Sarah Berry, a geriatrician and assistant professor at Harvard Medical School. "You can also discuss if any medications can be reduced or eliminated."

Arriving before your actual appointment time gives you a chance to fill out paperwork, go to the bathroom if necessary, and knock out some of the routine steps of the visit, like a blood pressure check. "If I'm in the room at 10 for a 10 a.m. appointment, but the patient isn't there waiting because he only just arrived or he's in the bathroom, we're losing minutes," Salamon says. She recommends arriving 15 to 20 minutes early.

Despite an early arrival, you may wind up waiting longer than anticipated if your doctor falls behind schedule. Why does this happen? "We cannot predict who is coming in the door or how simple or complex the problem is. Some days a provider might be ahead of schedule, sometimes on time, and, unfortunately, often a bit behind just to be able to see everyone who needs to be seen," says Dr. DiGiovanni. But take heart. "I've also found that when patients realize you are acting in their best interest and are always willing to spend whatever time it takes to care for their problem on any given visit, these people almost never mind waiting at subsequent visits. They understand that you're doing the same for everyone." He suggests that you bring some reading or work material so that you can use the time well regardless of the wait.

When your the doctor walks into the room and asks how you're feeling or why you're there, answer with a detailed yet concise explanation. In the business world, it's called an elevator speech — an effective summary that lasts about the length of an elevator ride. "Make it one minute or less if you can," advises Dr. Salamon. "Telling long stories would be great if we were going to dinner, but they have no place in a doctor's office."

Coming up with your elevator speech may be tough on the spot, so prepare it before the appointment. Dr. Salamon recommends including the reason for your visit, what your symptoms are, and if there's anything stressful going on in your personal life that would affect your health (like a divorce, job change, or move). If you're seeing a doctor who's taken care of you before, include only the pertinent information that's developed since your last visit, such as a new health condition or medication you're taking.

"People get embarrassed and may leave out things that could be really important, like alcohol or marijuana use. They may not want the doctor to make judgments. But you really do need to be upfront about what's going on," Dr. Salamon says. Other topics that may be difficult to talk about include depression, sexual dysfunction, and incontinence.

If you feel awkward, remember that you have only a limited amount of time with an expert who can help you. It's up to you to get as much as you can from the visit.