Communication: Making Sure You Have Success

Addie Peretz, MD, Robert Cowan, MD

In this article, we will discuss how to make the most of your visit with your practitioner. We will help you prepare to see your doctor and understand the things you should know when you leave the doctor’s office.

Checklist prior to your visit:

  • Write down what you want to talk about BEFORE you go into the office—come with a plan.
  • Keep a headache log as the bedrock of communication.
  • Bring in a list of the medications you have tried for pain and let the doctor know what worked and what did not work.
  • Arrive on time for your appointment to ensure that you have a full visit.

What you should know when you leave your visit:

  • Have a Treatment Plan:
    • What to do WHEN you get a headache.
    • What to do to prevent headaches from happening.
    • Side effects to be aware of with any new medications.
    • Know the ground rules with your provider:
    • What is an emergency and what to do when there is one.
    • Whether to call or email to ask and get questions answered.

The Appointment

Many patients feel like a deer in the headlights when they go in to see their healthcare provider. Often there is a lot going on and too little time. As a result, sometimes patients leave the doctor’s office more confused than when they came in. This article should help you avoid that lost feeling and help ensure that you get the most out of your appointment.

Come to your Appointment with a Plan

Studies have shown that most doctors will frequently interrupt their patients. Sometimes, you have to be a bit firm to make yourself “heard.” It is best if your appointment begins BEFORE you step foot in your provider’s office. Jot down notes about the issues you want to talk about.

A headache log can be a good way to give your provider a sense of your headaches. In your headache log you should write down how often your headaches happen, how painful they are, how long your headaches last, and whether your rescue strategies are working. Some people also write down things that seem to trigger their headaches. There are many headache log apps available, including Headache Diary Lite, Headache Diary, iHeadache. If you prefer not to use an app you can always jot down when you have headaches in a calendar.

In addition to a headache log, it is also helpful to write down a list of what have tried in the past to make the headaches better. It is particularly helpful if you can tell your doctor what medications you have tried for headaches in the past. Telling your doctor what you liked and did not like about medications you have previously tried can better help them figure out a treatment plan that is right for you.

Leave with a Written Treatment Plan

Studies report that patients remember only a small part of what they are told during a visit with their provider. It is a good idea to write down information or ask for a written treatment plan. What should a treatment plan include?

Every treatment plan will be different, but most should include:

  • What to do when a headache starts?
    • Should you take the medicine right away or wait and see how it goes?
  • It can be useful to score how bad the pain is on a scale of 1-10 (with 1 being minimal pain and 10 being unbearable pain). For instance, when my headache is a 6/10 (different people will have a different idea about what a “6” is, but you should know what yours is) then that’s when I take medication. You should discuss when to take medicine with your provider.
  • How long should it take for your medicine to work?
  • What should you do if your treatment is not helping? I.e. What is your rescue plan?
  • What else can you do to help decrease the pain besides taking medications?
    • Could a dark quiet area for when you have a headache or removing bad smells, flickering lights, or loud noises help manage your headaches?
  • If a trip to the Emergency Room or Urgent Care is part of your treatment plan, what medicines would be best (and what medicines should be avoided)? It is always good to have a plan from your provider when you go to the ER.

How do you prevent headaches?

  • Are there changes you can make to help you prevent headaches?
    • For example many patients with migraines need regular sleep and eating schedules as well as daily aerobic exercise to help prevent headaches
    • Are there behaviors that you can learn that can help reduce or prevent headaches? See the ABCs of Headache Trigger Management for how to manage triggers with behavioral changes.
  • If you know of definite triggers, what is the best way to address them?
    • Should you avoid a particular trigger or “cope with it”? Can you modify it or take preventive measures before exposure to a trigger?
  • Does your provider recommend that you take a medicine to help prevent headaches?
    • When should you take the medication, morning or night? How often should you take it?
    • What are the most common side effects?
  • Make sure to discuss a plan for specific situations that might require special instructions. Some of the more common specific situations include travel, stressful events, and pregnancy.

Know the Ground Rules
Ask your provider what is the best way to communicate with him/her.  Is the method the same for both routine questions and in an emergency? It is best to find out early in the relationship to avoid misunderstandings.

1. What to do in an emergency
Most healthcare providers have a system set up to help in emergencies. But sometimes providers and patients have different ideas about what is an emergency. Most would agree that a headache unlike any headache you have ever had in your life is an emergency worthy of a call to 911. This is very true for sudden onset, severe and more than momentary pain.

2. What is not an emergency
Most would agree that refills should be during office hours addressed with a phone call to the pharmacy or the office

3. Ongoing Communication
Have a clear sense of what to do when you need advice, and how best to communicate with your healthcare provider. Some providers are using e-mail for routine non-emergency questions and communications. This method may have a 24, 48, or 72 hour turn-around response time. Others prefer a phone call to the office and a call back.

Conclusion

Having an open and effective relationship with your healthcare provider is essential for good headache care. Like all relationships, it often comes down to good communication. Make sure that your provider knows what you want to get out of your visit. Make sure that you have a clear plan when you leave the office. These simple but important actions will help insure that you get the most out of your relationship with your provider.