How to make the most out of your doctor’s appointment

There was a time that when a doctor used to see his/her patients for 20 – 25 minutes, but that’s unfortunately shrinking now. Doesn’t matter who you are and how much time you want to spend at your physician’s office. Getting the most out of your doctor’s appointment has been significantly affected by insurance companies, because the doctors aren’t financially encouraged to take time for critical thinking with their patients. Instead, they will get paid for sending them to get as much tests as possible. How can you avoid getting caught up in this?

Insurance companies make it hard for doctors to spend time with their patients

Spending time asking questions and finding more about the medical history of the patient will not be reimbursed by insurance companies, but the number of patients they put through the office will get compensated. If insurance companies and the government would pay doctors an extra couple hundred dollars for critical thinking time, instead of paying for the $1,500 test, scan, or image, the health system would get better results, have lower costs, people would have better care and the doctor-patient relationship will get significantly improved.

Doctors could have the option of getting out of insurances and adopt concierge medicine. This requires that the patient pays an annual fee or retainer to the primary care physician, in exchange for which the doctor will provide enhanced care and commitment to the patient, in an adequate time. This is not a solution, though, for every physician and should not be the norm.

When doctors don’t spend very much time, they get rushed and work with stereotypes: what age is the patient, gender, what they do for a living and make quick thoughts about what may be the cause of their illness and what tests could prove their theories. You might have heard, more than a couple of times, the phrase “let’s order this scan or these tests and see what they show”.

Doctors are not always to blame here. Every other day, something comes down the pipeline and some regulations will interfere with the best medical advices. If a doctor considers that the best course of action is an MRI or an ultrasound, but the insurance people who have to act by strict regulations, not necessarily by medical considerations, think that there aren’t enough conditions to ask for this kind of testing, then the examinations are not going to be approved and the financial and reimbursement frustrations will ensue. These types of situations drive the doctors crazy as they want to make their ends meet and take care of their patients.

Is it the doctors’ fault that they’re moving faster and jamming more patients, or is it just that the whole health care system is on the verge of collapsing and the quality of care has gone down?

Tips on making the most out of your doctors’ visit

Considering this, patients should take some extra steps for preparations when going to see a doctor: think about how to make your visit more productive, what kind of questions you should be asking, bringing all relevant test results or list of medications that you are taking.

How to get the most out of your doctor’s appointment?

• Have a written list of all of the medications, instead of the doctor going through one of those bags, with the old bottles and look at everything. Make a list of all the allergies that you have, make a list of all the medications that you take and be very specific about the reason why you’re there.
• Talk frankly about what’s bothering you: If you feel that your doctor is not hearing you, don’t be shy to say: “Doctor, I need your help with these symptoms. What’s the diagnosis, should I get this test?”. Just questioning the doctor can stop the whole rush and basically get them to devote time to you. Put your finger right on the issue when you sense the doctor is on automatic pilot and not really hearing you. Break them off out of that by asking the question: “doctor, I know I’m a little bit young and I know I’m not at high risk for cancer, but could this be that?” or “You know, I’ve been told I’ve had this condition for two months… they’ve been treating me, it’s not getting better, could it possibly be something else?”. Get them to use their critical thinking they got their training for and break them out of that automatic pilot.
• See them in their early office hours. Doctors are a little more tired when you see them at 3 or 4 o’clock. Try to get an appointment with them at 7 or 8 a.m., as one of the first patients.
• Ask for a second opinion: There are circumstances when doctors tend to send their patients to do a biopsy without sufficient risk factors. This should be each patient’s choice to decide if they feel that the statistics are in their favor and they could wait for a palpable  lump to appear or be subjected to a lot of biopsies with 90% false negatives. In these circumstances, having a second opinion could help you make a better and safer decision.

The fact is that some doctors are under pressure to meet financial quotas imposed by the hospitals and insurance companies. However, this doesn’t mean that they’ve abandoned their vocation of helping their patients and improving their lives. Knowing what to ask and how to present all the facts of your illness when going to the doctor, will create a bigger and more comprehensive picture that will help them put the puzzle together and know which course of action to recommend.

Finding your balance as a doctor: Tips from David Samadi

As a very successful doctor, David Samadi has made lots of sacrifices on the road of becoming one of the leading urological oncologists, specializing in robotics and minimally invasive surgery for prostate cancer. It is a well known fact that at the age of 15 he was forced to leave his parents and little sister Heidi in Iran and flee the country with his younger brother Dan. During the eight years of living among strangers, in Belgium, the UK and, finally, the US, the only motivation for the two was the goal to succeed. After this lonely period, their parents and little sister were finally able to fly to the US and the Samadi family was reunited.

Dr. Samadi’s ambition to succeed was motivated by the sacrifices his parents were making back home in Iran. After they came to the US, his drive didn’t stop. He went on to complete his master’s degree, his training in urology and fellowships in proctology and robotic radical prostatectomy. His professional life has been on the rise ever since. He has performed over 7000 robotic prostate surgeries, pioneered the SMART technique that managed to achieve the Trifecta for most of his patients, has written many publications and held speeches internationally. More than that, he is often called a “celebrity doctor” due to his repeated appearances in Fox’s Sunday Housecall, on Fox and Friends, frequent articles in media publications, podcasts and videos on his personal sites. He even had a guest cameo on Law&Order: Criminal Intent, playing a prostate cancer doctor, raising awareness on the issue. These might appear hectic for the ordinary person, but Dr. Samadi enjoys every single facet of his professional life: “It’s a very exciting life that takes me from surgery, to broadcast news, to the Emmy Awards and then, the next day, I meet people from different countries, who I’d never meet if didn’t do what I do.”

David Samadi’s wife has been alongside him for 18 years now

In 2000, David Samadi met his wife, Sarah Danielpour, at Cedars Sinai Medical Center in Los Angeles, where she worked in Hospital Management. “I’m fortunate to have a wife who is a superb mom and a great partner,” Samadi says of his wife, who, like him, is from Iran. Together, they have two children, a daughter and a son. David Samadi’s family is a large and atypical one. Him, his brother, sister and 20 cousins are all doctors. He has 5 nephews only from his brother’s and sister’s side, so when the entire family comes together, Samadi and his wife have a full table.

His professional work does sometimes put a strain on his personal life: “My immediate family has paid the price. They would like to see much more of me”, Samadi says. Even though the thousands of patients he has had all these years have taken up a big part of the time spent in family, Samadi insists that all doctors must try to disconnect once in a while from their hospital lives and enjoy valuable time spent with their loved ones.

David Samadi’s tips for work-life balance

• Find a favorite physical activity – Dr. Samadi was captain of the soccer team back in Iran and has always been a competitive person. He is an active person and still plays tennis, golf and other sports. Practicing sports can help reduce stress, clear the thinking, increase self-confidence. Any doctor should have a physical activity that gives him 1 or 2 hours weekly of time out from his/her medical practice.
• Focus on your spirituality – Dr. Samadi was raised Jewish by his family and remembers how his dad taught him about Judaism on their 45 minutes drive to school. After all these years, even when apart from his parents, he maintained a close relationship to his spirituality: “I practice my religion every time I raise a scalpel. Taking care of all people regardless of religion and using my God-given talent to help others and save lives is what is imprinted on me from my faith.” David Samadi and his wife are active members of Temple Beth Shalom in Roslyn, NYC. Focusing on your religion or on whatever your inner motivation for helping people is, will give you purpose through the hard times and keep you going.
• Go on holidays – Even though your schedule might be booked throughout the entire year, your patients won’t benefit from you if you’re tired, overworked, stressed out, on the verge of a physical or emotional breakdown from all the stress and responsibility. Try to empty your schedule at least once every six months and go on a trip with your family, for 7-10 days. When you’ll return, everything will seem more bearable.
• Get enough sleep – This might feel like a dream to you, especially if you’re a surgeon, but the lack of sleep will, in time, lead to fatigue, daytime sleepiness, clumsiness and can affect the brain and cognitive functions. It could also affect your mood, your patience and overall well-being. Not sleeping enough will affect both your professional and personal life, so make sure you allow yourself to rest for as long as possible.
• Delegate tasks whenever possible – Assigning some tasks, especially administrative ones, such as scheduling, filling up forms, ordering supplies and medication, to members of your team, will clean up your plate from not so important tasks. You will be able to dedicate yourself to the important issues of your patients and will be able to leave the practice once every appointment has been met.

Balancing work and personal life is a struggle for the modern man and woman, which increases in complexity, especially for those practicing medicine. Doctors are generous persons who, more often than usual, will sacrifice their personal lives for the wellbeing of their patients. Even though this shows dedication and passion towards the profession, being one-sided helps no one: not the patient, not the doctor and not his/her family. “Balance is not something you find. It’s something you create”. In other words, you need to make continuous efforts to be happy in both areas of your life.