How much of your care is planned?

Your doctor should be using “pre-visit” planning to make sure that your care is proactive, not purely reactive. Here’s how the American Medical Association says we should do it:

  1. Your next visit should be set before you leave the clinic at your current visit. This should include scheduling any needed labs or x-rays. Unfortunately, not all electronic health records (EHRs) allow for proactive lab scheduling, so your doctor’s staff may need to use a look backward strategy, where a staff person orders labs according to a protocol based on your medications and diagnoses a few days before the next appointment. Regardless, you should have repeat labs and imaging available when your next appointment comes around.

  2. Before your next appointment, someone from the clinic–often a nurse or MA–should contact other providers you may be seeing to get results of testing or treatments they may have performed. Ideally, copies of these results should be shared with you.

  3. You should have the chance to check your status on preventive health between visits so you know what to ask your doctor about when you arrive at the next visit. This helps to identify “gaps in care,” like immunizations or screenings. Some clinics develop checklists like this one from Better Health While Aging. While this list is geared toward the primary care of aging patients, other providers like orthopedists, oncologists, or cardiologists may have specialty- or disease-specific checklists.

  4. You should get a reminder of any upcoming visits, either by email, text, or phone call, at your preference.

  5. A list of your current medications should be provided to you upon check-in so you can review the medication list for errors. This can be either a paper copy or a copy through the clinic’s “portal.”

  6. A review of your medications may be paired with a pre-visit questionnaire to see if you have new medications, problems, or symptoms that can start to be evaluated even before the doctor sees you. Here’s an example from the American Academy of Family Physicians.

  7. Your clinic’s staff and your doctor should hold a pre-clinic “huddle” to anticipate some of your needs and gaps in care so that the first time they consider these problems isn’t the moment you step into the lobby.

As the Medical Director of the Kansas Business Group on Health, I’m sometimes asked to weigh in on hot topics that might affect employers or employees. This is a reprint of a blog post from KBGH.