One might think it isn’t necessary. However, a certain lack of understanding of what matters when visiting a doctor can lead to talking at cross purposes and thus a poor treatment outcome. I am referring in particular to my special situation – I see a lot of patients for a second opinion – either to confirm or dismiss a diagnosis of Multiple Sclerosis or to advise patients on appropriate therapy.
Often these patients have already had several contacts with doctors and have had to undergo many questions and examinations. Nevertheless, even today, where a lot of technology and lab tests are used, the most important source of information is the patient himself and his medical history. The collection of the medical history (the anamnesis) is therefore perhaps the most important medical task, especially in fields such as neurology or internal medicine.
Therefore, I like to hear the patient’s own words about their medical history, which confuses many patients – because, as I am often signaled, all of this “is in the records.” But it’s not the same as hearing the complaint directly from the patient, because a record entry always contains a subjective evaluation of the previous examiner – and this needs to be checked when presenting for a second opinion.
What I am primarily interested in are the subjectively perceived complaints, their strength, and the temporal sequence of their occurrence. As a rule, I always give patients the opportunity to talk freely about their complaints, later I ask more closed questions to gain as accurate an impression as possible. And the more precise the answers are, the better my overview and my basis for decision-making.
Therefore, it is indeed advisable to prepare a little for a doctor’s visit – to recapitulate,
- how and when the disease started,
- when flare-ups occurred,
- what quality the flare-ups had,
- when which medications were taken
- etc.
There are always patients who bring me a subjective summary of their medical history, which is very helpful. However, it should really be limited to subjective perception. What interests me less are descriptions of when they were at which doctor and what this or that doctor said – I can usually take that better from the records.
Therefore, it is also of great value to have access to the entire file situation. Some patients have wonderfully organized files that they provide me with, others only have a few unsorted pieces of paper with them. As said, the more complete the documents, the better my decision-making basis. Therefore, it is also advisable here to prepare for the doctor’s visit by gathering the medical documents. I don’t expect any order at all – I am well trained to pick out the documents that interest me – the main thing is that the information is available at all.
This also applies to imaging diagnostics. Especially when it comes to the diagnosis of MS, the MRI images are of great importance. I like to get my own impression, not because I don’t trust the radiologists’ findings, but because it is part of my task to evaluate the images in the context of the medical history – and the radiologists can’t do that, because they only deal descriptively with the MRI or X-ray images. Therefore, you should always have the CDs with the imaging with you when visiting a doctor for a second opinion – and not just the latest images, but ideally the entire course, because only then can the neurologist best assess the dynamics of an MS.
One last little tip – use your own words when describing complaints, avoid medical technical terms, because these are often charged in a completely different way and may not express what you want to say. Present things as you personally experience and feel them.
