Questions the doctor will ask during the interview

Last week we looked at the interview that takes place the first time a patient sees a doctor. We established that the doctor should ask the patient specific clarifying questions about the reason why the visit was made.

The interview does not have to last more than 5 minutes. The interview should also include questions about whether the person has diabetes (sugar) and or hypertension (pressure).{{more}} All adults should be questioned, as these conditions are prevalent and many times undiagnosed. Sometimes, when asked, patients reply “no” to these questions, not understanding that the pressure does not have to be high to have “pressure” or the sugar high to have “sugar”. Once you are taking medications for sugar and pressure, then you have them.

Your doctor should ask you whether you are taking medication for sugar or pressure or any other medical condition, like heart disease, a previous “stroke” or high cholesterol, to name a few. If you cannot remember the medication, you should take them with you to the doctor. This is a very important gesture, since all medications can interact with others and your doctor should ask if you are taking medications before prescribing others. Its always better to take your medications with you, as answers such as “the same medication you prescribed” or “didn’t the doctor put it in the letter”, does not explain why most patients are either taking the wrong medication, the wrong dose (2 instead of one), the wrong dosing interval (once a day instead of 2 times a day), old medication (from a previous prescription or box which was not discarded) or 2 similar medications (visiting too many doctors and not discarding or disclosing medications from the previous doctor).

The doctor will ask you if you have ever been admitted to hospital and the reason. You should tell your doctor if you have had surgery in the past also. He or she should enquire as to how long since you last saw a doctor and for what reason. You might be asking why does a doctor need to know all this information? That’s not his business. Yes, it is! If he is concerned about finding out what’s wrong with you, he will ask and if you want him to find your diagnosis, you should volunteer the information. That’s why you should go to a doctor that you trust. Presently, I’m the only one of my kind in this country, so patients have little choice. Nevertheless, if I sense that a patient is uncomfortable with me, I give him the option of getting a second opinion overseas, or, if he can wait to see some colleagues of mine who visit once or twice a year, I will even write the referral letter! So the doctor needs as much information as possible, for his sake and for the sake of his colleague to whom he might refer you.

Your doctor should enquire about your use of “recreational” drugs like cigarettes, alcohol, cocaine and marijuana. These can interact with and affect the way medications work. This is especially true of cocaine and alcohol. In our society, where more than half the men over 20 take a drink or two every now and then, this is especially important. Alcohol “excites” the enzymes in the liver that get rid of certain medications from the body. These enzymes are normally “awake” so the medications are removed slowly. With alcohol, they are removed faster, so the medications do not work as long as they should and hence are ineffective or not very effective.

For sexually active young women, questions about the last period should be entertained, as they affect whether we do certain types of X-rays. Remember all this information is gathered within the first 2-3 minutes of the interview. If you imagine the average general practitioner’s visit for new patients is 15 minutes, then the first 3 is for the interview, the next 5 is for the examination, the next 2 is for you to get dressed, as the doctor writes down his thoughts. The last five is to discuss his thoughts with you. Specialists usually take longer, as their interview and examination is usually more detailed, hence their charges.

Next week, I will look at how the social and sexual history affects our practice.

For comments or question contact:
Dr. Rohan Deshong
Tel: (784) 456-2785
email: deshong@vincysurf.com