- By Debra Witt
Most doctors' offices are far from cozy, and few lend themselves to lengthy conversations. But if you want to get the most from your visit — and your medical treatments — you need to speak up and engage your doctor in some frank dialogue, especially if he or she is prescribing new medications.
The Centers for Disease Control and Prevention reports that 84 percent of all doctor visits result in new prescriptions — a total of 4 billion in 2011 alone, according to the American Academy of Family Physicians.
Clearly, there's a lot to talk about.
"Some patients may have been raised to never question authority and they view their doctor as an authority figure," says Dr. Jeffrey Cain, president-elect of the academy and the chief of family medicine at Children’s Hospital Colorado in Denver. "Some may be intimidated by the office setting. I say, Get over it!”
"Your doctor is your partner, your counselor and your collaborator," he adds. "Arrive ready to talk and listen — and don’t leave without making sure you have answers to all of your questions."
Before you step out of a doctor's office with a new prescription, Cain advises, be sure to ask these seven questions:
1. What is this prescription for?
The answer to this simple question should ensure that you fully grasp the health issue(s) you face, and the reason why this medication is necessary. "If you don’t understand your problem," Cain says, "you might downplay the importance of following the treatment plan." Explaining why you need a prescription is your doctor's job, but taking medicati0on as prescribed is yours.
2. How will this medicine help me?
This gets to the heart of what you should expect from the drug. For example: Will it will ease symptoms like pain or inflammation, or completely eliminate them? "When you know what the medication can do for you, you’ll be more likely to take it," Cain says, adding that approximately 20 percent of all new prescriptions are never filled — in part, he says, because too many patients minimize their health problems.
3. What are the side effects?
You know that potential side effects will be listed on the information sheet that comes with each prescription. But it’s important to hear from your doctor which, if any, should be of greatest concern to you. Many common side effects are bothersome but just temporary, Cain notes. "But if you don’t know what these are ahead of time, you might give up on the drug too soon." For example, many high blood pressure medicines increase the urgency to go to the bathroom. Often, this side effect goes away in a few days, and there are some steps you can take to minimize it, "but if you don't know that," Cain says, "you may stop taking the drug."
4. How do I take this medicine?
Other medications, alcohol, and certain foods and vitamins can impact the effectiveness of many drugs. Ask your doctor about the best times of day to take a drug, which foods to avoid and whether the medicine can be safely combined with your other prescriptions.
5. Do you know how expensive this is, or if my insurance plan will cover it?
New drugs can be more expensive than older treatments for the same condition — and some insurance plans may not cover them. "Your physician should be aware of the drug’s cost and your insurance," Cain says. If cost is an issue, discuss it with your doctor and, if possible, find an acceptable alternative before you leave the office. "There may be an equally effective, lower-priced option, including generics," Cain says.
6. Are there non-drug options I can try?
"Many major health concerns, including diabetes, stroke and heart disease, are best treated with lifestyle changes," Cain says. If you are making modifications to your daily routines, like giving up smoking or changing your diet, your doctor may be able to prescribe a lower dose of a medication, or shorten the time you’ll need to be on a drug. "Or we could delay trying a medication in order to give lifestyle changes some time to take effect," he says.
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7. Why is this new drug better for me than what I was taking?
This is an important question to ask when your doctor suggests a new medication for an existing condition. "It’s another chance for you to get more information about your condition and the new research that’s out there," Cain says. Doctors switch medicines for many reasons: The drug you’ve been taking simply doesn't work for you anymore; new research has uncovered previously unknown risks; you may have developed new side effects that can be minimized with a different medicine; your insurance no longer covers the old drug; or a new study suggests that a different medication will deliver better results.
Your Job: Sharing Your Prescription List
If you're like 1 in 3 American adults, you regularly take more than one prescription drug, according to the CDC. Think your doctor knows all of the medicines you’re taking? Not necessarily.
You’d be surprised, Cain says, how often a physician’s list of a patient's medications varies from the lineup of drugs actually being taken. The problem, he explains, is that many patients simply don’t take all the medications they’ve been prescribed, or they see multiple specialists for different ailments and don't keep every office up-to-date on their prescriptions. It’s important to write down the names of all the medicines you take, and your daily dosage and frequency. Over-the-counter drugs, vitamins and supplements should be included on your list, which you should bring with you to every doctor's appointment. "Show it to the doctor, even if they don’t ask for it," Cain says. Your doctor should be able to evaluate potentially harmful drug interactions and, if necessary, compensate by adjusting your prescriptions.
"The best doctor-patient relationships," Cain says, "are open and collaborative."
That's definitely a healthy prescription.