Last week's column focused on what you can do before a medical appointment to get the most out of it. This column will focus on the appointment itself, and how to get the help you need.

Wear appropriate clothing to your appointment. Plan ahead: if you have a cough, your health care provider is going to have to listen to your chest and back with a stethoscope, so wear a shirt that is easy to get on and off. If you have an ingrown toenail, wear easy-to-remove shoes.

If at all possible, don't bring children to the appointment with you. Their presence is distracting and will make it more difficult for you and your provider to focus on your health concerns.

Arrive to your appointment on time or a few minutes early, so you have time to fill our any necessary paperwork. Bring your insurance information to every appointment. Be sure to inform the receptionist if you have moved or changed your phone number.

A medical assistant or nurse may take you to an exam room and take your vital signs. They may ask you the reason for your visit. Tell them briefly, but you don't need to go into detail unless they ask. Don't assume that everything you tell them will be passed on to your health care provider.

When your health care provider comes in, pull out your notes about the reason for your visit. Tell him or her why you have come and what you hope to accomplish with the visit. Start with the most important problem (and realize that your health care provider may not agree with you about what is the most important problem, so be prepared to negotiate). At the end of the visit, if there was not enough time to talk about everything on your list, make another appointment.

Your health care providers have the right to expect that you will be honest with them. Don't withhold information because you are embarrassed; this will only make things more difficult. They also have the right to expect that you will follow their advice. Don't promise that you will stop smoking and start walking two miles a day if you know you won't do so. If you feel that you can't do what they advise, tell them why, and perhaps you can negotiate a better solution. If you can't fill a prescription or have a test done because you don't have enough money, say so! There may be a less expensive solution.

You have the right to expect that your health care provider will listen to your concerns, do the necessary physical examination, order appropriate tests, and prescribe medicines or other treatment when necessary. You have the right to ask questions until you thoroughly understand the reason for any tests and treatment your provider recommends. You have the right to disagree with your health care provider, but should do so in a respectful way.

Be sure to follow through on any tests or treatment your health care provider recommends. Find out how you are going to get test results: should you call the clinic or will they call you? How long will it take before the results are available?

If you need to get a prescription for medication filled, chose a pharmacy near your home. It is best to get all your prescriptions from the same pharmacy so if two different providers prescribe medicines for you which may react badly together, the pharmacist is more likely to notice this and bring it to your attention. Start medications as soon as possible, and take them exactly as prescribed. Report any side effects to your health care provider.

Communication is the key to having a successful medical appointment. Some preparation on your part can make it much more likely that you will be able to communicate your health concerns and that they will be addressed and resolved to your satisfaction.

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