Doctor’s Visits…Aren’t They All the Same?

Scheduling a doctor’s visit can be confusing if it’s your first time or you haven’t been in a while. Some folks even have to resort to calling their parents for help, or let's be honest, the more organized spouse.  Let’s face it, scheduling this appointment can be a hassle.  Not only do you have to provide portions of your personal history but then there’s the insurance information too.  Who hasn’t stumbled over which is the Group ID vs Member ID?  And just when you think the test is over the front desk staff ask what do you need to be seen for?  Essentially, what type of visit do you need?  But hey, don't worry, I'm here to help you crack the code of the different types of doctor's visits. Let's make this appointment a little less stressful!  Here’s a list of the 6 standard office visits:

1. New patient appointment: First-time visits are scheduled as new patient appointments.  There are certain situations where you may have seen the doctor before but will need to be treated as a new patient.  Pertinent health history is reviewed during this appointment. In some states, if you haven’t been seen within 3 years of your last visit, you’re considered a new patient. It’s important to maintain a relationship with your doctor in the event you have an urgent or emergent need.

2. Established patient appointment: Congratulations on finding your new doctor! Once you’ve completed the new patient visit you’ve become established with the practice.  Established patient appointments are all the visits that follow the new patient visit. The term “established patient” more so defines the relationship you have with the practice. 

3. Acute care appointment: The term urgent visit can be used synonymously. These are focused visits with specific questions and physical examinations for new health concerns.  Examples that warrant an acute care visit would be abdominal pain, burning with urination, fatigue, a cough, etc.

4. Annual Physical: The annual visit is an important visit.  It’s your free visit, meaning no co-pay is needed. However, that part can get tricky.  Stay with me.  I’ll explain later. A physical is typically completed once a year. Preventive screenings, such as pap smears, colonoscopies, mammograms, and lab testing are discussed during this visit.  Family history is crucial and is taken into account when determining which screenings are appropriate.  The annual physical is also an opportune time to review nutrition and exercise recommendations, screen for mental health conditions, and discuss contraception.  Now back to the tricky part. If a new concern is discussed during the physical it can be combined with an acute care visit. Thus, a co-pay is needed. 

5. Medicare Wellness Visit (MWV):  If you are a Medicare health insurance holder, you can schedule a Medicare Wellness Visit.  This visit is designed specifically for seniors and is similar to an annual physical but with an additional focus on the increased risk of complications related to falls, fractures, and injuries. It includes a thorough review of medications, vision and hearing screenings. Additionally, the Medicare Wellness Visit also provides an opportunity to have discussions about advanced care directives.

Hopefully, this review clarifies the different visit types and highlights the different components and purposes of each visit.  

Will there ever be enough time?

Visit times in the doctor’s office seem to be getting shorter and shorter. Leaving patients, and surprise…even their doctors questioning the care that’s provided. The new game is how do we make visits more efficient? Can this be done? Some doctors have taken it upon themselves to circumvent this by establishing direct primary care practices. Creating more autotomy with which medicine is practiced and how visits are conducted. Others have begun to develop the skillset of support staff. Thus, separating data collection from the physical exam and decision-making. Nonetheless, how medicine is practiced has become challenging from the lobby to behind the exam room door.

Navigating a visit to the doctor’s office can be difficult especially if it’s your first visit or you haven’t been in a while. It can be even more intimidating if you are functioning in the capacity of a patient advocate. Don’t fret though! I’m here to help you make the visit a little bit easier and enjoyable.

First things first, and I mean FIRST! Find the right physician for your medical needs.   Establishing the best doctor-patient relationship is number 1 on the list of how to navigate your doctor’s visits.  Throw away the list of the perfect significant other and replace it with the perfect doctor.  I’m just kidding.  However, this relationship is one of the most important relationships you’ll ever have. When you leave that initial visit, otherwise referenced as the new patient visit, there’s only one question that needs to be answered.  Will I be able to trust them with my health?  All the other boxes may be unchecked.  However, this one can’t go unfulfilled.  It can be a matter of life or death.  

Second, when preparing for your visit identify what kinds of questions you have.  Don’t forget to write them down.  Remember, we are trying to optimize our time.  Are you interested in preventive measures or would you like to understand how to better control conditions that may have already taken place? This is important because it helps to determine the type of visit. In today’s world of medical practice, the visit type is essential.

Why is the visit type important? First, we should discuss the different types of visits. Most offices will have the following visit options: new patient, acute care, chronic care, comprehensive physical, and procedural visits. There can be other visit types based on the specialty. Now that we’ve discussed the visit types, we can discuss their significance. Primarily, this is used to set the focus of the visit (agenda) and the length of time. What is the purpose or priority?  Is there a new problem that needs to be addressed?  Are we assessing the status of a pre-existing condition? Or are we preventing a condition from occurring, thus screening tests and counseling are the focus?  The request to focus on the visit's agenda isn’t to neglect other concerns but to allow for the most appropriate decisions to be made with clarity.  The human body can be vastly complex.  Dedicating the proper amount of time to these matters is truly what’s in your best interest.  Combining multiple visits in one can leave you unsatisfied.  If you find yourself in this situation tell the front desk staff that you have multiple concerns when making the appointment.  Perhaps the length of the visit can be adjusted to accommodate this.  Also, utilize a telehealth visit after an in-person visit.  The physical exam has already been done. Therefore, the second visit might be more conversational to determine the next steps. 

Third, try your best to bring concise documentation of your past medical history.  When trying to enhance your visit records that are pertinent to your concerns are most helpful.  This allows you to become more familiar with certain medical processes and allows your doctor more time to focus on your needs. What’s more satisfying than preventing repetitive tests and gaining more time?

Last, end your visit by reviewing the treatment plan. Ensuring that you have a proper understanding of what to do will help increase the likelihood of achieving your goal.  Both you and your doctor just might leave the visit with a smile and a good day. 

Hopefully, these tips will help you and your doctor achieve a satisfactory visit.  Now take a deep breath with me and relax those muscles.  We’ll talk about creating health goals next time.