Individuals living with a digestive disease or disorder are usually destined to a long-term relationship with a gastroenterologist. How can you make the most of this? As a patient, you can take an active role in managing your disease. You can set the tone for a successful doctor-patient rapport based on mutual respect, ensuring that the lines of communication remain wide open.
A consultation with a gastroenterologist is an opportunity for you to benefit from highly specialized medical expertise. Gastroenterologists have focused their extensive medical training on the digestive tract and are uniquely qualified to assess and manage these diseases and disorders. They have likely treated a number of cases similar to yours. Make the most of this valuable time by preparing well in advance. Below are some guidelines to follow when meeting with a specialist.
Pre-Planning at Home
Diary: Some patients keep a diary of relevant medical occurrences. Keeping such an ongoing record throughout your disease state is a good idea and it will help you prepare a written summary of your current condition and past treatments for discussion at any medical appointment. Over time, such a record will help you understand things that have been helpful for you. Sometimes, when faced with an intense medical crisis, patients forget specific details from the past, and referring to this written record is like finding a hidden treasure.
Summary: Prepare a brief, accurate summary of your pertinent medical information – this is where referring to your diary could be helpful too. The summary should be no longer than one page, including things such as:
- your name, birth date, and the current date
- your height and current weight
- your diagnosis, if you already have one, and when this was made
- status of any other medical problems
- any surgeries you have undergone
- all medications you are taking, including dosage, and listing any treatment side effects or reactions you may have experienced
- any allergies you have
- all alternative therapies, herbal products, and supplements you are using
- other life events that could affect your physical or mental health (e.g. you are planning pregnancy, you work at a stressful job, you are ready to retire)
- the name and contact details of your general practitioner (GP), pharmacy, and any other healthcare practitioner involved in your care
Questions: Think about your situation well ahead of your appointment and jot down questions as they come to you. A few days before your appointment, look over the questions and prioritize them. Going over this list with the specialist will be a useful learning tool for you and will ensure you get the answers you need quickly and thoroughly.
Scheduling: One other note about preparation – when scheduling the visit, think about a day and time that is most convenient for you. This helps avoid delay and potential conflicts, especially since you may make your appointment weeks in advance. Be sure to call the specialist’s office to confirm your appointment a day or so ahead of time.
Be punctual, allowing lots of travel time so that you don’t arrive stressed and rushed. Use any waiting time to review your documents, take along a book to read, or get out your iPod and sit back and relax until they call your name. Get to know the doctor’s medical and administrative staff by name; everyone in the office appreciates a pleasant patient.
Be organized and use the time efficiently. You have about 15-30 minutes to tell the doctor what is going on; so your advance preparation is vital. When asked, describe your symptoms and offer any information regarding when they started and if there are times when they improve or worsen. Be sure to include other health issues even if they seem unrelated to your gastrointestinal condition. Clues about symptoms occurring outside of the digestive tract can also be quite helpful to the gastroenterologist in determining a diagnosis and an appropriate treatment. Be as honest and open as possible about your lifestyle and present condition. Explain why you are seeing this doctor, there could be many reasons, including moving to a new area, new onset or recurrence of disease, dissatisfaction with a former physician, or needing a second opinion.
An initial appointment with your gastroenterologist will be different from most follow-up visits, as it is throughout this meeting when the physician will gather everything necessary from your medical history that might affect decisions regarding the best way to manage your disease. Although your GP will have sent information about you when referring you to the specialist, you should still make sure that everything the gastroenterologist has in your file is accurate and up-to-date.
Give the physician a copy of the summary mentioned above and make sure to keep a copy for your own reference. You might want to consider taking your current medicine bottles with you to show the doctor, and if you have had ostomy surgery and your questions relate to this, then it might be helpful to take a sample of your appliance supplies with you, as this can make explanations simpler.
Prioritize so that you raise your most important concern(s) first, just in case you run out of time. Other issues of lesser priority can wait until your next visit, or perhaps you can ask your GP these questions.
Take notes, or have someone accompany you to take notes, as it is important that you completely understand and remember what your doctor tells you. This includes knowing the purpose and results of any diagnostic tests that the doctor orders. Some people find a doctor visit to be stressful, and when receiving information while in this state, have difficulty remembering it later. Repeating instructions or explanations in your own words is a useful way of confirming comprehension. Stick to the essentials, especially at an initial consultation, as too much information can be confusing and takes up extra time.
As the appointment winds up, ask what you should do in the event that you experience complications, aggravated symptoms, or a flare-up before your next scheduled appointment. Be sure to get any new prescription that your doctors suggests written out before you leave. Read it, checking that your information is correct and that the instructions are as you discussed and understand them. Medication compliance can affect the treatment outcome and, consequently, there are very specific pharmacological reasons why your doctor prescribes medication a particular way.
If you have discussed the need for additional information or care, ask the doctor for a recommendation or assistance in finding a medical professional to help. This could include seeing a registered dietitian, for example. Request any printed resources relating to your condition, or contact GIS for more details on any gastrointestinal diagnosis. Discuss the timing of your next appointment, being sure it is within 6 months of your first visit, or you may need another referral from your GP, which could result in additional waiting time.
When the appointment concludes, and if you are grateful for what you’ve received from the visit, then be sure to say so. Thank you goes a long way!
Editor’s note: The usual procedure in Canada is that your general practitioner refers you to a gastroenterologist when caring for you requires a specialized level of education and training. Most medical plans will not cover the cost to see a gastroenterologist unless your GP refers you. However, sometimes you might want to do a bit of investigation on your own to locate the right specialist for you, so please refer to our “Resources” section, where we’ve included some websites that you might find useful.
Beware of Medical Information on the Net
Obtaining accurate up-to-date information about your body, and any disease or disorder affecting it, is a foundation on which good care can flourish. Take caution, however, when gathering health or disease information from the internet. There are many self-serving charlatans preying on ill people by offering, often expensive, miracle cures. Others simply offer misinformation. Be sure you look to sites that are not selling products, and to those run by reputable health organizations such as The Canadian Society of Intestinal Research, where gastroenterologists licensed to practice in Canada oversee the published material.
Helpful Resources for Gastrointestinal Diseases & Disorders
GIS produces a number of up-to-date, easy-to-read patient information pamphlets & booklets for wide-spread distribution and provides them free of charge to individuals, healthcare professionals, hospitals, pharmacies, libraries, and various other parties throughout Canada.
Our current list of topics includes: Celiac Disease, Constipation, Crohn’s Disease, Diverticular Disease, Gastroesophageal Reflux Disease (GERD), Hemorrhoids, Hiatus Hernia, Inflammatory Bowel Disease, Intestinal Gas, Irritable Bowel Syndrome, Functional Dyspepsia, Pancreatitis, Stress Management, Support Groups, Ulcer Disease, Ulcerative Colitis, and Ulcerative Proctitis.
To place an order, click here, or phone 1-866-600-4875.
IBS & IBD Support Groups
GIS support group attendees offer one another understanding, comfort, and encouragement. Meetings are without charge and are open to people with gastrointestinal diseases and disorders as well as their family and friends. A large part of each session is dedicated to open sharing and discussion. Meetings sometimes include presentations, mini-seminars, videos, and other features. To join a support group, phone the GIS office.
Websites & Phone Numbers
Are You Trying to Find a Gastroenterologist?
You might want to help your general practitioner find a specialist that is right for you. The following websites allow you to search for a doctor by specialty and the location where they practice.
Nation-wide information is available through The Royal College of Physicians and Surgeons of Canada website. Click on “Directory of Fellows” to search for a physician or go to one of the specific websites listed below by province or territory.
- British Columbia
- New Brunswick
- Newfoundland & Labrador
- Northwest Territories
- Nova Scotia
- Prince Edward Island