How to get the best out of your GP

Statistics show Australians attend their GP on average six times a year. It is also clear that health literacy and quality of healthcare has never been so important.

Having worked as a GP for 16 years, I’ve shared the journey with thousands of patients. In this article, I’d like to offer some practical suggestions for the health consumer in order to get the very best out of their GP.

Booking your appointment

Often GPs allow long appointments to be booked for issues like mental health, or for multiple issues. Unfortunately, it isn’t always possible for the GP to extend the consultation so be prepared that you might need to return for a further appointment. Cost can be an issue so it is always worth being upfront if you are seen privately. Many GPs will discount or bulk bill follow-up consultations.

Patient patients

The first time you see a GP, it will take time for them to get to know you. Bring in a health summary from your last GP, or write a list including: serious medical problems and hospital admissions, operations, medications and allergies, and family history.

Many GPs, myself included, have been tempted at times to start bombarding the patient with questions, thinking we already have the answers. Despite this, the first minute or so when you are talking is precious time for you to explain your agenda in your own way.

Setting the agenda

What you want from your consultation may be different from your GP. If you can, clarify your thoughts, concerns and expectations about your health. If you have more than one problem, tell your GP at the start so that you can both prioritise and set aside the appropriate amount of time. Rushing through a list in one go is not good in the long run.

On the record

Make notes if you’d like a record for later. Sometimes I provide a summary of major ‘take home’ points for my patients, especially if a lot has been covered. I started doing this after a few patients returned having completely forgotten points discussed or overlooked certain agreed actions from the last consultation.

Is your GP listening?

GPs are trained to listen first and speak later. Unfortunately, not all GPs abide by that saying. A study in the USA found that many patients will have stated their agenda by about six seconds, though some took almost two minutes. Doctors only elicited a health consumer’s agenda half of the time.

Many GPs, myself included, have been tempted at times to start bombarding the patient with questions, thinking we already have the answers. Despite this, the first minute or so when you are talking is precious time for you to explain your agenda in your own way.

Ask your GP to let you finish if you don’t feel you’ve had a chance to say everything you need (within reason). It’s well known that inadequate listening by the GP can lead to problems such as doing the wrong examination or test. In the worst-case scenario, you could get the wrong diagnosis and treatment.

What is your GP thinking?

Doctors may share similar training yet we develop our own methods of diagnosing and treating our patients. One GP might like to get a good understanding of all your past medical issues, family history, smoking and alcohol status etc. before moving on to your current problem. Having this knowledge at the start can often make a difference to the outcome.

An example: 30-year-old ‘Jenny’ comes in with a breast lump. She might receive a more conservative approach such as surveillance before having a scan further down the line, but if her family history is of cancers that increase her risk then management should, of course, be fast-tracked.

On the other hand, another GP may prefer to deal with a current issue and get to the less ‘urgent’ items on another occasion. That might make a health consumer feel happy that something has been done but may miss addressing items that could affect long term health.

An example: 50-year-old Joe comes in with a sore knee. It looks like arthritis and he is sent home with advice on painkillers and exercise. He feels better so he doesn’t return. But he hasn’t been asked about his father and uncle dying of heart disease in their 40s, so this might be a missed opportunity for screening.

Do I need an examination?

Many patients feel embarrassed or apprehensive about having certain intimate examinations. That is quite understandable, and even doctors can feel the same way when they see another doctor. GPs are used to patients getting nervous, and if made aware beforehand, they can gently explain about the procedure and take it at the patient’s pace.

Personality and communication

Is your GP rigid or flexible? Are they paternalistic, as in “Do as I say” or more about you – “What would you like to do?”

Does your GP explain difficult terms, and answer your questions to your satisfaction? Are they patient with you? Do they encourage you to take on responsibility and autonomy in your health management?

It depends on your personality and communication style as to whether you’ll be able to work together towards your health goals.

Confidentiality

Another important issue is when GPs (and other doctors) are within earshot of others. Your GP should never discuss your health with anyone else without your permission. A good doctor never forgets about confidentiality, and the circumstances where this trust can be broken are extremely rare.

Continuity of care

Ideally, you will have just one GP, so they will know you and your issues and be able to manage you better than someone who only sees you occasionally. However, given that many GPs work part-time, and in any case all will take time off at some point, try to stick to a maximum of two GPs in the same practice. Not only will they be able to share your health record, they can have more of a team approach.

Getting a second opinion

If your regular GP seems to have hit a roadblock with managing your health, or you just don’t gel due to personality differences, you’ve a right to a second opinion. This could be within the same practice or in a different one. A fresh pair of eyes and a new perspective can make a big difference if progress has stalled. Some people feel understandably guilty if they move to another doctor, but that is unfounded.

Look for a doctor with good communication skills, empathy and a collaborative approach that empowers you.

Asking for assistance

Apart from medical advice and treatment, what about navigating the health system? Only about a quarter of people surveyed by the ABS found it easy to navigate the health system, with increasing difficulty for people experiencing psychological distress. People may need help with booking an outpatient appointment or investigation, understanding a treatment plan, or working through options. Again, ask your GP if you need help.

Mental health issues

The Australian Institute of Health and Welfare (AIHW) found that during 2015-16, the number of people attending with mental health conditions was on the rise; a third attending with depression. And with an estimated four million Australians experiencing a common mental health condition in 2015, these statistics show the seriousness of mental healthcare.

There are many facets to a successful mental health consultation.

In brief, I’d recommend booking a long appointment, and if possible, that a partner/friend/relative accompanies you. In my experience, that gives the health consumer emotional assurance, as well as the support person being an advocate. In addition, more objective information can be provided this way, as sometimes someone with mental health issues may be too distressed or lacking in full insight to give a full explanation of symptoms.

Your health is important and should be top priority for your doctor too. Look for a doctor with good communication skills, empathy and a collaborative approach that empowers you.