How can I get my doctors to talk with one another about my medical care?

You are the one person who knows what each doctor is doing. You are the one person who sees them all. And you are the one person who can make sure that all your medical providers are on the same page. Of course, there will be times when two of your doctors will consult with each other about your case, but this is not the norm. You can improve the overall quality of your care by taking on this responsibility.

Make sure all of your medical care providers have a current list of your medications, vitamins, supplements, and over-the-counter medications. Include the dose and how often you take each one. If you use one pharmacy, you are more likely to have the pharmacist notice if two medications have bad interactions. If all your doctors know what you are taking, you have an even better chance of avoiding problems.

Give copies of all your medical tests to all of your medical providers. Your lab is not going to fax your results to a long list of doctors. You doctors are not going to send your results to one another. When you see the doctor who ordered the tests, ask for a copy. These are your tests, you paid for them, and you have a right to have a copy of them. Then you can mail, fax, or hand-deliver those results to the rest of your doctors. They will become part of your chart and may provide clues about other problems.

The ultimate responsibility for the coordination of your medical care rests with you!

Samantha H.'s comment:

All of a sudden, I got this blinding headache. I have been through a lot but never felt anything so bad, so painful. I had trouble seeing. My doctor gave me a referral to a neurologist. The receptionist told me there was a 6-month wait. Six months! I couldn't live like this for 6 months! I explained what I was going through and begged her to call me if she had a cancellation or maybe ask the doctor to see me at the end of the day. She clearly didn't get it. The pain got worse. I called again. Finally, I called the doctor's service after hours. They paged the doctor. He called. After we talked he told me to go straight to the emergency room where he would meet me. It's a darned good thing too because I had an aneurysm^[1] in my brain. They did surgery that night. And I am still alive to tell the tale!

How can I get past the staff at the front desk and make my concerns known to my doctor?

Not only do you have the frustrations of dealing with your chronic illness, you also have to deal with the front desk staff at your doctor's office. For some unknown reason, a lot of these people have forgotten how to smile. Even worse, they have appointed themselves as protectors of the doctor. If your doctor has wonderful staff, you can skip this section. But sooner or later you will encounter the Gatekeepers. It's a good idea to be prepared.

You are building the foundation of a relationship that you will need down the road.

The best thing you can do is be pleasant and very human with the Gatekeeper. Even though you may be stressed at having to be at the doctor's office, the Gatekeeper sees stressed people day in and day out and is somewhat immune to your distress. Smile, say hello, and say something nice. You are building the foundation of a relationship that you will need down the road. Use her name. Thank her. Pay her a compliment. You want her to remember you fondly when you call desperate to make an appointment or need the doctor to call you back.

When you call, identify yourself by name and mention that you are a patient of doctor so-and-so. State your request clearly and concisely. Ask the person taking the message to repeat it back to you. A lot of information can be lost in translation! If you can, fax your request to the doctor. Follow up a little while later with a call asking if your fax was received, and instruct that person to give it to the doctor. This technique works very well. If you don't hear back within 24 hours, repeat the process.

If you have a true emergency, say so up front. If necessary, call 911 or go to the emergency room. If your medical need is pretty serious but not critical, you can use the technique of last resort—the after office hours call. Caution: Use this only in extreme circumstances or everyone, including the doctor, will be upset with you. Don't be the boy who cried wolf. When you call after hours, you get the answering service. They will then call your doctor who will decide how to respond.

Respect the doctor's time. Respect the Gatekeeper's job. But make sure you get the medical attention you need.

• [1] Fluid-filled sac in the wall of a blood vessel that can weaken the wall and cause it to rupture.