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What is this topic about?

This topic is about things that might happen during a visit to a healthcare provider. It is also about ways to make the visit go more smoothly.

Although different things will happen at each visit, many visits follow similar steps. The steps are outlined in the section "What is likely to happen during the visit?" Each of the steps is then described in more detail in its own section.

This topic is about regular primary care visits. It is not about visits with specialists, emergency room visits, or other types of healthcare visits that will likely have different steps to them.

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What is likely to happen during the visit?

Below is a flow of the steps that often happen during a visit. These steps are not always the same. They may be different for each provider or they may change based on the reason why you are having the primary care visit. However, this is the flow of events that happens at most primary care visits.

  1. Check in with the receptionist or front office desk when you arrive. The receptionist may ask you to sign in or wait to be checked in.
  2. Wait to be called for your turn to see your healthcare provider.
  3. Have the nurse or assistant take your vital signs and guide you to an examination room.
  4. Wait for the healthcare provider to come into the examination room.
  5. Have a conversation with your healthcare provider about your health and your concerns. Your healthcare provider may ask you some questions.
  6. Get an examination by your healthcare provider. Sometimes, especially in teaching hospitals, your healthcare provider may also talk to their supervisor, or their supervisor may examine you or ask you more questions.
  7. Have another conversation with your healthcare provider about what he or she thinks is going on with your health and what they recommend as next steps. You may want to ask your healthcare provider some questions.
  8. Work with the nurse or assistant if they come back after you've talked to your provider. The nurse or assistant may need to do some tests, give you a shot, give you some instructions, or do other wrap-up things.
  9. Check-out with the receptionist or front office desk before you leave.
  10. Consider follow-up instructions. You may have been asked to do some follow-up things, like make an appointment with a specialist, get some labs or x-rays, fill a prescription, or do something at home. See the After the Visit topic for more information on follow-up instructions.
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What do I need to know about checking in when I arrive?

It is best to arrive a little early for your visit so that you can check in. When you first enter the office, go to the receptionist or front desk and let the person there know you have arrived.

You can say, "My name is [your name] and I am here to see [your healthcare provider's name]."

If you have any paperwork prepared, give it to the person at the desk.

You can say, "This is my paperwork. What would you like me to do with it?"

The person behind the desk should let you know what to do next with the paperwork.

If you do not have any paperwork prepared--or even if you do--the person at the desk may give you more forms to fill out, or more papers to read. Most of these forms are part of standard care. Unfortunately, some can be very difficult to understand (for any patients). If you are worried about filling out or signing a form, you can ask the office staff, a nurse, or someone you trust to explain it to you.

After you are checked in, the person at the desk will probably ask you to wait until it is your turn to see your healthcare provider.

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What are some tips for handling the waiting room?

Some tips for handling the waiting room are listed in the section, "I have a hard time with the waiting room, what might I do?" in Preparing for a Visit.

If you think one of the tips might be helpful to you, bring it up to the person behind the desk at the end of the check-in process, and ask if the person can accommodate your needs. Explaining that you are on the autism spectrum can help the person see this as an accommodation and not just a preference. It can also be helpful to include briefly why it's important that you be accommodated, so the person knows you are not just being fussy.

Example #1:

I am on the autism spectrum and I have a very hard time handling the waiting room. I worry it may stress me out too much to have a productive visit. Would you be able to text me on the phone when it is my turn, so I can wait outside where it's quieter?"

Example #2:

"I am on the autism spectrum and uncertainty can stress me out too much to have a productive visit. Would you be able to let me know right away if my wait will likely be longer than 15 minutes?"

If you really don't wish to disclose your autism diagnosis, you can also be specific about the reason why you need to be accommodated without bringing up autism.

Example #3:

"I have unusually sensitive hearing and sounds can stress me out too much to have a productive visit. Would it be possible for me to wait in a quieter area?"
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What might the nurse or assistant do before I've seen the provider?

You will often see a nurse or assistant before you see your healthcare provider. This is normal in many clinics and offices. The nurse or assistant is an important part of the healthcare team. He or she communicates with your provider, and works together with your provider during your visit. The nurse or assistant has to keep your health information private just like your healthcare provider does.

The nurse or assistant will usually show you to the examination room and get some basic health information from you. He or she may ask you the reason for your visit, about any medications you are taking, or for clarifications on some of your paperwork.

He or she will often take your vital signs. This may happen in the examination room or in another part of the office. For example, scales for measuring height and weight are sometimes in the hallway. Vital signs are:

  • respiratory rate (how fast you are breathing)
  • temperature
  • blood pressure
  • heart rate
  • weight and height

The nurse or assistant will sometimes give you an examination gown to put on, and ask you to change into it.

If you need the nurse or assistant to accommodate you with something, it is OK to ask. For example, you can ask him or her to give very specific instructions, or to guide you to the room instead of just pointing.

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Tips for Staying Comfortable While Waiting for the Provider

It is OK to ask the nurse or assistant for things that will help you feel more calm and comfortable while waiting for the provider to show up. For example, you can ask:

  • how long it is likely to be before your healthcare provider shows up
  • to be told if your healthcare provider will be delayed and your wait gets longer
  • if you can wear your coat or other clothing over the examination gown until the provider comes in
  • if the lights can be dimmed, shades opened, or other changes made to the light in the room
  • if there is a quieter room available, or if you could wait somewhere quieter for your provider

It can be helpful to include briefly why it's important that you be accommodated, so the nurse or assistant knows you are not just being fussy.

You can say, "I have a very hard time with [describe what makes you uncomfortable], and worry it may stress me out too much to have a productive visit. Would it be possible [describe the tip that you think will be helpful]."

Example:

"I have a very hard time with being cold, and worry it may stress me out too much to have a productive visit. Would it be possible for me to wear my sweater over my examination gown until the provider is ready for me?"

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What might my healthcare provider ask me?

If you have made a list of things you would like to have addressed, share it with your healthcare provider at the beginning of the visit so that you and your provider can set a plan for the rest of the visit. Then the provider will probably ask you questions regarding the issue(s) to be addressed at that visit.

Your provider will interview you about the symptoms of the problems you want to take care of. If you have used a Symptoms Worksheet to organize your symptoms, you might find it useful to refer to your worksheet when your provider asks you about your symptoms. Do not hand your provider the symptoms worksheet unless he or she asks you to see it. The worksheet is just for you to better be able to answer the provider's questions.

If your provider is asking a lot of questions, it's not to be nosey or invade your privacy. Doctors are trained to ask questions in a particular way in order to make a proper diagnosis and treatment plan.

In addition to asking questions about your health concerns, many providers will ask you for information that may seem very personal. They do this because these things can have important effects on your health or healthcare. They do not do this because they think you are a bad person or the type of person who would do bad things. They ask these questions of everyone. It's best to be honest about this stuff. Personal or embarrassing questions might include:

  • Habits - smoking, alcohol, drugs
  • Diet and exercise
  • Living situation, employment, disability status
  • Intimate relationships - sexual preference, sexual activity, how many partners, birth control and STD control, threats, violence, abuse
  • Mental health - depression, sadness, mania, anxiety, panic attacks
  • Social supports, social life, stressors in your life
  • Healthcare Power of Attorney, guardianship, emergency contacts
  • Preventative health - see "Prevenative Healthcare" section of "Staying Healthy"
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I have a hard time answering these types of questions, what should I do?

If you have trouble answering your healthcare provider's questions here are some things you can ask your provider to do that might make it easier for you to answer. Not all of these will be useful to every person. Not all of these will be possible. Providers are more likely to do these things if you pick the one or two most important suggestions for you.

  • Specific Questions - Have your provider ask very specific, concrete questions and avoid very broad questions.
  • Yes/No - Have your provider ask yes and no questions when possible.
  • Extra Time - Ask the provider to give you extra time to respond to questions.
  • Read written notes - Ask your provider to read notes you wrote before or during the visit.
  • Examples - Have your provider give you examples of the types of things people may experience and have you explain if you experience them too.
  • Multiple Choice - Ask your provider to give you a list of possible symptoms or answers to choose from.
  • Life Events - Have the healthcare provider help with time questions by linking to important events in your life.
  • Reword - Ask the provider to reword something if it confuses you.

It's OK to not know the answers to questions the provider is asking. It's also OK to not to be 100 percent exact or confident in your answers.

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What might my healthcare provider do to examine me?

The provider may need to examine your body to diagnose you and recommend next steps. The provider may examine you with his or her hands or with an instrument. The provider may touch or look in your eyes, ears, nose, mouth, breasts, spine/back, abdomen, extremities, genitals, rectum, or skin. What part of the body, and the kind of examination the doctor will do, depends on the health concern being addressed.

If your healthcare provider has a supervisor (for example, you go to a clinic in a teaching hospital), the supervisor may also examine you or ask you questions.

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I have a hard time with being examined, what might I do?

If you have trouble tolerating exams or procedures, here are some things you can ask your provider to do that may make them more tolerable for you. Not all of these will be useful to every person. Not all of these will be possible. Providers are more likely to do these things if you pick the one or two most important suggestions for you.

  • Who Will Do What - Have the provider explain what parts of the visit the nurse or assistant will do and what parts of the visit the doctor will do.
  • Explain First - Have the provider explain what he or she is going to do before doing it.
  • Equipment - Have the provider show you the equipment he or she will use before it is used.
  • Trial Run - If possible, do a "trial run" of difficult exams or procedures before they are done for real. For example, practice with the equipment or walk through the steps that will happen.
  • How Long - Ask the provider how long something is likely to take.
  • Warn - Ask the provider to let you know when they are about to touch you or do something to you.
  • Clothes - Ask if you can keep as many clothes on as possible or limit the amount of time you have to be undressed or in a gown.
  • Extra Time - Ask for extra time to process things you need to see, hear, or feel before you have to respond (for example, pressing and asking if something hurts).
  • Avoid Touch - Ask to be touched as little as possible during the exam.
  • Firm and Deep Touch - Ask to be touched with a firm, deep pressure if possible (not a light touch).
  • Sit or Lean - Ask if you can sit, lie down, or lean on something during procedures, when possible.
  • Signals - Ask if you can use a signal to tell the provider that you need a break.
  • Check In - Have the provider ask you from time to time if you are able to handle the pain or discomfort.
  • Anesthesia - Ask if anesthesia is an option if you need it to tolerate a procedure.
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What might I want to ask my heathcare provider?

After your healthcare provider has examined you, they will talk about what they think is going on. You might want to ask your provider some questions about what they think is going on.

Here is a good list of questions you might want to ask your healthcare provider:

  • What do you think is causing my problem?
  • Is there more than one condition (disease) that could be causing my problem?
  • What tests will you do to diagnose the problem and identify which condition is present?
  • How good are the tests for diagnosing the problem and the conditions?
  • How safe are the tests?
  • What is the likely course of this condition? What is the long-term outlook with and without treatment?
  • What are my treatment options? How effective is each treatment option? What are the benefits versus risks of each treatment option?
  • If my symptoms get worse, what should I do on my own? When should I contact you?

(Taken from article on MedicineNet.com by William Shiel, Jr, MD.)

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What are some tips for understanding diagnoses and recommendations?

Here are some suggestions that might help you make sure you understand your provider's recommendations. Not all of these will be useful to every person. Not all of these will be possible. Providers are more likely to do these things if you pick the one or two most important suggestions for you.

  • Restate - Restate what the provider said in your own words to see if you got it right.
  • Get Another Explanation - Ask a supporter who communicates well with you to re-explain the things to you.
  • Write Things Down - Ask the provider to write things down, or write things down yourself and have him or her check it.
  • Get Names - Ask for the name of your health condition and look it up in a credible source.
  • Discuss Options - If a decision about something needs to be made, discuss your options with a trusted person before making a decision.
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I have trouble being included in decisions about my healthcare, what should I do?

If you are having trouble being included in discussions or decisions about your healthcare, here are some suggestions as to how you can be more involved. Not all of these will be useful to every person. Not all of these will be possible. Providers are more likely to do these things if you pick the one or two most important suggestions for you.

  • Extra Time - Ask for extra time to make a decision. It's OK if that means you need to come back or communicate the decision at a later time.
  • Ask for Concrete Information - Tell your provider to be very blunt and concrete with you about what will happen if you do or do not follow your provider's recommendations. If possible, have the provider give concrete examples.
  • Get Detailed Information - Ask your provider to direct you to detailed information or resources about your health conditions.
  • Involve Others - Have the provider give a person you trust detailed information about your health conditions and choices.
  • Discuss - Discuss your healthcare choices with a person you trust and then speak to your provider about what you've decided.
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What might I do if there isn't time to cover everything I want to cover?

Not all of your concerns can always be covered in one visit. If you're not able to get all of your concerns covered, it is OK to ask for another appointment to finish up. The front office staff or receptionist can usually help with scheduling another appointment.

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What do I need to know about preventive care?

Preventive care includes things that can help prevent a major health problem, or can help catch a health problem when it is still minor or easier to treat. Preventive care includes things like cancer screening, vaccinations, and dental cleanings.

Some preventive care, such as screening for diseases like cancer or diabetes, needs to be done regularly. You may want to ask your healthcare provider during the visit if you need to make a separate preventive care appointment for anything.

For more information about preventive care, see the topic Preventive Care under Keeping Yourself Healthy.

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More Tips for Communicating with Healthcare Providers

It is OK to ask your healthcare provider for things that will help you communicate with him or her better. Here are some tips to make it more likely that the provider will understand and give you what you need.

If you ask for accommodations, make it clear that it is a disability-related need, not a preference.

Example: "Even though my speech is fluent, I have a really hard time communicating verbally. May I please write down my answers instead? It will help me give you better information."

More information about asking for accommodations is found in "How do I request ADA accommodations for my healthcare?" in the Equal Access section.

  • If someone helps support you with your healthcare, explain (or ask your supporters to explain) the role of your supporters to your healthcare provider. Different people have different ways they like to be supported. For example, some people like to do all the communication with their healthcare provider themselves and have the supporter just take notes, while others may want the supporter to do most of the communication. Your healthcare providers may not understand what role you want your supporters to play in your healthcare unless they are told.
  • It's OK to ask your healthcare provider to go more slowly. It's OK to ask your provider to re-explain something or write it down.
  • Let your healthcare provider know that you respect how tight their schedule may be. One way to do that is bring a list of your health concerns and at the start of the visit discuss which of the issues to address right away, and which may need to be taken care of at another appointment. It is OK to ask for another appointment to get all of your concerns addressed.
  • Show your appreciation for the provider's efforts. When the visit is nearing an end, you can simply say, "Thank you for your time and effort."
  • Regular preventive care or follow-up visits may strengthen your relationship with your provider because you will see him or her more frequently.
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What might the nurse or assistant do after I've seen the provider?

The nurse or assistant might come back after you have seen your healthcare provider. He or she might talk to you about things the healthcare provider has recommended. For example he or she might go over any new medications, might show you how to do something you'll need to do at home, or might give you more information about your health condition. He or she might have instructions for you about testing, or about seeing another healthcare provider. The nurse or assistant might also do some tests or draw blood. Use the tips in the sections, "I have a hard time answering these types of questions, what should I do?", "What are some tips for understanding diagnoses and recommendations?", and "More Tips for Communicating with Healthcare Providers," for communicating with the nurse or assistant.

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What about check-out and follow-up?

After you have seen your healthcare provider and done any other things with the nurse or assistant, you may need to go back to the front desk or receptionist and let them know you are done with your visit. Depending on your situation, there may be some extra steps to checking out. Examples of steps some people might need to take are:

  • Schedule another visit with your healthcare provider to cover something that wasn't addressed at this visit
  • Schedule a follow-up appointment, lab, or other type of visit that the front desk or receptionist can help with (see the topic After the Visit for more details)
  • Schedule a preventive care visit
  • Pay for something
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Summary

Most regular visits with a primary care provider follow these steps:

  • Check in with the front desk
  • Wait to be called for your turn with the healthcare provider
  • Have the nurse or assistant take your vitals and show you to a room
  • Wait for the healthcare provider
  • Talk with the healthcare provider about your concerns
  • Get an examination
  • Talk with the healthcare provider about what they think is going on with your health
  • Work with the nurse or assistant on any final steps
  • Check out
  • Consider follow-up instructions

During all of these steps, it is OK to ask for things that can help you best participate in your healthcare. You may ask for things you need from front desk staff, nurses and assistants, and from the primary care provider. It is usually easier to get your needs met if you briefly explain why what you need really matters. Otherwise people might misunderstand and think it's just a preference or that you are being fussy.

Healthcare providers like to feel appreciated and respected, just like anyone else. It can improve communication with them to let them know you appreciate their work and respect their time.

If you aren't able to cover all of your health concerns in one visit, it is OK to make another visit to cover the rest of the issues.

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