For more than J0 years, I have recommend that health-care consumers ask a friend I or family member to accompany them on doctors' appointments. It makes sense. Having a family member or friend present is like having another set of ears to hear what the doctor is saying and a second voice to ask the questions that need to be asked.

Most doctors appreciate an advocate being present, especially if the patient is under great stress or is otherwise unable to comprehend all that's being discussed. Any patient who has a serious health problem or faces a major course of medical treatment would be wise to take someone along on doctors' appointments. When a person's health is at stake, it can be incredibly stressful, which means the patient is probably not operating at 100% of his/her mental capacity.

But just accompanying someone on a doctor's appointment is not enough. Here's bow to be a good advocate.

Write questions in advance. We've all heard this time and time again, but there really is no substitute for writing down the questions you want to ask the doctor. To use your time with the doctor most efficiently, go one step further. Divide the questions into two categories. First list the questions that apply directly to the patient, such as "What do you expect to find from this test?" or "Should the medication be taken in the morning or evening?" Then list the questions that involve the advocate or caregiver, such as "Will he need assistance at home after the surgery?"

Be sure the patient is included. Once at the doctor's office, make sure the doctor speaks directly to the patient at all times. Too often, the doctor assumes that the patient won't understand what's being discussed and speaks to the advocate. But even if the patient doesn't understand, he still can hear and probably feels nervous. It's very reassuring when the doctor focuses on the patient. On the other hand, if the doctor ignores the advocate's questions, it may be helpful for the patient to say, I've brought along my friend (daughter, neighbor, etc.), and Id like her to be included in all discussions. During the appointment, the advocate should take notes. If the doctor asks the patient a question, the advocate first should let the patient try to answer. If he cannot, then the advocate can respond, if appropriate. Before leaving, the advocate should verbally review what the doctor has said.

Don't forget the office staff. The advocate should introduce himself to the receptionist and any staffers who assist during the appointment. Be sure also to get the name of the doctor's primary nurse. Tell the receptionist and the doctor's nurse, if possible, that you are a friend or relative of the patient. Ask if it is okay if you call either of them directly if you have any follow-up questions or concerns. Ask for the best times to make such calls.

Most important, don't be shy. Remember that you are representing a person who is relying on you for help.

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