In the US, the typical doctor's office visit lasts seven to 10 minutes. During that time, the doctor reviews your medical history, asks questions about your symptoms, performs an exam and orders tests, if necessary.
This approach can be effective for emergencies or acute illnesses, such as earaches, bronchitis
or chest pain. It doesn't work as well for chronic diseases, such as diabetes, arthritis, asthma or fatigue.
Reason: Doctors don't ask questions that reveal the key facts about a person's life that can significantly affect the development and progression of disease.
Example: One of my patients had severe rheumatoid arthritis. She failed to improve even with the latest, most powerful drugs. None of her doctors thought to ask about her diet, which was triggering the release of inflammatory chemicals that exacerbated her symptoms.
I ask my patients to complete a 20-page questionnaire before their initial visit with me. In many cases, their answers give important clues to an accurate diagnosis. Even if your doctor doesn't ask the questions listed below, you should bring up these issues with him/her during your appointment.
Questions your doctor should ask—but may not...
1. Have you ever felt better after avoiding particular foods? Up to 40% of healthy Americans report having an intolerance to one or more foods.
Why it matters: Millions of Americans react to wheat, dairy or other specific foods or food groups. Food intolerance is a frequent cause of diarrhea and other digestive problems. It also can cause fatigue and headache. Patients often suffer for years without being accurately diagnosed.
The quality of a person's diet can have a significant impact on the risk for chronic or recurrent disease...energy levels, mood and body weight...recovery from infection...and the control of chronic disorders such as diabetes and high blood pressure.
What you can do: If you have unexplained symptoms, such as headache or diarrhea, keep a food diary to record everything you eat and drink over a three-day period, including spices and condiments such as pepper and mustard. The most common culprits are milk products, wheat, corn, yeast, sugar, artificial colors and flavors and spices. Eliminate a suspected problem food from your diet for five to seven days. Do Your symptoms improve when you avoid the food? Do they get worse when you reintroduce it? If you find a problem food, ask your doctor whether you may have a food intolerance.
2. What are the major sources of stress in your life? Our bodies' nerves, hormones and immune cells work together to help us cope with emotional stress. In people who suffer chronic stress, this network becomes overwhelmed and stops working efficiently.
Why it matters: The body is designed to respond to stress and often benefits by becoming stronger. However, when people experience high levels of stress on a daily basis, the cost of responding to stress exceeds the benefit. This results in an increased risk for cardiovascular disease, infection, depression and other illnesses.
What can you do: It's impossible to eliminate stress altogether, but we all can learn to manage it more efficiently. For example, daily exercise-30 minutes of walking at a moderate to brisk pace-diminishes the effects of stress-related hormones.
3. Do you feel close to your family and/or friends? Doctors are often reluctant (or too busy) to ask about patients' personal lives. However, personal relationships are among the most important factors in preventing and treating disease.
Why it matters: Patients who are diagnosed with serious illnesses, including cancer and heart disease, live longer when they have a strong social network. Research also shows that people who are active in their communities or close to family and friends are less likely to get sick in the first place. A social support network. also eases depression and protects you from the effects of daily stress.
What you can do: Take stock of your relationships with other people and nourish them by spending time with people you care about. If you are isolated, get involved in activities that help others.
4. How much personal control do you believe you have over your health? There are two primary ways that you can approach your health—you can rely on your doctor to tell you what to do...or you can actively participate in your health care.
Why it matters: Research shows that people are healthier and have better medical outcomes when they take responsibility for their own care.. .make important lifestyle changes...and generally put themselves in charge of their own health.
What can you do: The first step is to motivate yourself and make a commitment to yourself and those you love that you will be proactive in advocating for your own health. The second step is to learn what you can about the health conditions that affect you.
5. Do you have physical problems or certain personality traits that remind you of someone in your family? Your family medical history can help identify diseases that you may be predisposed to develop. Family history is an especially important risk factor for depression, heart disease, diabetes, high blood pressure and allergic and autoimmune disorders. Most cancers are not due to genetic risk factors, but to environmental exposures or diet.
Why it matters: A family history of a disease doesn't mean that you will develop that illness-but knowing your history, or just noticing similarities, makes it easier to predict and prevent future problems. For example, if you suffer from unexplained fatigue, weight gain or mood disturbances, and there is a history of thyroid problems in a close family member, such as a parent or sibling, your symptoms may be thyroid-related.
What can you do: Maintain a family tree that includes the health status and cause of death of grandparents, parents, aunts, uncles and siblings—and show it to your doctor.
