1. Maximizing Your Doctor Visit Kathleen Costello, MS, ANP-BC National MS Society

2. Satisfaction with Healthcare Overall changes in healthcare –Less time –More expensive Visit cost, copays or co-insurance, Lower reimbursement –More specialized –More complex issues –More need for specific documentation

3. Who should be your MS provider? Every healthcare provider is different –Personality –Communication style –Knowledge and expertise about MS It is important for you to find a provider: –who is knowledgeable about MS care –whom you respect –with whom you feel comfortable. –who respects you, your values and priorities –who wants to work with you to manage your multiple sclerosis (MS)

4. A Relationship You and your MS provider will have a long relationship that may require: –Complicated treatments and monitoring –Treatment of relapses –Honest discussions about adherence and symptoms –Potentially difficult discussions Employment and disability Changes in roles and relationships Difficult symptoms: depression, sexual function, elimination, falling

5. Tips for a Successful Appointment Prepare, prepare, prepare! –For your travel –For the content of the visit –For visit follow-up

6. Tips for a Successful Appointment Insurance –Know your co-pay or co-insurance for the visit –Bring your insurance card and your ID to the visit –Know your insurance coverage Does your insurance policy require that you have MRI, lab tests, PT, etc.

7. Tips for a Successful Appointment Do your best to be on time for your appointment If you cannot make it (unless it’s due to an emergency) call the day before to cancel/re-schedule Do you have directions? Do you need someone to drive you? Plan to be at least 30 minutes early for the appointment so that : You have time to get ready You plan for reasonable travel time – including potential traffic issues and the possibility of getting lost You have time to get from the parking lot to the office

8. Tips for a Successful Appointment If this is your first visit: –Verify that the office has received your records – particularly your MRI (the CD or films, not only the report) –Complete any pre-visit forms

9. Tips for a Successful Appointment First visit –Write down the what led to the appointment What are your symptoms? When did they begin? Have the symptoms changed over time? What have you done about the symptoms? Were you evaluated? What was the outcome? –Know your medical/surgical and family history –Have an up-to-date list of your medications, supplements and allergies

10. Setting reasonable expectations What are the visit goals and expectations –How long are visits? –What will happen during the visit? –What is reasonable to accomplish in a brief routine follow-up appointment? Is it OK to call to report symptoms or other issues in between visits? –What should you call about? –Should you call about new symptoms? Wait to call? How long? –When should you expect a return call?

11. Tips for a Successful Appointment Prioritize! –What do you want to talk about? –Remember, visit time is very limited, so Be organized – write it down What is the most important issue or problem that you need to talk about? What are your questions? –Keep your list of medications AND supplements up to date

12. Don’t be Bashful Talk about it! –Some symptoms may be difficult to talk about and others you may not realize can be related to MS So it is important to bring them up –Be honest - Leaving out details or only providing part of the story can be bad for your health –Tell your provider about complementary and alternative treatments you have tried or are considering Not everything can be addressed in a single visit – however, if you prepare ahead of time, your most important issues can be discussed and managed

13. Patient Bill of Rights To be treated with respect To have and to express my feelings and opinions To be listened to and to be taken seriously To set my own priorities To say no without feeling guilty To ask for what I want To get what I pay for To ask for information To make mistakes To choose not to assert myself To change my mind

14. Patient Bill of Responsibilities To keep scheduled appointments To be honest with the doctors and other healthcare workers To give information about my experience and condition as clearly and briefly as possible To respect the doctors and healthcare workers To understand that no one has all the answers to MS To follow the treatment plan agreed upon