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Benefits of Creating a Patient File

Seeing a new doctor for the first time can be a stressful situation. First, you are disclosing very personal information to a complete stranger. Second, you only have fifteen minutes or so to fill your new doctor in on your entire medical history. Third, it is all too easy to forget essential information when the clock is ticking and other patients are waiting. Help make your first meeting with your new doctor run smoothly by preparing a patient file in advance. This file will tell your new doctor almost everything he needs to know about you and the state of your health. Your patient file should include the following information:

1. Patient identification

Under this heading, write down all of your contact information, including your full name, home address, and business and home phone numbers. You can also include your e-mail address. Just be wary about using your work e-mail account; you don’t want your employers viewing sensitive information about your health.

2. Contact person

Your contact person should be someone trustworthy and reliable. This person will be told sensitive information about your health, so you might not want to list your noisy neighbor as your contact person. Consider listing two contacts in your file; if one is ever away on vacation, you will still have an alternate contact person in case of an emergency.

3. Personal and family data

Your family’s medical history says a lot about your own health. If your blood relatives had early diagnoses of cancer or heart disease, your doctor will want to test you for similar conditions. In this section, list all of your relatives who suffered from a serious illness - like heart disease, cancer, MS and osteoporosis. In addition, indicate their age when they were diagnosed, and make note of the outcome. Your doctor will want to know if your aunt’s cancer went into remission or if your grandfather’s triple bypass was successful.

This section of your file should also include information about your own life. First, your doctor needs to know your age and your weight. She will also want to know what types of hazards you experience at work. If you have a stressful job, or if injury rates are high in your line of work, make note of it here. And list your daily habits, remembering the cardinal rule of doctor-patient relationships - you must never lie. Your doctor can only treat your medical conditions if they have a complete picture of all possible causes. If you fail to mention your two-pack-a-day smoking habit, your doctor may never be able to effectively treat your bronchitis. Forget to mention your love of greasy diners, and she may treat you for an intestinal disorder instead of indigestion. In addition, write down any significant life events you recently experienced, like a retirement, a new promotion or a divorce. Big and unexpected events can trigger stress in certain people, and these high stress levels can lead to health complications.

4. Past medical history

If your body is your temple, then previous illnesses are the graffiti upon your temple walls. A broken arm or an emergency surgery can leave a lasting imprint on your body, one that can impact all future courses of treatment. For instance, your doctor would never recommend an intensive exercise regime if you just underwent a hip replacement surgery. In this section of your patient file, inform your doctor of all your past illnesses. Make a special note of any recurring illnesses - your doctor needs to know if you always come down with strep throat in winter, for instance, or if you suffer from an itchy rash in summer. If you suffered from trauma following an accident, mention any treatment you received for broken bones or concussions. Also let your new doctor know of any surgeries you underwent in the past, whether emergency, elective, or cosmetic.

5. Allergies and drug reactions

In this section, tell your doctor about your allergies - food, pollen or otherwise - since an allergic reaction can impact your overall health. And obviously, inform your doctor about any reactions you have had to prescription drugs in the past. This way, your doctor can avoid prescribing the same medication.

6. Ongoing health conditions

From irritable bowel syndrome to diabetes, many people deal with chronic health conditions. In this section of your patient file, list all of your medical conditions, stating the severity of your symptoms and the impact of these symptoms on your daily life. This information will help your doctor tailor a treatment plan to suit your needs. If you can remember it, note the date you first experienced symptoms, as well as any life events that coincided with these symptoms. If your migraines started when you received your first promotion, your doctor might teach you stress relieving exercises instead of prescribing medication to treat your headaches.

7. Health maintenance

This section includes all records of your immunizations and diagnostic tests. Your former doctor’s office should have all of this information in your file, but sometimes tests and immunizations go unnoticed - if you received a flu shot at a clinic, for instance. In this section, simply list your immunizations and diagnostic tests, including the dates and the locations of the tests. This way, your new doctor can easily track down any missing records.

8. Consultants' names

If you have seen a consultant or received a second opinion for a medical condition, note that doctor’s full name and address in this section. Your new doctor may want to retrieve your test results or consult with the specialist to better understand your current medical conditions.

9. Long-term treatment

In this section, write down any medications you are currently taking, noting the dosage and frequency. And don’t forget that vitamins and herbal supplements are drugs, too. Though often considered harmless, these pills can interact with a wide variety of prescription drugs, leading to dangerous and potentially fatal side effects. Your doctor will want to be aware of any potential side effects before prescribing a medication. You can also include the name of your pharmacy in this section; sometimes, your doctor’s office can send your prescription straight to your pharmacy.

By creating a patient file, you are eliminating most of the stress that comes with meeting your doctor for the first time. It is far easier to disclose personal - and often embarrassing - information in writing than it is in person. If you have a health condition that you are simply too embarrassed to talk about, point your doctor to the ongoing health conditions section, and he can lead the discussion from there. And you won’t have to worry about forgetting important information due to time constraints, since everything your doctor needs to know is already in your file. Arriving at your first appointment with your file in hand also proves to your new doctor that you are committed to improving your health. Doctors appreciate patients who are equal partners in their own health maintenance. Creating your patient file is the first step to leading a long and healthy life.