Before you panic (or call your grown children and start nagging, Mom), wait – the yearly check-up for your family doctor to bang your knees with her little hammer or listen to your breathing has kind of gone out the window.

According to Dr. Sharon Domb, Division Head of Sunnybrook’s Academic Family Health Team, research suggests that annual physical visits aren’t exactly necessary or effective at catching disease early or preventing chronic health issues.

But you aren’t off the hook.

“You should still visit your family doctor at least once a year – but the focus for family physicians has shifted toward prevention,” Dr. Domb says.

Here are some tips from Dr. Domb to help you communicate with your doctor on your next annual preventative visit.

Ask ‘Is my screening up-to-date?’

Your doctor will likely ask you this and have access to your records. But you can still start the discussion. For example, sexually active women over age 21 should be having a Pap test every three years. There are other guidelines for cancer screenings. Check Cancer Care Ontario  for more information.

Share your family history.

Your doctor likely took a family history when you had your first appointment (which may have been years ago!) and so things change. Changes in your family members’ health could have an impact on your health. “So, you are 40 years old. You normally wouldn’t have any screening for colon cancer yet,” Dr. Domb says. “But, let’s say your father or sibling has just been diagnosed with colon cancer – those screening recommendations change and so it’s important for your doctor to have all the information.”

Learn more about immunizations.

Your doctor will offer you the standard immunizations but there are also new or optional immunizations (not covered by OHIP) that may be recommended by physicians. For example, the shingles vaccine has been approved and recommended for adults over age 50. (And may soon be funded according to the provincial budget).

Ask your doctor about the latest vaccines that may be recommended for your age or your children.

‘Is there something I can do to my lifestyle to reduce my risk of chronic disease?’

Maybe it’s your weight. Could be your diet. Maybe you have difficulty finding the time or energy to exercise. Talk to your doctor about how to prevent illness. “Do you smoke? Be honest with your doctor. We can give you support to help you quit,” Dr. Domb says.

Ask about Advance Care Planning.

Do your loved ones know your values and wishes in the event of a devastating illness or accident leaves you unable to speak for yourself? Is now a good time to start having those discussions? Your family doctor can help you get advance care planning discussions started. (Visit advancecareplanning.ca for more information)

Remember: Secrets, secrets are no fun. All they do is hurt someone.

When it comes to your health, secrets can hurt you!

Firstly, at your annual visit or during any visit, be open and honest about other remedies you are taking. “It’s generally believed anything ‘natural’ or ‘homeopathic’ is unharmful and therefore, patients often don’t mention them to me,” Dr. Domb says. The truth is, these other remedies can have interactions with prescribed medications. So, share the list with your doctor.

Secondly, tell your doctor about stress and weight changes. “Patients come to me saying, ‘I need to be off work for six months, I can’t handle the stress,’ and when I ask how long it’s been going on they say a year,” Dr. Domb says. “If only they’d have come to me sooner.” Your family doctor can support you before it gets to the point that you are at the end of your rope. A similar situation often occurs with weight changes – if you gain or lose a significant amount of weight, talk to your doctor.

Sounds like communication is key when it comes to your annual check-in with your doctor. (Don’t worry Mom, I’ll give my doctor a call!)

If you don’t have a family doctor, visit Health Care Connect.

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Seeing your family doctor?

At your annual check-up, ask or tell your doctor about:

• Screening and immunizations
• Family history
• Lifestyle
• Advance Care Plan

Secrets can be bad for your health. Talk to your doctor about your

• remedies and supplements
• Weight gain or loss
• Stress level

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A version of this post appears in the Town Crier newspaper in Toronto, Ontario.

The post 5 (+1) ways to talk to your family doctor appeared first on Your Health Matters.

The Question: Is it the family physician’s job to gather test results and explain the outcome of those tests – blood tests, ultrasounds, X-rays and CT scans – and offer options going forward? Every test I have had, the results are sent to my family doctor, yet he says it is not his job to explain it to me and offer solutions or options. Half of the tests are missing or have not arrived at his office. There is no follow up. Every time I see him it is like the first time but he has been my primary caregiver for 25 years.

The Answer: You raise a very good question: Whose job is it to communicate test results ordered by one physician and conducted by another? If, as you point out, the test results go missing, you have no way of knowing and may assume [wrongly] that there was a negative finding and all was well. It is for that reason, it is important to ensure that the loop has been closed on every test result.
According to Jocelyn Charles, Chief of Family and Community Medicine at Sunnybrook, a physician who orders a test – for blood, ultrasound, X-rays or CT scans – is responsible for responding to abnormal results and communicating these results to the patient.

“Specialists are expected to communicate their assessments, test results and recommendations to the patient and the patient’s family physician,” wrote Dr. Charles in an email. “The family physician can only discuss results from specialists if they are forwarded to him/her, ideally with a recommendation about any further investigations or treatment.”

Ultimately, it is the responsibility of hospitals, laboratories, radiology facilities and specialists to ensure that family physicians receive results and information pertaining to their patients in a timely manner, she said.

As the family physician has no way of knowing what tests were done by the specialist unless this was communicated to them, Dr. Charles suggested patients call their family physician before their appointment to ensure test results have been received.

In addition, patients can request the specialist’s office, hospital or laboratory to forward the results to their family physician prior to their appointment. Ideally, this should not be necessary, points out Dr. Charles, who said efforts are underway at Sunnybrook to improve accountability for timely communication of information to family physicians.

Frank Martino, president of the Ontario College of Family Physicians, suggested patients remind the specialists that test results should be sent to the family doctor, providing the address if necessary right at the appointment time.

He pointed out that it is incumbent on him, as a family physician, to learn the results of any test he has ordered on a patient.

“I have concerns about this patient’s problem not getting the results,” said Dr. Martino. “And a physician who says it’s not my job to explain things to you. That’s part of the relationship.”

However, not every negative result – a test that has normal findings – needs to be communicated. There are, however, exceptions to that rule: the test ordered was due to a screening test, a suspected cancer, a biopsy, a bad diagnosis such as diabetes or anemia or a condition where symptoms have persisted, suggesting the need for more and different medical investigations to help aid in a diagnosis. In those cases, even though the test has not found anything, it’s vital for the physician to close the loop.

“It’s extremely important to communicate with your patient,” said Dr. Martino. “If there’s a particular test with a particular complaint, such as knee pain, then we go back to the blackboard, and come up with a plan for diagnosis.”

Tracking results, he points out, is not a simple matter and he is particularly concerned about these missing test results you mention.

“What we hope is that physicians have a process in place to reconcile test results that have been sent out to be done,” said Dr. Martino, who is a member of Queen Square Doctors family health team in Brampton. “And we hope that is a strong and fulsome system. Certainly, for critical results, there should be a system in place to reconcile those and act on them.”

I, too, am particularly concerned about your missing test results and for that reason I would suggest you contact your family physician to follow up. That may also be a good time to discuss how you are able to learn of test results with abnormal findings. I would also follow the advice of Dr. Charles and to call ahead of your appointment to ensure test results have been received and to request the specialist, hospital or laboratory fax or send these results to your family doctor.

The post Test Results: Whose Job is it To Tell The Patient? appeared first on Your Health Matters.