What to Expect at the Doctor's Office

Most routine visits to the doctor share a similar format. Your doctor will want to ask you questions, perform a physical examination, order any tests that are appropriate, and prescribe treatment or give medical advice.

Different doctors have different styles of talking with patients, and each may structure his or her office visit a little differently. You will obviously have a different visit if you go for a specific problem — such as knee pain — compared with a routine physical. What happens during your visit also will change based on your age, other medical problems, family history, etc.

The following is a description of a typical routine visit or checkup. The better prepared you are, the more likely that your questions will be answered and that you will receive the treatment and advice that you need. If you have a complicated medical history, or a variety of concerns or questions, you may wish to prepare notes before you go to the doctor.

The first time you see a doctor, he or she will want to review your medical history in detail. This includes present and past medical problems, previous surgery, hospitalizations and routine medical care. Knowing this information can help your doctor make a correct diagnosis or prescribe the right treatment in the future. If you are making a return visit, he or she will want to know about anything that has changed since you were last seen.

Medications — Let your doctor know about all the medications that you are taking. This includes medicine prescribed by other doctors, as well as all medications that you are taking "over the counter," including vitamins, herbs and supplements. If you are on a complicated regimen, consider making a wallet card that includes the names of all your medications, including dosage and quantity taken each day.

Allergies — Tell your doctor if you have ever had a bad reaction to a prescription medication or over-the-counter product.

Family history — Your doctor will want to know specific information about medical problems that affect blood relatives, especially your parents, brothers and sisters, and children. Medical problems in grandparents and cousins are also important, though slightly less so.

Health habits and exposures — Your doctor will want to know about other factors that affect your health. Common areas of concern include:

• Tobacco use, including cigarettes, cigars, snuff and chewing tobacco
• Alcohol use — how much, how often
• Use of illicit or street drugs
• Sexual practices, especially those that increase your risk for HIV and other sexually transmitted diseases
• Exercise and pattern of physical activity
• Diet — what you do and don't eat
• Exposures to hazardous substances on the job or at home, including asbestos, solvents, lead paint and pesticides
• Accident prevention — whether you wear your seat belt in the car, or wear protective equipment for biking or inline skating

Review of systems — To gather more information, your doctor may ask a series of questions about your bodily function. This may include whether you've experienced problems with joint pains, bowel habits, sexual function, headaches, chest pains, shortness of breath, indigestion, etc.

At almost every visit your doctor will want to examine you. Sometimes this can be as simple as measuring your blood pressure or looking in your ears. On other occasions this may be a complete "head-to-toe" exam. The physical examination at a routine visit can include any or all of the following:

• Measuring your height and weight (which can be used to calculate your body mass index or BMI.)
• Checking your blood pressure and pulse
• Examining your skin for moles or rashes
• Checking the lymph nodes ("glands") around your neck and under your arms
• Looking in your ears
• Checking your vision and looking in your eyes
• Checking your teeth, gums and throat
• Feeling your thyroid gland (at the base of your neck)
• Listening to the blood vessels in your neck
• Listening to your lungs
• Listening to your heart for murmurs or irregular beats
• Feeling your abdomen for lumps, areas of tenderness or enlargement of internal organs
• Checking your testicles for lumps and feeling in the groin for hernias (MEN)
• Examining your breasts for skin changes and lumps (WOMEN)
• Performing a pelvic exam to look at the labia and inside the vagina, and evaluate the ovaries and uterus for size, irregularities and tenderness (WOMEN)
• Performing a rectal exam to check for lumps or growths in the prostate gland (MEN)
• Examining your joints
• Checking the alignment of the spine
• Checking your reflexes and sensation
• Assessing your memory and mood

Depending on your age and symptoms, your doctor may choose to perform only selected parts of this examination.

Even if you feel healthy and your examination is normal, your doctor can make recommendations to keep you healthy.

Bad habits — If you smoke, your doctor almost certainly will encourage you to quit and may offer assistance. He or she may talk with you about cutting down on alcohol if you have more than one or two drinks per day. Your doctor also may discuss "safe sex" if he or she thinks you are putting yourself at risk.

Good habits — Your doctor will want to talk to you about eating a healthy diet, maintaining a healthy weight and getting adequate exercise. If you are under stress, he or she may discuss ways to manage this. Other good habits include limiting exposure to harmful sun rays, and preventing injuries by using seatbelts and protective equipment.

Vaccinations — Depending on your age, medical problems and occupation, your doctor may recommend a variety of vaccinations including tetanus, influenza, pneumococcal pneumonia and hepatitis B. Travelers to developing countries may require additional special vaccinations.

Vitamins and supplements — Eating a healthy diet is the best way to get the vitamins and minerals that you need. However, your doctor also may recommend protective supplements such as multivitamins, calcium or aspirin.

For more information:

Agency for Healthcare Research and Quality
540 Gaither Road
Rockville, MD 20850
Phone: 301-427-1364
www.ahrq.gov/ppip/adguide/

American Academy of Family Physicians
11400 Tomahawk Creek Parkway
Leawood, KS
66211-2672
www.familydoctor.org

American College of Physicians — American Society of Internal Medicine
190 N. Independence Mall West
Philadelphia, PA 19106-1572
Toll-free: 1-800-523-1546, x2600
Phone: 215-351-2600
www.doctorsforadults.com