Questions to ask a specialist

A referral does not carry your story with it as reliably as you would hope. In a national survey of doctors, only about a third of specialists said they usually received notice of why a patient was being sent to them, and only about six in ten primary care doctors said they usually got the specialist's findings back, according to O'Malley and Reschovsky in the Archives of Internal Medicine in 2011. Researchers have called the handoff between your regular doctor and a specialist dropping the baton for a reason. That means two things for you: the specialist may not know your history, and your own doctor may never hear what they concluded.

You can close both gaps yourself, and it takes about ten minutes of preparation. Bring your story, and ask for the loop to be closed. This checklist is the specialist-visit companion to our questions to ask your doctor guide, and it works for any field, with a few add-ons for the common ones.

A specialist does their best work when they can see where you have already been. Bring a current medication list (including vitamins and supplements), your recent test results, and, when imaging is involved, the actual scans or discs, not only the radiologist's report. The report is a summary; the specialist often wants to look at the images themselves, and having them on hand can spare you a repeat scan and the wait that comes with it. Add a short timeline of your symptoms, when it started and what changes it, because that plain history is often more useful than any single test.

The Agency for Healthcare Research and Quality's advice for any visit is the same simple thing: bring all your medicines and write your questions down beforehand. It matters more with a specialist, because you usually get one focused visit to make a plan, and the details you forget are the ones that change it.

Here is the question that does the most quiet good, and the one patients almost never ask: how and when will you send your findings and plan back to my regular doctor? Ask it out loud, and ask who is responsible for coordinating your care between the two offices. Coordination falls through the cracks between practices, not within them, and a specialist's careful plan helps nothing if your primary doctor never hears it. While you are at it, settle whether this specialist is taking over this part of your care or handing it back, because the two doctors do not always agree on that, and you are the one who lives with the confusion if they do not.

Some questions carry any first visit. Why did my doctor send me, and what are you looking for? What do you think is going on, and what else could it be? What tests do you recommend, what will each tell us, and when and how will I get the results? What are the treatment options, and what would you start with? Then add the few that fit the field. For a cardiologist, ask your blood pressure and cholesterol numbers and what they mean for you, and which symptoms mean call 911. For a neurologist, ask whether a scan will actually change the plan, and what side effects a new medication carries. For an endocrinologist, ask what your lab numbers say, how you will know a medication is working, and when to recheck it. The printable groups these so you can take just the block you need.

People forget 40 to 80 percent of what they are told in a medical visit, as Kessels found summarizing the research, so do not rely on memory. Write the answers down, or bring someone who can while you listen.

The thing that makes a first specialist visit go well is walking in organized: the medications, the recent results, the images, the history, all in one place instead of scattered across portals and folders. That is what KeptWell holds. Upload your records and the binder reads them, keeps your medication list current, and gives you one plain-English picture to bring to any specialist, and to share back with your regular doctor afterward. Here is how it works, and it is free today, with an honest plan for what comes next.