The more eye contact we have in that first visit, the better start we get off to in our relationship – Hans Duvefelt, MD
Some practices won’t see a new patient until their old records arrive. My new practice doesn’t work that way. I’m very okay with that.
With few exceptions, I find that most patients have a need to tell their story and I appreciate the opportunity to hear and react to that story in real time. For details they can’t provide, I reassure them “we’ll get that from your old records”, or “we can check that with the pharmacy”. In Maine, there is also the state database, Maine Health InfoNet.
That first conversation between doctor and patient sets the tone for the rest of our relationship. It is when each patient starts to figure out how much they can trust your interest in them, your knowledge about their medical condition and your respect for their past choices and current priorities.
In each such initial conversation I try not to interrupt more than absolutely necessary.
In my reaction and mirroring back I also make sure to weave in something that deepens my patient’s understanding of their medical condition or their medication – without seeming overly confident, but more showing that I have a genuine interest and experience to bring to the table.
I might tell them how their disease was first discovered, how their treatment was invented or how many different approaches there actually are.
I make very sure to listen for each patient’s priorities. This ranges from long term health goals for their chronic conditions to why they are bringing up new symptoms.
One question I often ask about new symptoms is “are you worried this is a sign of something dangerous, do you want it to go away or are you just wondering how your body works as far as this sensation goes?”
My initial housecalls are one hour long, just like many office based specialists and twice as long as my colleagues’ in office based primary care.
