Get the best health care: our panel of medical experts tells you how to make the most of one-on-one time with your doctor, dentist, therapist and other health pros

Shape, April, 2005 by Kristyn Kusek

I have a family history of melanoma, and to make matters worse, I spent way too many of my teenage summers slathered in baby oil, lying in the sun. My skin-cancer risk is relatively high, so I get regular exams. This time, I was seeing a new dermatologist. She barreled into the room, gave me a quick once-over while she jabbered to the nurse about another patient, then left. She'd barely glanced at my skin, much less given me a chance to ask her anything. I knew that if she had missed a cancerous mole in her hurry to complete the exam, it could mean the difference between life and death--to me.

Fortunately, it didn't, but her brusque manner had left me tongue-tied, vulnerable and ill at ease, an all too common experience for patients today. "Doctors stand over us while we're lying on exam tables and call us by our first names while we call them by their titles," says Jonathan H. Amsbary, Ph.D., an associate professor of health communications at the University of Alabama in Birmingham. "Plus, they're clothed and we're not. Of course we feel uncomfortable!"

However, from wrong diagnoses to prescriptions for medications that don't help, studies show that poor doctor-patient communication is to blame in many cases of bad health care. So it's vital to know what to say and when to say it during all health-related visits--including those with dentists and dietitians. Here, advice on how to better navigate your next appointment.

OB-GYN

Before you go

* Record your medical history. "For an annual exam, take a few minutes to review your 'health story' from the past year," advises Michele Curtis, M.D., M.P.H., a gynecologist in Houston. "Write down anything that's changed, both major things like surgeries and minor things like new vitamins [or herbs] you're taking." Also note any health issues that have come up among your parents, grandparents and siblings, he suggests--your doctor may recommend steps to help prevent the same problems.

* Get your records. If you've had gynecologic surgery or a mammogram, request a copy of the procedure records from your surgeon or specialist to bring along (and keep a copy for yourself as well).

* List your concerns. Write down your top three concerns in order of priority. "Research has shown that the third item patients bring up during a visit is usually what brought them in," Curtis says. "People get embarrassed and want to 'warm us up' first, but time's short, so you should always ask the most important question first."

During the visit

* Write down your "numbers." If your annual OB-GYN exam is the only checkup you get all year, write down the following stats: blood pressure, cholesterol level, weight and body mass index, and height (if you've shrunk even a millimeter, it can be a sign of bone loss). File the info away to compare with next year's numbers.

* Get tested for STDs. If you've had unprotected sex even once, ask for chlamydia and gonorrhea checks. These infections can have serious consequences, including infertility. If you've had unprotected sex with a nonmonogamous partner, you should also be screened for HIV, hepatitis B and syphilis.

* Request backup. If your doctor is slammed with appointments and doesn't have time to get into the nitty-gritty of each of your concerns, ask if there's a physician's assistant, nurse practitioner or nurse available (or midwife, if you're pregnant). "They're great sources of advice and often have more time to sit with patients," says Mary Jane Minkin, M.D., clinical professor of obstetrics and gynecology at Yale University School of Medicine in New Haven, Conn.

DERMATOLOGIST

Before you go

* Check out the services. If your concerns are mainly cosmetic (you want to ward off wrinkles or erase sun spots), go to a dermatologist who specializes in cosmetic treatments. But if your concerns are more medical (say, you have cystic acne or eczema or suspect you might have skin cancer), stick with a medical-based practice, suggests Alexa Boer Kimball, M.D., M.P.H., director of dermatology clinical trials at Massachusetts General Hospital in Boston. If you have an uncommon condition, consider an academic medical center, which is more likely to be up-to-date on new research.

* Go au naturel. Wash your face--makeup can camouflage problems. And forget about showing off a manicure or pedicure: "Patients should take their nail polish off if they're having a skin check, since moles [and melanomas] sometimes hide underneath the nails," Kimball explains.

* Bring your beauty supplies. If you suspect you're allergic to a skin-care product, bring in everything you use on your face and body, including makeup and sunscreen. "It's much better than telling your dermatologist, 'I think it's a white cream in a blue tube,'" Kimball says.

During the visit

* Take notes. "Dermatologists are notorious for recommending multiple medicines for different areas of the body, so it's a good idea to write everything down," Kimball says.

* Don't be modest. You can keep your underwear on during a full-body skin check, but it precludes a more thorough exam. Melanomas, and other serious conditions, do occur on the genitals.