Your First Visit
Clipboards and Waiting Rooms Are a Thing of the Past
For most people, when seeing a new doctor, they’re used to a quick, 15-minute “in-and-out” visit, at most. And if that’s the case, a new-patient appointment with us will be unlike anything they’ve ever experienced.
In our practice, things are different.
Greeted at the Door
At our practice, we greet you right at the door.
You’ll notice that there’s no waiting room, because patients don’t wait; we greet you right at the door. You may also notice that there’s no clipboard with pages of symptom questionnaires, and no cup filled with pens of questionable cleanliness. Your doctor will take care of all of that for you during your visit.
When you walk in, we bring you back promptly to our consultation suite. This is not an empty room where you sit and wait. Instead, your physician is right there, ready to welcome you in and begin your appointment, on time.
That first time you come to us, we do something called a Comprehensive Evaluation.
This is the opposite of the conventional, five-minute visit. We recommend patients leave at least sixty minutes available in their day for this. For many, this one visit with us is more time than most people have spent with their PCP over the course of 5-10 years. It’s also time spent directly with the physician. It’s a chance for us to get to know you better, and to design a plan for how to address your personal health goals over the coming weeks and months.
What does a Comprehensive Evaluation entail?
We start by sitting down in some comfortable chairs, and seeing if you have any additional questions about the practice that have popped up since you booked an appointment.
Then, we just listen.
We open up the floor and welcome the opportunity to learn more about you. This involves exploring what we call your health timeline:
Where you’ve been (your medical history)
Where you are now (your habits & lifestyle)
Where you want to go (your health goals)
We want to know it all: what does your family life look like? Do you have pets? A busy work life? Do you exercise? What does dinner look like for you? What do you do for fun or to relax? What do you do when you’re stressed?
Importantly, we then home in and discuss your specific health goals. Put another way: if you closed your eyes and imagined yourself feeling “healthy,” what would you see? For example, you may want a life without medications, or maybe to live strong past 100. Maybe you’re looking to take a deeper dive into your health, and uncover any opportunity to optimize for the long term.
In the conventional system, the standard approach is to skip everything and focus exclusively on #3. Doctors want to know what diseases you’ve been stamped with, and whether or not you want a medication for it, as they move you down the health care conveyor belt.
But knowing your habits and goals, in our mind, is equally important.
Your health timeline gives us a complete understanding of what’s most important to you, serving as the backdrop for your health, and informing every future decision we make together.
By knowing where you are now, and then where you’d like to be, we can then go back over all of your medical history, and make the best plan with a new frame of reference.
When we then go over your history, we’ll touch base on any current medical conditions, as well as any medications you happen to be on, your allergies, past surgeries, any preventive screening you’ve had, and then really dig into your family history. This information is crucial to understand exactly what your risk factors are for the future, and how we should proceed over the long term.
The Physical Exam
First, rather than rushing you in and getting vitals with an elevated blood pressure the second you walk in the door, we do this at the start of the physical exam, when you’ve had time to settle in and get to know your doctor better.
Then we move to the exam chair and perform an extensive physical exam. This includes heart and lungs, and abdominal exam, neck and thyroid check, and a musculoskeletal and neurological exam, among others.
This exam serves two purposes. First, as a screening exam, the physical allows us to rule out a few rare but worrisome conditions.
Second, it serves as a baseline snapshot, in case things are better or worse in the future. Despite all the technological advances of modern medicine, there’s a reason the history and physical make up 90% of the diagnosis. Our family medicine training, in seeing all kinds of patients (well and sick), has honed a strong intuition about when things aren’t quite right.
This is the ‘country doc advantage:’ when a doctor knows a patient so well that they can say, “Oh, I know Mr. Smith, and, well, he’s just a little worse off today than he was a few weeks ago.” That intuition, in our experience, is an extra tool that can often lead to an earlier diagnosis or a sooner intervention.
A Tailored Approach to Care
Finally, when we have all the information, we step away from the exam chair, and sit back down to talk things out a bit more.
This is where we often seem like a big departure from the conventional system. You may be familiar with doctors who give a paternalistic, “you-must-do-this” spiel to their patients. That’s not us.
Instead, consider us your personal medical advisors, and so, with your goals in mind, we go through everything in detail, outlining a plan and discussing options, and then—with your input—design a care strategy together that makes sense for you.
Though this occasionally means prescribing medications, it’s not always the case. Our advice almost always involves giving you some trusted resources to explore: a new recipe, a great book, or a handy app. Frequently, it involves getting baseline labs to track your metabolic health. And sometimes, depending on your history and circumstances, we discuss getting additional screening tests, imaging, or the like. There’s no formula to any of this, because it’s all tailor-made for you.
We then ask you how you feel about the plan as it stands, and if you have any thoughts, questions, concerns before touching base on what follow up in the coming weeks would look like.
From there, in case questions naturally pop up after the visit, we give you a card with our personal cell and email, so that you can reach out to us directly.
It’s a different process than you may be used to: less time waiting, more time with the doctor, and plan designed specifically for you.
In our minds, it’s just a better way of getting care.