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Making the Most of Your Doctor Visit #2
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DUKE MEDICINE
Joe T Minchew, MD posted:
Here are the rest of the suggestions (had to break into to two parts due to the character limits)

5. Make sure that all records pertaining to your treatment to that point are present at the provider?s office to coincide with your visit. This includes all previous physician notes, hospital treatment records, particularly operative reports. You will usually need to contact the physician offices and hospitals separately to obtain these records as one will often not have the records of the other. Hopefully, the age of the electronic medical record and shared data will eliminate this requirement but we are not there yet. The best way to ensure that the records are present when you are is to take them with you. If you are specifically seeing the provider for a second opinion on surgery, make sure you have a clear statement from the surgeon as to the planned procedure and the rationale for that procedure. You can not get a second opinion if the provider can not review the ?first opinion?. Unfortunately, many times physician offices fail to forward records to other offices despite your requests. It is best if you obtain the records yourself if you can. If time and/or distance precludes this option, definitely check with the new provider?s office well prior to your visit to insure that they have received the necessary information. There is a tendency among some patients to want the new provider or physician to ?start fresh? without being biased or influenced by the prior records or diagnoses and opinions of others. Unfortunately, while there is some understandable logic in this perspective, the new provider will be severely limited in their ability to evaluate your problem and make recommendations if they can not review clear documentation of the evaluation and treatments you have had in the past. The majority of physicians are extremely conscientious and will make their own diagnoses and formulate their own opinions based on the data
6. As with prior records, make sure that all previous imaging studies and diagnostic test (nerve tests, etc) are available for the provider to review. This includes the actual images as well as the reports. You do not necessarily have to have printed films as most providers can now review images on a compact disc (CD) but it is critical that the provider can review the pictures. Most spine specialists review studies themselves in order to make diagnoses and treatment recommendations. While the radiologist?s interpretations are useful, they do not have the benefit of talking to you and examining you in order to correlate you symptoms and examination findings to the findings on your imaging studies. Unfortunately, most people over the age of twenty have findings on lumbar x-rays and MRIs even if they are asymptomatic. It is critical to correlate your symptoms to the studies. It is also very important to have all the imaging studies that you have had with you. X-rays, MRIs, CT scans, myelograms all have different indications for use and purposes. The do provide some overlapping information but they also provide information that the other studies can not or do not demonstrate as well. For example, MRI scans do not demonstrate problems with bone very well but CT scans evaluate the bone very well. So don?t just take your most recent MRI to the visit.
7. Go to the visit with a clear list of questions that you would like the provider to address and make these questions known to the provider at the appropriate time.
8. Go to the visit with an open mind. Try to listen to the provider?s assessment of the situation and their recommendations without being overly swayed by prior diagnoses or the findings or you x-ray or MRI reports.
Good luck and I hope these suggestions help!
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marilynk2 responded:
Can we clone you? Or, should I say, MAY we?
 
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SpielingPeter responded:
Thank you for taking the time to read this.
Since you are an orthopaedic surgeon, I was hoping that you could maybe give me some insight as to why I'm having pain in my left shoulder. I'm 19 and I've been in atheletics for most of my life. I was swimming when I felt my shoulder pop out of place and then pop *for the most part* back in. It's been quite a while since that incident and I'm still having "shocks" of pain that come/go & then kinda fades away numbly quite frequently. (that's the best way I can describe how it feels & it's hurting now as I type)
I know my body better than anyone else and I can see when my shoulders are relaxed that the left one sags at the socket as compared to my right.
The top of my arm bone feels slightly foward as compared to said shoulder. And it I can feel it "threaten" to come all the way out sometimes too.
I know this sounds gross but it doesn't really hurt *strangely enough* when I pull on my left arm while it's relaxed everyone can visually see it come down away from my collar bone more than a normal arm should.
Oh that reminds me, when I put pressure (and not very much) on the top of my left collar bone, it hurts quite a lot too.
I know it's not completely dislocated but what is going on? Is it particially dislocated or something? Let me know if you need any more descriptions or info.
Thank you again so much for taking time out of your schedule to read this.
Sheradon
 
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bj1208 replied to SpielingPeter's response:
hi Sheradon - welcome to the support group -

Dr. Minchew has been very busy and has not be able to actively be on the board.

The best thing for you to do is make an appointment with your primary care physician - he/she may order some tests (X-ray or MRI and/or CT Scan) to see what is going on there. Once those reports are done you should see either an Orthopedic Spine Specialist or a Neurosurgeon Spine Specialist - this does not mean you need surgery but they are the best at reading the results. And they can let you now what treatment options you should have - those could include physical therapy and/or pain management care.

It's best that you get this looked at as soon as possible - until then please avoid any activities or workouts as this may injure the area more.

Take care and let us know how u are doing - Joy~~
 
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SpielingPeter replied to bj1208's response:
Thank you for responding in his stead for me then.
I'll get it checked out as soon as I can.
Thanks again and I will.
Sheradon


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