What Will Hematologist Do On First Visit

On first visit with a new doctor, it is not uncommon for patients to feel overwhelmed by the amount of information they have to provide about their medical history. This article discusses some of the more common questions asked on initial visits and how best to respond. We hope that our answers help make your experience as comfortable and easy-going as possible.
What happens during an initial examination?
An initial evaluation begins with a patient describing his/her present state of health including any medications being taken at the time. A complete review of systems should also be discussed in order to identify any unusual changes from normal. In addition, there is usually a discussion regarding family history which may indicate genetic predisposition to certain diseases. It is important that all areas of concern be thoroughly addressed so that the physician has enough information to formulate appropriate treatment plans.
Who conducts the initial consultation?
Typically, the initial consult is performed by a primary care provider such as a nurse practitioner or physician assistant. These individuals are trained specifically in providing comprehensive medical examinations and are able to assess and treat many different disorders within the same practice. They are often called “medical home” providers because they take responsibility for managing both acute and chronic conditions throughout the lifespan of the patient. Because these professionals are familiar with the individual’s personal health needs, they are better equipped to determine if additional testing is needed to rule out other illnesses.
How much does an initial consultation typically cost?
The fee varies depending upon where you live and what services are covered under your insurance plan. For example, Medicare and most private insurers cover the majority of costs associated with routine office visits. However, if you have supplemental coverage through work, life or disability policies, then you may need to pay for deductibles, co-pays and coinsurance. If you do not have insurance, you may qualify for free screening or diagnostic services available through local health departments.
Is there anything I can do before my first visit to prepare myself?
Yes! It’s true that sometimes we think that just showing up for a scheduled appointment is good enough. But, taking the time to research your condition online, talk to friends who’ve been diagnosed with similar illness, or even ask your family doctor about your concerns is very helpful. You may find that getting educated about your specific illness helps you gain insight into its cause and effects. Also, knowing more about your own unique situation might enable you to speak intelligently with your healthcare provider about options for treatment.
After meeting with the doctor, what next steps should I take?
At this point, you may be referred to a specialist. Or, you may decide to start seeing a primary care provider (PCP) right away. Both situations require further coordination between specialists and PCPs.
In either case, you’ll probably be given recommendations for follow-up appointments along with instructions for completing forms or paperwork required for continued treatment. Depending on your diagnosis, you may also be recommended for lifestyle changes such as dietary modifications, exercise programs, stress management, etc.
Will my insurance company pick up the tab for all my future visits?
Most likely yes…but only if your insurance carrier believes the problem is part of their network of doctors and facilities. Your insurance company determines whether or not a provider is considered network based on quality standards established by each organization. Most insurance companies use criteria set forth by professional organizations such as the American Medical Association, American Academy of Family Physicians, American College of Physicians, the National Committee on Quality Assurance (NCQA), HealthGrades among others.
If you’re unsure about the status of a provider, call your insurance company’s customer service line to verify eligibility. Be aware that some insurance carriers impose restrictions on non-network physicians. For instance, Blue Cross and Blue Shield limit coverage of non-network providers to emergency room visits only. Others may prohibit non-network providers altogether. Check with your insurance policy to see if there are any limitations imposed on your choice of provider.
What happens after I return home?
Once you leave the office, it’s important that you continue to monitor your condition over time. That’s why it is always good to keep a written record of any symptoms you experienced while visiting your doctor. Don’t forget to bring this record with you to every subsequent visit. Many people find it useful to develop a relationship with their doctor via email or telephone. As long as you share accurate information with your healthcare provider, this approach may prove to be highly effective for ongoing monitoring.
What are some things I shouldn’t discuss with my doctor unless I’m absolutely sure they’re OK?
There are several topics you should avoid discussing with your physician. Some of them include:
1. Your drug usage – Whether prescribed or obtained without a prescription, illegal drugs are off limits. It is against federal law to give anyone else your prescriptions. Even worse, sharing your prescriptions could lead to severe penalties.
2. Other people’s health issues – Discussing another person’s medical problems with your doctor puts you at risk for legal trouble. Sharing someone’s medical records without permission is illegal. Federal privacy laws protect the confidentiality of your health information. So, don’t tell your doctor about other people’s ailments unless you’re sure your provider wants to know.
3. Sexual activity – Although sex is great fun, it is generally not something you’d like to talk about with your doctor. And, it certainly isn’t a topic you should bring up with your partner. Sexually transmitted infections including AIDS pose serious risks. There are also numerous other aspects of sexual activity that would be difficult to explain to a doctor.
4. Contraception – Unless you are sexually active, contraception is not a subject you should address with your doctor. Besides, it’s hard to get pregnant accidentally. Furthermore, your doctor doesn’t really need to know about your birth control methods. He/she can’t prescribe contraceptives. Nor can they handle your refills or renewals. Instead, contact an authorized contraceptive clinic.
5. Alcohol consumption – Drinking too much alcohol can increase your chances of dying prematurely. In fact, excessive drinking is one of the leading causes of death in America today. While your doctor won’t necessarily discourage you from drinking, you should definitely stop drinking completely if you are having unprotected sex.
6. Any illicit substance use – Illegal drugs such as cocaine, marijuana, heroin, LSD, ecstasy, psilocybin mushrooms, mescaline, etc., carry significant risks. Sharing needles used to inject street drugs is dangerous. You may also expose yourself to hepatitis C, HIV, and tuberculosis.
7. Pregnancy – Unless there’s a reason to believe otherwise, assume that you aren’t currently pregnant. Avoid telling your doctor that you’re pregnant until after you confirm the pregnancy using a urine test. Otherwise, you could put her in danger by giving her false information. After confirming your pregnancy, you should notify your doctor immediately.
8. Unsafe sex practices – Sexually transmitted infections such as gonorrhea, chlamydia, syphilis, herpes simplex 1 & 2, trichomoniasis, etc., occur by exposure to infected fluids. Sharing dirty needles with injection drug users increases the spread of viral hepatitis B and C. Condoms can reduce your risk of contracting HPV. Syphilis, genital warts, herpes, etc., can be transmitted through oral sex.
9. Multiple partners – Having multiple sexual partners exposes you to various infections. According to the Centers for Disease Control and Prevention, women aged 13 to 24 accounted for nearly half of all reported cases of Chlamydia infection in 2006. Genital warts affect approximately 7 million Americans annually. Herpes affects an estimated 90% of those who are infected.
10. STD clinics – Although STD clinics offer convenient locations for receiving STDs, you should never go to an STD clinic alone. Keep in mind that STD clinics are businesses designed to profit from your vulnerabilities. Therefore, they employ aggressive marketing techniques to attract clients. They will try to convince you that you have an STD or encourage you to undergo unnecessary testing. To avoid falling victim to marketing ploys, here are a few tips to remember:
a) Never disclose sensitive information such as your name, social security number, date of birth, credit card numbers, or bank account numbers.
b) Always meet face to face whenever possible.
c) Ask lots of questions. Find out everything you can about the facility, staff members, and procedures. Get copies of contracts or read consent forms carefully.
d) Make sure you understand the ramifications of undergoing testing.
e) Use caution when entering into agreements for treatment. Confirm that your health insurance will cover the entire bill.
f) Take advantage of counseling or education offered by STD clinics.
g) Consider consulting a licensed counselor instead of going directly to an STD clinic.
11. Emergency rooms – Going to an ER to seek treatment for minor injuries or cuts can land you in harm’s way. An emergency department is not the place to go if you have been exposed to a sexually transmitted disease.
12. Tattoo parlors – Getting tattoos done in unsterilized tattoo studios poses a major threat to your health. Infections acquired in these establishments can lead to serious illness or death.
13. Dentists – People who regularly visit dentists run a high risk of developing dental caries.

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