Recruit a friend or relative to go with you. When you’re in a chilly exam room, dressed in a paper gown, it can be difficult to focus on the time you’ll have to interact with your doctor, especially if you’re also feeling sick and miserable. That’s why it’s a good idea not to go it alone. 

A companion can help do everything from drive to take notes to ask questions. In fact, researchers at Johns Hopkins Bloomberg School of Public Health in Baltimore found that when patients had someone to help them communicate with their doctors, they were 50 percent more likely to be satisfied with their doctor’s ability to give information and 30 percent more likely to be satisfied with their physician’s interpersonal skills.

Minute 1

Build rapport. Though they may sometimes seem impersonal and cold, doctors are of course human. Taking a few moments to connect can help them set a different tone with you.

If your doctor is already a skilled communicator, Mauksch says, there’s a good chance she will open the visit with a handshake or a non-medical question. For example, if she knows your son has recently left for college, she might ask, “How is it going now that your son has left home?”

If, however, the doctor breezes into the exam room staring down at your chart and seems very distracted, slow her down and bring her attention back to you by making her aware of her behavior. Mauksch says a comment like, “It seems like you’re having a very busy day,” or “you seem really frazzled,” should do the trick.

Avoid overdoing it. Getting drawn into a long personal exchange can end up putting even more time pressure on the interaction, frustrating you and your doctor.

Minutes 2 to 3

Review the list of reasons for your visit. According to a study by researchers at the University of Rochester in New York, doctors listen to a patient’s concerns for an average of just 22 seconds before interrupting. That means your doctor may only hear the first one or two reasons for your visit, creating the possibility that your most urgent or bothersome complaints will go unaddressed.

However, if you list your complaints, before your doctor asks where it hurts, it helps your doctor to know what needs her focus at this visit, and it puts you in control of the flow of information. 

And going over your list really won’t take that long. A study published in the Sept. 28, 2002 issue of the British Medical Journal found that when patients are allowed to speak at the beginning of a doctor’s visit without interruption, most spent less than two minutes spelling out their complaints.

Tell your doctor that you’ve made a list of things you’d like to address and ask if it’s okay if you go over it with him. Explain that you'd like some help determining which problems are most important to tackle at this visit. That will let your doctor know that you respect his time and that you’re willing to accept some of the responsibility for time management.

Avoid using demanding language that will put your doctor on the defensive. “You want to use words that will ‘activate’ your doctor, that will cue her into working with you in a collaborative, efficient way,” Mauksch says. Ask, don’t tell, and your doctor will most likely agree.

Minutes 3 to 5

Set an agenda. Primary care doctors are generally asked to tackle three to six patient concerns per visit, and there usually isn’t enough time to address them all. Without setting priorities, some of your most pressing needs might fall by the wayside.

“The mistake doctors make,” says Mauksch, “is that they hear one or two symptoms and they immediately go into diagnosis and treatment and when they come up for air the visit is already half over.”

When your doctor knows the number and urgency of your concerns, she will be more likely to address the problems that are most important to you and to her. She also will be better able to make rapid judgments about time constraints.

After reading over your list, tell your doctor about the top two or three things that are most pressing, and ask your doctor if, based on her expertise, those seem like the most critical issues that need to be addressed. “Remember that doing a good job on one problem may mean setting others aside temporarily,” Mauksch says.

Don't deviate from agreed upon priorities. If you asked to talk about your diabetes and new back pain, for example, don’t launch into a discussion about the side effects of your high blood pressure medication. Similarly, if your doctor seems to get side-tracked, gently ask why he or she feels its important for you to get vaccinations at this visit when you came to talk about back pain.

Minutes 5 to 16

Get ready for the clinical exam. Your doctor will likely use this time to investigate your symptoms and discuss challenges that prevent you from managing your disease.