Transcript
Matthew DeVane, DO FACC: [00:00:09] Hi, I'm Doctor Matt DeVane.
Carolyn Lacey, MD FACC: [00:00:11] And I'm Doctor Carolyn Lacey. We are cardiologists at John Muir Health and this is our podcast, Living Heart Smart.
Matthew DeVane, DO FACC: [00:00:18] Our physician partners and colleagues are going to help guide you through many different and important cardiovascular topics to help keep your heart happy and healthy.
Carolyn Lacey, MD FACC: [00:00:25] Thank you for listening and we hope you enjoy our show.
Matthew DeVane, DO FACC: [00:00:33] Carolyn and I have been talking a lot about what is the best way to communicate with our patients and our listeners about how to get messages out, and we've kind of come up with a theme of maybe doing the top five or the top seven or the top ten of whatever topic we want to talk about, and we think that's a good idea. Hopefully, you guys will enjoy it. Tonight. We're going to start with our very first one, and it's the top five ways you can prepare to be ready for your first visit with a cardiologist. It's a big deal to come to see a cardiologist. We know there's a lot of, you know, little, little anxiety coming to see a heart doctor, checking out your heart and your health. And so we just want you to be totally prepared when you come. And this is all really Carolyn's thoughts. And she's put together some really good thoughts for us today. And I'm going to ask her to talk about the top five ways to prepare for your cardiologist. Carolyn.
Carolyn Lacey, MD FACC: [00:01:24] Thanks, Matt. I like being able to succinct this down into just five ways to do it, because I see on news magazines and my your my news app and all these articles about ways to get ready for your doctor's appointment. And they tend to have lots of extra stuff in them. But really, when I read those articles, I think, how is that going to lead to a really good appointment? Because you're coming to the cardiologist and we want to be part of your team to really help take care of you. And we want you to have a good experience, and we want you to feel like you are more confident, less afraid, because everyone's afraid when they come to the doctor.
Matthew DeVane, DO FACC: [00:02:07] And we just want it's a it's a one visit, the first visit. We want it to be the most efficient visit that you can have and for you to get the most out of it, the things that you want to get out of it. So it's a team effort. So I think this is a great idea.
Carolyn Lacey, MD FACC: [00:02:19] So I think the first place to start is actually well before you come into the office, it is when your doctor, your primary care provider, tells you, I think I need to refer you to a cardiologist. And I think that a lot of us, our brains might stop working at that point, because why do I have to go see the heart, doctor? What's wrong with my heart? But. I think if you can sort of be a part of that discussion, don't be an ostrich. Don't hide. Don't put your head in the sand. Say, well, why do you think I need to be referred? What about my symptoms? What finding did you see on my EKG? Um, what question are you asking? I think that's important. It's really hard when you walk into the room and you say, why did you come in today? What's going on? How can I help you? And you say, I don't know, you tell me. Right. My doctor already sets.
Matthew DeVane, DO FACC: [00:03:16] Yeah. Not a good way to start. Yeah. It is surprising how many people aren't quite sure. And I'm not sure if that's because of, you know, whatever reason, whatever reason it is. But that is a great way to start the visit. I'm here because blah blah, blah. And then we start.
Carolyn Lacey, MD FACC: [00:03:30] Right? And I think that the next thing that the that you can do is to sort of keep a little diary. So if you've seen your PCP and you've said, I'm having some palpitations, well, start paying attention to those palpitations. And when we ask questions about your symptoms, we talk about things like, where's the location of your symptoms? What does it feel like to you? What we consider the quality of your symptoms? Does it move or radiate anywhere? Are there anything else that happens? And when we are giving a history, when we're taking a history, it really is sort of like writing an article. Who, what, where, why? When you know how long, what are you doing? What makes it better or worse? All of these things help us take your symptoms and figure out what problems there could be dealing with. Yeah.
Matthew DeVane, DO FACC: [00:04:20] I mean, we're problem-solving, right? We're trying to put together the puzzle, the puzzle of what it is that you're having a problem with. So the more details that you can give us, really, the easier it's going to make our job. And so, yeah, even things like when did this first start, has it ever happened before? Is it getting worse? Is it getting better. Those sort of things. So I like that idea. Just have patients be proactive and aware and document and help us get through it. Yeah.
Carolyn Lacey, MD FACC: [00:04:45] And remember we're talking about just explaining your symptoms. I didn't ask you to tell me what your diagnosis is. It's not your job to make the diagnosis. That's kind of our job that's been trained to do. It's okay. Absolutely.
Matthew DeVane, DO FACC: [00:04:57] Team effort will team effort.
Carolyn Lacey, MD FACC: [00:04:58] Yeah. Yeah. So you know, we also want to know what other medical problems that you've had. If there's any family history in your family history, especially cardiac family history. Somebody's had a heart attack surgery, valve surgery, sudden death, arrhythmias, all those things. And then when we ask you about habits, it's not to be judgy. Habits are important. So just be honest about it. We've heard it all. We've heard it all. So just so especially smoking, that's a really big one. Um, and then we know that you will be looking on Google. We know.
Matthew DeVane, DO FACC: [00:05:32] Yes, that's.
Carolyn Lacey, MD FACC: [00:05:33] Part of no part of the.
Matthew DeVane, DO FACC: [00:05:34] Package. That's okay.
Carolyn Lacey, MD FACC: [00:05:35] And so Google is going to give you Google is going to give you everything. You're going to type in. You type in some words and Google only looks for the words. And so it'll give you all all of the options that have the words in there. But they may or may not be pertinent to you, but something's going to make you more frightened than others. And just what are you most worried about? So we can kind of get that off the table.
Matthew DeVane, DO FACC: [00:06:01] Those things are not put into context around your issues. So that's what we're there for, right?
Carolyn Lacey, MD FACC: [00:06:06] Yeah. That that's what we help sort of sort out. We sort of help synthesize your symptoms together. Um, and then bring a list of your medications I. This is so important, being able to know what medications you're taking. We there are so many patients who have complications or they have a bad outcome because of medication errors. And I really want to know exactly what you're taking. And so a medication is not just a blood blood pressure pill. It's pink. It is the name of the medication, the dose, which is usually how many milligrams or milligrams, and then how you take it. What's your instruction for how you take it every day? Um, and when we ask you about your medications, don't just leave it up to the electronic medical record trust, but verify.
Matthew DeVane, DO FACC: [00:07:00] Yeah, you have it. A lot of patients that try to update their med list online, which is very helpful, but we can't be sure that everything's jiving. So we're still going to ask. It's a little bit repetitive for some people and we apologize ahead of time, but it's so important that we just need need it happen. And if you're absolutely don't know, just grab all your bottles, put them in a bag, and bring them on in and we'll take we'll figure it out, okay.
Carolyn Lacey, MD FACC: [00:07:25] The next thing, the third thing I think that's important is arriving early for your appointment. There's it's coming to the doctor's office. You have to go to registration. We have to verify your insurance. You have to park. You have to walk into the office. There's a lot of stuff that's happening in the beginning before you even get to see the get to see the physician. And then you may as well just plan to settle in. This is cardiology. Things happen, emergencies happen. Um, so listen to our podcast.
Matthew DeVane, DO FACC: [00:07:56] Yeah.
Carolyn Lacey, MD FACC: [00:07:56] Please, please. Or bring a book or something like that to just right help. Our goal is really to try to be able to walk in at the time. If you're scheduled for 9:00, I want to walk in and start talking to you at 9:00. But there's these other things beforehand.
Matthew DeVane, DO FACC: [00:08:13] Yeah, you just need to partner up with everybody because it's a bit of a process, especially if it's the first time you've been to our office, because there's going to be there stops stuff. So yeah, get there early. And because it's a team approach, it's not a team approach. It's not just Carolyn Lacey walking in at 9:00.
Carolyn Lacey, MD FACC: [00:08:31] I can't do.
Matthew DeVane, DO FACC: [00:08:31] That. So anyway. Yeah, be early. Yeah, I.
Carolyn Lacey, MD FACC: [00:08:34] Need help. Yeah. So the fourth thing is when you're in the room, so you've already you've already made your form, you've already registered, you've already verified the insurance, we're bringing you into the room. And some things to expect when you come in. We're going to be taking your vital signs. There's going to be a blood pressure measurement. We're going to measure your pulse. We're going to measure your weight. That's again one of those things that's not to be judgy. We just want to know on our scale what's the number. Because we oftentimes track the weight for a lot of different cardiac reasons. We want to see what our scale is and see if it's tracking on our scale. We'll put a little pulse ox monitor on you. Many times people are going to get an electrocardiogram or an EKG, ECG. That's the one that that's the printout on the little pink paper. That gives us a lot of really big overview of what's going on with your heart. So just sort of expect that that's going to be done. And that takes about ten minutes to do all of those things right before I've ever walked in.
Matthew DeVane, DO FACC: [00:09:37] So yeah, by the time you've, you know, assured all the medicines are correct, checked all the vitals appropriately done, an EKG and it takes, you know, at least 10 or 15 minutes.
Carolyn Lacey, MD FACC: [00:09:47] So our medical assistant is going to do that.
Matthew DeVane, DO FACC: [00:09:49] Thank goodness. We have an incredible team of medical assistants that you'll meet first. And then they work closely with us.
Carolyn Lacey, MD FACC: [00:09:58] So we can't do it without them. It is most definitely a team effort. Um, and the other thing that we'll do beforehand that the medical assistant will help with is they will go through your medications again one more time. Don't get frustrated. Just go through it. Um, it's just one of those things that, again, the more we verify that information, the better we'll verify your pharmacy. If that's that's also the time that if you want someone in the room with you, if you want your family member or you want a chaperone, just ask. That's okay. Yeah. You know, our goal is to just start at the time that we're that we're scheduled to start. Right? Yeah. Um, and then I think when we go through the appointment, after we've talked about what's been going on, we've talked about your health history, we've talked about your symptoms that you're having. There's probably going to be some testing at the end. Um, and I get asked very frequently, are we going to do the test today? And so some of the tests that we will often schedule an echocardiogram, a stress test, a nuclear stress test, a monitor, most of that's going to require some form of insurance authorization. This is the structure of what we the structure of our health care in the United States. And there are too many. We can't pay attention to how we can't we? Can't keep track of every little nuance that every different insurance company wants. Everybody has a different insurance company, and they all have different rules that we have to learn to deal with. Yeah. Um, but when you do get tests ordered, I just encourage people to schedule as many as you can as you're walking out the door because then they're done. I'm not very good at calling back and scheduling for things myself. Well, I.
Matthew DeVane, DO FACC: [00:11:43] Think the key is, um, you know, bring your appointment book, bring what you're going to need in case other activities or testing or appointments need to be made that day. Calling back in can be a challenge for you and for us and for everybody. So the most efficient thing for you is leave the office, make the next appointments if needed, and keep moving and moving the ball forward.
Carolyn Lacey, MD FACC: [00:12:04] If you need some help and they, you know you're going to have some tests that are done at the hospital. Instead, there are some things we can't do in the office that we need to do at the hospital. Just make sure you have the instructions on how to call scheduling to get that done. Yeah, I think when it comes down to how I explain to patients on how to get through their appointment, I think of I think of me as an example. And I'm not a very good patient. Most doctors aren't. But so I think of the things that I need to do, and, you know, that I would I would sort of struggle with and this is how I came up with this list.
Matthew DeVane, DO FACC: [00:12:39] I love the list. Yeah. It's encouraging us for patients to be proactive and for us to be working with them closely to get the most efficient and productive meeting that we can.
Carolyn Lacey, MD FACC: [00:12:50] Hopefully to take care of them and make them feel a lot better. That'd be great.
Matthew DeVane, DO FACC: [00:12:55] Okay, that was excellent review. Can you please summarize for us, Carolyn, the top five things patients can do to prep for their cardiology visit.
Carolyn Lacey, MD FACC: [00:13:04] Okay, so number one, know the reason you're coming to see the cardiologist in the first place. Number two, keep a diary which includes your medication list. That's more than the color of the pill. Name the dose how you take it. It's so important. Number three come early. It's a process. There's just a lot of stuff that happens before you actually get to have a discussion with the physician. Number four, remember, it's a team approach. I can't do what I do without my medical assistance, without all the people who are doing all the administrative work beforehand so I can help be with you only and just pay attention to what's going on with you. And number five. If you have testing scheduled, schedule it as you're walking out. Make as many appointments as you can because that's the best opportunity to do it.
Matthew DeVane, DO FACC: [00:14:00] Excellent. We look forward to seeing you. This is Doctor Matt DeVane and on behalf of my co-host, Doctor Carolyn Lacey, and our partners at John Muir Health, we hope that you enjoyed this show and we really hope that you keep living heart smart.
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