Always Tell the Doctor If...

I keep a laminated copy of the information in Table 1 in each of my examination / treatment rooms. It is placed where it is obvious to patients and their guests. I developed the chart and began using it in an effort to obtain as much information as possible. The ultimate goal is to provide better care and improve the details in my documentation.

What the Chart Covers

• Circumstances that should be addressed routinely: pain scores and changes in symptoms
• Health issues that could present challenges during care: allergies, implanted electronic devices, pregnancy, forms of abuse, etc.
• Health issues that could indicate the need for immediate referral: trouble with bladder and/or bowel function, etc.
• Acupuncture: a fear of needles (obviously if you do not provide acupuncture at your clinic, this question is not relevant)
• Safety issues related to specialized equipment: asking patients not to sit on tables or try to operate equipment
• Insurance issues: changes in employment

How to Use the Chart

The chart is reasonably self-explanatory, but to be sure patients pay attention to it and its questions, I show the chart to everyone during the report of findings and/or first treatment.

I explain the significance of the chart's questions, and give a few examples of answers and situations that make use of the chart necessary. I ask patients to review the chart each time they enter the room.

During an established-patient visit, I usually point to the chart and ask the patient if he / she has anything to tell me. I don't run down the list, asking every question each visit. I am entrusting the patient to read the chart. So far, the fact that I ask about the chart and its contents routinely seems to be helping patients recognize the importance of reporting new information.

Personalize It to Your Practice

Some of the questions, the more serious ones, are in bold print to emphasize their importance. The chart isn't perfect or completely one-size-fits-all, but it has been another step in the right direction for my practice. I recommend you consider developing your own version, personalized to your practice. I think you will like the results.

Table 1: Follow-Up Questions for Established-Patient Care

ImportantNotice
ProvidingImportant Information About Your Situation

Always Tell the Doctor if you:

• Haveany concerns / questions
• Haveany implanted medical devices, especially electronic devices that usebatteries; i.e., pacemaker, stimulator,pump etc.
• Are orcould be pregnant
• Have pain (please rate the pain on a scale of0-10)
  • 0= No pain
  • 10= Terrible pain (you cannot drive, work or attend school etc.)
• Have experienced changes in your symptoms
  • Nochange
  • Symptomshave improved
  • Symptomshave moved
  • Symptomshave increased
• Have limited your activities due to yourcondition (changed your work, job or household activities)
• If you have been able to return to activitiesthat have been limited recently due to your current condition
• Are having trouble following home instructions
• Haveallergies to latex / adhesives
• Areafraid of needles
• Havebeen injured since your last visit
• If you haveseen another doctor since your last visit, and why     
• Arehaving trouble with bladder or bowel function
• Arehaving thoughts of suicide
• Don'tfeel safe at home
• Arebeing verbally, physically or sexually abused
• Have experienced a change in employment and/orinsurance coverage

Please do not sit or lie on the chiropractic tables and equipment until asked to do so by the doctor. The tables havemoving parts that can shift with your weight. Sudden movements could irritateyour condition. This rule also applies to friends and family accompanyingpatients. 

When being lowered or raised on one of the hydraulic tables, establish and maintain full body until the tablestops moving.

Please do not move or attempt to operate any of the equipment in the treatment rooms.