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“How do you do it?” A co-worker asked me once one day as we were closing up the office for the day.
“Excuse me?” I blinked in surprise at their question.
“How do you do it?” She repeated. “And you’re a single parent to boot! I don’t think I will ever get the hang of doctor’s offices!”
“It’s actually not that hard, once you know the tips and guidelines from fellow parents.” I chuckled

It’s a question I do get a lot. And I realized a few days ago, I really need to share this with all of you. Feel free to pass along to loved ones, co-workers, whomever. This information deserves to be shared far and wide.
For the new parents out there, Congratulations on the new bundle of joy. You may have noticed the baby doesn’t comes with instructions. Relax, you got this! This Medical Coding Mama is so delighted at your new little one has joined your family. A warm congratulations to all the new parents out there in the world!
Here’s some tips I have learned as a parent and some tips I gleaned from friends
You are not going to jive with every doctor you come in contact with. It’s perfectly normal.
Don’t get too worried if your child is not always on the chart. It happens. You will not be the first parent to not have your child on the chart percentages, nor will you be the last set of parents.
When you’re a first-time parent, poop blowouts happen. It’s stinky and messy and your kids clothes will be stained. It’s inevitable that you will have a poop blowout at the doctor’s office, especially if your child is sick. They’ve just about seen it all. Just ask for wipes in case you forgot to pack some or ran out of diaper wipes in the diaper bag.
If the doctor asks for the child’s social security number, RUN! In the United States where I live, it’s against the law to give out the child’s social security number before 18. It’s to prevent medical identity theft, and identity theft and prevent problems for them later in life.
If you’re worried the doctor is going to think less of you because of your diaper bag, don’t. Trust me when I say the doctor has seen just about everything type of diaper bag there is, from designer duds to the ones you get at a lower priced store. It’s not going to faze them one bit. It might get a good discussion going, but it won’t faze the doctor whatsoever.
It’s perfectly ok to cry when your child gets their shots. I don’t like shots either, and I’m an adult. I always have to close my eyes when anybody gets a shot. Why? I faint at the sight of any needle, period. I’d rather not have someone pick me up off the floor because I saw a needle, just saying.
Never lie to your child that shots won’t hurt, it does, but only for a minute or two. Lying to your child about shots will weaken your child’s trust and they will always wonder about everything else you say. One of my friend’s doctors told the child the shot wasn’t going to hurt. Calling out the doctor on the lie made the doctor think about that lie. Never did find out if he quit saying that shots didn’t hurt to children.
If the doctor or the assistant can’t get blood from your child, ask for a smaller needle like a butterfly needle to be used. People tend to forget that a child’s blood vessels are A LOT smaller than an adult’s.
If they need to take blood from the hand or foot, they need to ask permission from the parent first. Getting blood from either of these places is quite painful and sometimes you get a massive bruise if they nicked a vein. I myself, have to get blood drawn from the back of my left hand simply because my lovely veins putter out in the crook of my arm. If they get half a vial of blood from the crook of my arm, they consider that lucky. However, if they need more than one vial of blood to test, they automatically go to the back of my hand now because the veins puttering out in the crook of my arm just isn’t going to cut it when they need lots of blood taken. I always pick the left hand because I’m right handed and if I have to sign anything, I’d rather not be in any form of pain in order to sign paperwork!
Make up an index card of allergies for each child ( including medicine allergies). I suggest using the 4×6 index cards because the cards are bigger that the 3×5 cards. You’ll run out of space to write on the smaller index cards. Doctors love stuff like this because it can be scanned into your child’s chart. Let the front desk know if there’s writing on both sides so they can scan both sides into the child’s electronic chart.
If your child has an unusual name, put how to pronounce it on the first paperwork. That will help when you get called back. There is nothing more embarrassing than getting chewed out by a parent when they pronounce the child’s name wrong. My own child has an unusual name and people get flustered when they say it wrong. I just chuckle and tell them they gave it a good try, I’m used to having my child’s name mispronounced and I just shrug it off as no big deal. Some parents however blow it all outta proportion……need I say more?
When going to a new doctor and the office says to come in 20 minutes early for paperwork? Better make it at least a half hour before the appointment time. 20 minutes makes for a rushed parent and sloppy writing on the paperwork and that doesn’t help anybody in the billing office if we can’t read the messy writing. A half hour to 45 minutes is a good time frame to come early so you can get through all that lovely paperwork.
If possible, ask the office if they can mail you the forms ahead of time so you can fill out the paperwork at home, it then can be the 20 minute time frame ahead of the appointment. Some offices have the paperwork online to download and fill out and print out for when you come to the office.
Make sure immunizations are up to date. Because down the road, the school district is going to need that immunization record.
If you’re a single parent, please don’t freak out when the office asks for a copy of the divorce decree. It’s to cover us when insurances contact us to make sure the right parent is getting the statements. ( and they do contact the billing office with questions, oftentimes the insurance doesn’t realize there’s a divorce decree involved and they want to know why the kids last name is different or they payer is not the custodial parent)
Another thing as a single parent: Don’t bash the other parent. It makes you look bad and it shows the doctor you’re a poor sport. And let me tell ya, doctors HATE poor sports. It makes the visit miserable for both you and the doctor, just a warning for ya.
If the other parent lives in another state or is in another area: inform the doctor of that, or else the doctor is going to want both parents in the office for discussion when it’s not possible with one parent living so far removed from the area.
If it’s an abusive situation, SPEAK UP! The doctor wants not only you and your family safe, he/she wants their staff to be safe too. I’ve heard of too many doctor’s been accosted because the abused parent didn’t think to speak up and paid the price when they were shot in front of the doctor.
Remember, all doctors are mandatory reporters. A lot of parents forget that little tidbit in divorce situations. Don’t make false statements, it will come back to bite you in the butt.
Remember to make the most of the time you have with the doctor. You only get 20 minutes tops in most cases. If your child is new to them, they will take more time
If you have questions, write them down! And do the most hard questions first. Most often from my vantage point in the back office, the parents rattle through the easy questions and then the doctor has no more time for your family and is heading out the door and onto the next patient with the parents going….Wait! and then the hard questions don’t have answers because you ran out of time during the office visit. Do the tough and hard questions first, the other questions can wait til later and another appointment.
If you want the other parent to know the doctor’s orders reports etc, you need to put them on the paper for HIPAA where they’re allowed to be in the loop. Otherwise, the other parent will not be told anything per HIPAA guidelines. And that makes for some tough choices and a lot of shouting. I’ve seen many parents escorted out the door because they discovered they were not on the HIPAA sheet and raised a real stink about it. If there is a divorce decree involved, the other parent must be told what the doctor says or you will be held in contempt. (and that’s never fun y’all. I’ve seen a lot of that from my vantage point of the back office)

We have all heard the travel horror stories when someone who has a medical condition travels and how things get messed up.

As a medical coder, I’ve been in enough doctor offices in my career that I share some of the doctor’s best tips for traveling with a medical condition, that I have gleaned over the years.

Do not put your medications in your checked in bag. I don’t know how many times I have heard of a patient that put their medications into their checked bag, and then the checked bag gets lost, which means the medication also went missing. It brings major panic to a patient. One of my co-workers had her mom do this, the mom flew in to visit my co-worker and her checked bag got lost. Well, it became an urgent situation because my co-worker’s mom had epilepsy. My co-worker called the airline to explain the situation and that they needed to find her mom’s bag because it had her mom’s medicine in it. When the airline was going “well….” my co-worker the calmly explained her mom has epilepsy and if her mom died having a seizure because the airline refused to find her mom’s checked bag that had her mom’s medicine, the airline would get sued for wrongful death. When the urgency of why they needed the bag came through loud and clear, along with a possible lawsuit, miraculously the checked bag that had been lost, was found within the next 5 hours.

Bring all the medicine supplies you need with you. And I do mean everything, extra needles if you’re a diabetic, catheters, extra stuff you need so you know you have them and don’t have to go looking for a pharmacy that doesn’t know your history. I remember a story that I read a few months ago, a person who had a colostomy bag had it popped y a security person. the person was on his way to his daughter’s wedding, and the liquid poop and pee was all over his clothes from when the security guy popped the colostomy bag. The guy was humiliated. His daughter who had witnessed all this, immediately called her local senator and emailed him the footage she’d taken of the incident. when they got to the airport of city the wedding was to be held, senators were there to greet him and his family, and they brought fresh clothes for him to change in, had a doctor present to check him out to make sure there had been no infections in the colostomy bag( thankfully it was covered with a towel the entire flight in case it leaked more) and they were whisked off to the wedding venue like VIP’s because of what had happened. And the national security people got a tongue lashing from the government on how this had been handled in the first place and all security agents around the country got training on colostomy bags so the incident would never happen again to another patient who had one. I remember shaking my head with sadness and horror over what had happened to this guy and his family after reading of the incident in the newspaper online.

Get a note from the doctor. I realize this sounds really super silly, however, I have seen the benefit of having a letter from the doctor to show security, what the condition is, what medicine you need on your person, if you have an insulin pump or pace maker and why you can’t go thru the scanner with either of those, and that they were put in surgically( you’d be surprised how many security people think you can just pull those out to show them….)

If you have an insulin pump/Pace Maker, you CANNOT GO THROUGH THE SCANNER, the insulin pump/pace maker will malfunction with the magnets from the scanners at the airport. I have heard several horror stories and read a few horror stories of people being humiliated by security personnel who smashed a vacation’s worth of insulin, or triggered a heart attack because they forced the person with a pace maker through the scanner( and then security gets a call from the higher ups because the rightfully furious family members called and complained. )I worked for a doctor that fielded calls from all over the USA to confirm the insulin pumps and pace maker could not go through the scanner by security people who thought it was a complete joke. I wish I was kidding about that one…however, I’m not kidding, not by a long shot. It put patients in a dangerous position and it would have been quite dire if something had happened and the patient died in the air on the airplane.

Know where the nearest local hospital will be on your travel/vacations. Just in case you need medical care right away.

Bring your medical history list(hospital EMR’s DO NOT talk to each other from across different states….) I’ve had more calls come into the office about a patient and they were just confirming that the patient was telling the truth. I always shake my head on that one. It would be wonderful if all the Emergency room EMR’s talked to each other all over the country.

Check with the doc to see if you can even travel at all…. I have to admit that this one is the hardest for all the tips for people. There’s a lot of things that go into a decision from the doctor….and sometimes, it’s not a pleasant surprise when the doctor tell you that you can’t travel period! from my position in the back office, I can attest that there are several swear words flying to the doctor after a patient has been told they can’t travel period because of their health. Yes, most of the words are f-bombs or other swear words as the patient leaves the doctor’s office.

Consider getting travel medical insurance. Some people might consider it pricy, however, I’ve known many patients who have gotten medical travel insurance and were quite thankful they had it when something went wrong on vacation! So please, if the option of travel medical insurance presents itself, please at least look into it or go ahead and get some type of travel medical insurance to bridge the gap if your medical insurance refuses to pay anything simply because you went on a trip or vacation.

If you have metal inside you from a hip replacement, surgery, bring a letter from the doctor explaining why you have the hardware inside you in the first place. I have a sibling that has 2 metal hips from when a growth plate broke in their leg. When it happened to the other leg, the doctor wrote up a report for a medical trade magazine describing the case and the findings. My sibling has a small laminated card that they carry explaining about the titanium hips at such a young age for when my sibling has to go through the scanners at the airport. My sibling says it’s not exactly fun when they have to get scanned with a wand because the screws holding the metal hips would come out due to the small magnet in the scanners. Thanks to the small laminated card, my sibling doesn’t get hassled much once security sees the small laminated card with an explanation from the doctor. Without that little laminated card, I am pretty sure my sibling would be hassled much more than they are.

Alert security ahead of time about your medical condition and what you can and can’t do in order to be safe. Just giving the security team a heads up makes for a better experience. It may not be perfect, however, if the security team gets the heads up before you travel, it can mean all the difference of missing your flight or not!

So that’s all the travel tips in a nutshell. Your call to action is: if you’re traveling soon, print out this tip list and refer to it while traveling, make sure security gets a heads up(especially if you’re diabetic, have a pacemaker, that sort of thing so they can help and assist if needed) and your trip will be as memorable as you could have hoped and dreamed about.

As a medical coder, just when I think I have seen it all, another curveball comes at me and I’m amazed at how much people DON’T know.

So I decided that people need to know the 10 biggest mistakes I see come across my desk all the time, and try to educate the world so people don’t get themselves into trouble with medical insurance, on the stuff they don’t realize what they’re doing is a mistake, that can cost them dearly if they don’t realize what they’re doing is a mistake of epic proportions in some cases.

So here’s to helping you, and your wallet from getting hit too hard by the mistakes I see people making every time I come into the office!

Mistake #1: Lacking a general understanding of common insurance terms
Don’t worry, no one is saying you have to develop an intimate knowledge of all the health insurance terms that are detailed on sites like healthcare.gov. That said, it could be well worth your while to read up on the terms that can be found there like:
Co-insurance
Co-pay
Deductible

Understanding them is a very important part of how much a given health plan costs.
For the record, deductible refers to the amount you have to pay for any care you receive before your insurance provider will cover the remainder of its cost. Co-pay is a specific, set fee you pay at the time of service. Co-insurance is the amount you’ll have to pay after you pass your policy’s deductible.

Mistake #2: Deciding that because you’re young or healthy (or both) you don’t need health insurance
It’s easy to assume when you’re young or healthy or both that you don’t need to bother with health insurance. The fact is, you never really know when you’re going to become ill. The last thing you want to worry about at that point is how you’re going to pay for medical care. Sadly, I see this come back to bite people ALL the time. They don’t have insurance and then they need emergency surgery or there’s been a freak accident and then they get the rudest wake-up call they will ever get when they see the bills. All that stuff from the unexpected surgery or the procedures to help them out from their freak accident is frightfully expensive and most of the time, I get handed the now shell shocked patient to set up a payment plan of some sort to help them pay off the bill they weren’t expecting.

Mistake #3: Picking a plan because of its low premiums
Hardly anyone recommends choosing any type of insurance plan based on how affordable its premium is, and health insurance is no different.
The reason: those monthly payments are just a portion of the costs that are sure to be tied to any treatments or services you receive moving forward. As mentioned earlier, you’ll also likely have to contend with and prepare for other expenses like co-pays, co-insurance, or deductibles, depending on your personal healthcare needs.
That’s not to suggest a high premium is always the right choice. But you should always carefully consider all of your options before picking a particular plan.

Mistake #4: Skimping on coverage limits
Buying health insurance is a good idea. Buying enough health insurance coverage is better. Many people, however, make the mistake of not purchasing enough coverage.
This is a big deal because if you skimp on coverage, because it can leave you open to some shockingly high out-of-pocket costs. Having an idea of what exactly you need to cover can also help when choosing a plan and making sure what you need to have covered for your healthcare will be covered. There is nothing worse than me or another medical biller/coder having to tell someone that the procedure or the surgery wasn’t covered by insurance. That’s never fun for me or anybody else to deliver that news because it turns out the situation was much worse than what was expected.

Mistake #5: Dragging your feet when it comes to the health insurance marketplace’s “open enrollment periods”
Waiting to buy insurance until you need it never has been a great idea.
What happens if you fail to purchase a policy during an open enrollment period? You may have to sit tight — and uninsured — until the next one rolls around, and that could mean a wait of nine months, if your timing is particularly bad. I honestly would NOT risk it by staying uninsured, because as I’ve seen time and time again, not being insured WILL come back to bite you if you aren’t prepared for some unexpected bills!

Mistake #6: Misunderstanding the difference between “preventative” and “diagnostic” care
That doesn’t mean you should expect that every “preventative” service is offered at no or little cost.
Even when no co-payments or other charges are associated with this type of service there are times when it leads to additional care that’s considered diagnostic rather than preventative. That’s the kind of care you’ll be charged for, so be sure to ask your physician or specialist up front about the costs that are likely to be tied to any future or follow-up visits.
As an example, a patient goes for a routine checkup. That qualifies as preventive care. During the appointment, the patient complains of frequent headaches. The doctor then treats the headaches with tests and medication. Those headache tests and medication may qualify as diagnostic care, which isn’t always covered. The check-up would be covered but diagnosing or treating the headaches wouldn’t. Avoid situations like this by doing your homework with both your doctor and insurer before you make an appointment. It will save the headache later on by finding out it was a billed as a diagnostic care, not a preventative care, and therefore, probably not covered by your insurance plan.

Mistake #7: Neglecting to ask or figure out if a particular physician or specialist is “in network” or not
You should have that down pat before you ever set foot into a hospital or physician’s office. That’s because of the differing impacts in-network and out-of-network care can have on your wallet.
You NEVER want to find out your favorite doctor or specialist is not covered on your insurance plan….. having seen and caught many people mid-faint when they find out the hard way that their favorite doctor or specialist isn’t covered, at all, on the plan they chose(not fun I assure you), even if they were promised the doctor would be covered, and they found out later that just wasn’t the case, which makes for some very angry patients. Always check it out first BEFORE you sign up for a particular plan. If you don’t, it can and will come back to bite you if you didn’t check it out first that your favorite doctor /specialist was on the plan or not!

Mistake #8: Ignoring flexible-spending accounts when they’re made available to you
Flexible-spending accounts may not be quite as appealing as they used to be. But that doesn’t mean you shouldn’t take advantage of them when they’re offered to you.
Why? They still allow you to set aside money, tax free, that you can use later to pay off all sorts of health-related bills that insurance won’t cover, for starters. Also, the contributions you make to these accounts can reduce the amount of money you owe to Uncle Sam at the end of the year.

Mistake #9: Failing to make sure any medications you have to take are covered by your health plan
If you take one or more prescription medications, make sure they’re included on the list of covered drugs before buying a policy. If you’ve already got a policy, make sure your medications are on the insurance company’s formulary before filling prescriptions. If they aren’t, check with your doctor to see if there are any acceptable alternatives.)
Although this information usually is included on an insurer’s website, that isn’t always the case. To be absolutely sure, give someone there a call so can be sure one way or the other. Take the 20 to 30 minutes or so and call your insurance carrier and bring yourself peace of mind knowing you’re covered for your medicine, instead of finding out the hard way, at the pharmacy counter, that your medicine isn’t covered. That’s never a pretty picture. I’ve been witness to many tears while waiting for prescriptions and the person had to pay out of pocket because their medicine wasn’t covered by their plan.
A related mistake to avoid: using a pharmacy or mail-order service that isn’t “preferred” by your insurance provider. (Preferred ones can save you a lot of money.)

Mistake #10: Being too eager to pay your bills
It probably seems strange to suggest that “paying your bills too quickly” could ever be considered a mistake, but that’s basically the case when it comes to health insurance.
What should you do instead of paying your healthcare bills as soon as they arrive on your doorstep (or shortly thereafter)? You should wait to send in payment until after you’ve received an explanation of benefits, or EOB, from your insurance company.
This document details the services you received, how much the healthcare provider charged for them, and how much of that amount your insurance company is willing to cover.
I sincerely recommend waiting for your EOB because you may find errors while reviewing it, and you’ll probably want to have them taken care of before you send in your payment. Nobody wants to pay for an error on the bill ya know?

When a company’s reputation of being a toxic office proceeds it, you know something is out of whack. Did you know Doctor offices can sometimes be toxic too? That fact shocks some people actually. There are signs to look for so if you encounter a toxic office, you can turn tail and take your healthcare elsewhere. Going to a toxic doctor office will undermine your health faster than anything else will. Toxic environments up the level of stress and depression and fatigue, not only in the team that works for the toxic doctor, it adversely effects the patients too. So next time you go to a toxic doctor office, tune into what your feeling, because our bodies are fine tuned to pick up stress signals and toxic vibes.

“Hey! you heading to the Northwestern side clinic again?” My co-worker fell into step besides me.

“Yep.” I replied.

“Doesn’t it bother you they doctor treats her people the way she does?” She asked as we kept walking toward the elevators that would take us to our cars.

“It does, however those poor team members at the clinic realllllly need help learning the new system they just put in and I’m training them so they know how the system actually works, not from cheat sheets that do nothing to help.”

“Does the agency know what going on with the clinic?” My co-worker asked.

“Yep, they do indeed know what’s going on.” I replied

“What did they say?” She wanted to know

“Considering they were floored at what I told them, they told me I didn’t need to go back, however I explained these people desperately needed training on the new system that they have, and I’ve worked with that system so I’m staying for the week as per the contract.”

“You’re a brave woman…..” my co-workers voice trailed off as we reached the company cars we had to drive to the job sites we worked at as contracted medical coders. and we went our separate ways for the day.

So if you’re the patient and you’re going to a toxic office, are there signs it’s toxic? Thankfully, yes, there are indeed signs the doctor office is a toxic one.

Here are some of the signs to look for. There are many signs of a toxic office, however, I’m just going to highlight the most common of the signs………

You’ve Just Got a Bad Feeling About Things
Part of the danger of a toxic environment is that sense that you’re losing ground without anything actually happening. It’s time to trust your gut!
Here’s what to look out for:
An overwhelming sense that something is wrong.
A sick feeling in your stomach after you enter the front door of the doctor’s office
Feeling like you’re on alert.(and for good reason, you never know what could trigger a rage outburst from one of the office staff)
Feeling like there’s something “not being said” (no, it’s not your imagination. If you feel like this, make note of it and find out what is going on and why your gut is telling you with a neon flashing light feeling)
A strong urge to seek help or discuss the situation frequently with friends.
Sweaty palms, racing heartbeat or other abnormal physical signals of stress or anxiety.
If you have a strong sense of disengagement, or if any of these signs ring true for you, you may be in a toxic environment, and the time to act is now!

Watch for De-Energized and Unmotivated Workers
This usually indicates a fear-based culture lacking the practice of encouragement and respect often found in a caring environment led by strong servant leaders.
A toxic doctor office culture does not welcome people to offer their ideas, input, creativity, or strengths to the overall environment.

Watch for People Who Hoard Information
This is particularly worrisome if your doctor office is doing it. Here’s the real reason why they withhold information: it’s about power and control. And control at any level, across any function, or between peers is one of the most effective ways to kill trust.
I personally dealt with this when my first husband was told he was terminal with liver cancer. Because none of the team of doctors had said a word, we had no clue whatsoever what we were going to be told. Being blindsided was an understatement. I was very sad that nobody had told us for two months just how bad things were getting. When the doctor who broke the news (that my 1st husband’s cancer was terminal) realized we had no clue whatsoever of how bad things really were, he called the rest of the team in and chewed them out right in front of us. He was completely appalled we’d be kept in the dark for so long. And that’s when he broke the news that my first husband had weeks to a month to live before the cancer took him.

Communication breakdown: Why don’t people care? One reason is that the higher-ups don’t communicate well, or at all. A non-toxic office is one where there is, among other things, an open line of communication between staff and patient.

High turnover: The correlation to №1 is that the toxic office has a tough time keeping people around; either they quit or are fired. If you are looking for a job and find out that the place has a high turnover rate, run, don’t walk, to the nearest exit. This is most commonly seen if the patient goes to the doctor office every month and is startled to see brand new people at the front desk that weren’t there the month before and it continues like that for months….

Intimidation station: Another sign that office is toxic is that it is run on intimidation. There are many ways to motivate people, and yes, frightening them is one, but it sure isn’t fun and studies show it doesn’t work nearly as well as positive reinforcement. I worked in an office a few years ago where the stress level was always way lower when a certain doctor was on his weekly rotation at the hospital. Whenever this certain doctor was in the office, the stress level went through the roof and even patients felt it in the waiting room that the staff was walking on egg shells anytime this doctor was in the office. It was also eye opening when many of the patients he had switched to other doctors in the practice because that certain doctor belittled the patients as much as he did the staff!

Policies trump people: Toxic offices thrive on bureaucracy. Policies become a crutch and a wall to hide behind, masking all sorts of bad behavior. And the worst thing is the phrase “That’s policy, sorry, nothing I can do about it.” If you ever hear this coming from staff, run…… don’t walk to the nearest exit and switch doctors immediately if you can(some people aren’t quite as fortunate to do that if it’s the only specialist in town.)

After many hears from my vantage point of the back office, I kept hearing ” I don’t know what to ask!!” So here ya go, my take on the main questions to ask the doctor every year during your annual appointment.

So here’s a list of what patients have said over the years (and the ones that doctors respond to the most.) Use or improvise a variation of any of the questions for your next visit.

“How are my LDL levels?” LDL (or low-density lipoprotein) cholesterol is referred to as “bad” cholesterol. That’s because if it builds up in your arteries, it can lead to some serious heart problems. And every year, you should make sure that you ask your doctor how your LDL levels are looking. Talking to your doctor openly and honestly about your cholesterol will help you “prevent the majority of bad things—stroke, heart attack, and premature death, for example—from happening.

“What would my ideal blood pressure be, and how do I get there?” In addition to asking about your LDL levels, you should also ask your doctor annually about your blood pressure and, if it’s high, what you can do to lower it. I started to ask this myself when my blood pressure was dangerously high at one appointment several years ago. The office nurse checked 3 times, with 3 separate types of blood pressure cuffs and all three came up with the same exact reading! It was almost freaky just how the exact they all were.

“Which tests do I need and which are optional?” Don’t blindly consent to every test your doctor suggests. “It is important to ask about the benefits and risks of a test] so that you as a patient understand what a test is for and what it will determine, you can “make an informed decision as to whether to provide consent to participate.” If you feel unsure about a test after hearing the benefits and risks, your safest bet is to get a second opinion. If I’m unsure, I always go get a second opinion if that helps any.

What are the side effects of this medication? This is a question that not only should you ask your doctor not just annually, but every time you start taking a new medication. All Medicines have a myriad of side effects. And depending on if you can live with certain side effects or can’t take certain medicines because of other underlying issues with your health, speak up!

“Are my blood sugar levels healthy?” It’s recommended that adults get their blood sugar levels tested every year or every three years starting at age 45, depending on risk factors. While there are many symptoms of diabetes—like fatigue, extreme thirst, frequent urination, blurry vision, and weight loss—many people with diabetes have no idea that they have it. Considering more than 100 million adults in the U.S. currently live with diabetes or pre-diabetes, catching any problems early could greatly benefit your health. So even if you’re not in your mid-40s, it’s worth bringing this topic up to your doctor annually.

“What are the side effects of this medication?” An important question in my opinion. Sometimes, you need to alert or remind the doctor what medicine you’re already taking, because sometimes medicines can counteract other medicines and put your health at risk!

“Why do I need this medication?” If you’re unsure why a doctor is prescribing you a certain medication, just ask. “People who don’t understand why they are taking certain medications are likely to stop them, which can have a potentially deadly outcome. Patients who prematurely stop taking their anti-platelet medications after having a stent in their coronary artery can have a heart attack.

“What is my ideal weight?” Everyone’s ideal weight is different. That number depends on several things, ranging from height and age to bone density and preexisting medical conditions. You should make it a point to ask your doctor about your ideal weight every year. Doing so will give you a realistic number to strive toward—one that won’t require you to rely on crazy diet fads and unsustainable amounts of time spent at the gym.

“Are there any activities I should be avoiding?” Most people already know that they shouldn’t be smoking, binge drinking, and eating fast food long before they walk into their doctor’s office. However, some specific situations call for patients to avoid other activities that might not immediately send up red flags. If you have heart disease, for instance, some doctors note that exercising in an extremely warm climate can make it difficult to breathe. Talk to your doctor annually about which activities you should avoid in order to live a long, healthy, and happy life.

“Is there anything I should warn my family members about?” Many health conditions—ranging from breast cancer to hypertension—are influenced by genetics. If your doctor diagnoses you with a new condition or illness, make sure you ask them about whether your family needs to be tested, too.

“Are my bowel movements normal?” Though there is really no such thing as a “normal” bowel movement, you should talk to your doctor if you’re worried that your bathroom habits are a symptom of something more serious. And indeed they can be: The clinic notes that some of the conditions that can cause bowel changes include food allergies, gallbladder issues, pancreatitis, inflammatory bowel disease, and bowel obstruction.

“How is my thyroid function?” It’s very important to make sure that your thyroid is working properly. This gland, which produces hormones that keep your organs functioning, can wreak some serious havoc inside your body if it’s underactive or overactive. I’ve had cousins that need to be on medicine, and I’m asking about this very thing the next time I go in for my own annual exam.

“Should I be worried about my sleeping habits?” If you’re worried that there’s something wrong with your sleep habits, then you should definitely talk to your doctor about it. Sleep problems make you tired during the day, yes, but they can also be the cause of a condition or an indicator of bigger health issues.

“Should I see a specialist?” Sometimes your primary care physician just doesn’t cut it. If you think that your health issues require a specialist, then ask your doctor for a referral. There’s a reason why doctors like allergists and gastroenterologists exist, so don’t be afraid to ask your primary provider about professionals with specific specialties!

“Is a mammogram a sufficient breast cancer screening for me?” Patients should talk to their doctors before they schedule a mammogram every year. Though the X-ray technology has come a long way in detecting bumps and lumps, breast surgical  “mammograms can miss concerning findings” and that those with symptoms should get evaluated by a medical professional. What many people don’t know is that “patients who are at a higher risk of breast cancer need more than a mammogram.” If breast cancer runs in your family, talk to your doctor about an additional screening with an MRI since a mammogram may not cut it. you should always ask your doctor about the latest in breast cancer screenings just to make sure that you’re staying on top of things. Women should consult with all resources available—including their healthcare provider—in order to reach a personal decision about their own health goals.

“What can I do to improve my health?” While this may seem like a simple question, the answers you receive will help guide you. And even if your doctor’s answers are obvious—drink less, exercise more, etc.—hearing these things from a professional might just be the spark that encourages you to make some necessary changes in your life.

Making an appointment for your annual doctor’s visit is the first step toward taking care of your health. But once you’re actually at the doctor’s office, if you’re not actively asking questions and getting educated about your wellbeing, you’re doing yourself a major disservice. After all, what you do and say during your appointment can have a major impact oIt began when I saw the bag a patient was holding a few years ago. It was HUGE.