December 24, 2007

Developing A Good Relationship With Your Dermatologist

As in any ongoing relationship, especially if it may last for a long time, it's important to feel comfortable and have a sense of genuine rapport with your dermatologist. Key points in building this relationship include closely following your doctor's instructions, being patient, and feeling free to ask any questions that you may have.
 
You need to know some very specific information before you start popping those pills or rubbing the acne stuff on your face and body And just like that manual that came with your new iPod or computer, the medication your doctor prescribed comes with instructions. If you're like me, you'll probably find them much easier to understand than your iPod or computer instructions.
 
Read those instructions! Both the instructions that come with each medication and any handouts given to you by your doctor or anyone on her staff contain valuable information about your treatment regimen. If you weren't given an instruction sheet or other handwritten directions regarding medications, call your doctor for any necessary clarification.
 
Some folks expect things to work overnight and don't give the medications a chance. Impatient patients are a very common problem! If you think the stuff your doctor gave you isn't working, often it's because you haven't given it enough time to really kick in. For example, benzoyl peroxide may take four to six weeks to really start working, and some topical medications such as the retinoids can take up to three months before they show their stuff.
 
You see your face in the mirror every day. Your dermatologist only sees it when you come to the office for your appointments. The improvement, or lack thereof, will be much more evident to him.
 
Sure, you'll have some good days and bad days, but overall, it's important to stick with the routine and give it a real chance to work and judge the progress on a monthly rather than a daily basis. Rome wasn't built in a day and your acne won't disappear in a week!
 
Phoning
 
You, your healthcare provider, and her staff should view your acne treatment as a team effort. Like any good team, communication here is important, so don't hesitate to call the doctor's office with questions or concerns you have outside of your normal office visits.
 
Although office policies vary, the best time to call is in the morning after 9 a.m. when most offices are open. Many offices go "on service" during lunch hours and an answering machine (voicemail purgatory) or operator who isn't in the office may answer your call.
 
If you need to cancel or change an appointment, the receptionist can handle that information while you're on the phone. Other procedural-type queries may be fielded by members of the dermatologist's staff. And, if you have a fairly straightforward medical question, the receptionist may have a nurse call you back. But for more complicated situations and real "trouble shooting," ask to speak to the dermatologist or have him call you back directly.
 
Simply tell the person who answers, "I would like to speak to the doctor, and it's very important. Please have him call me back." Leave the times and phone numbers where you can be reached in the next 24 hours. (If it's not an emergency, don't say it is one!) The staff will then pull your chart and leave it for the doctor to review.
 
Here are some of the most common scenarios that call for a quick call to your dermatologist instead of sitting back and waiting for your next appointment, which may be three months away:
 
  • Your medication isn't working. If a medication is causing you problems, not working, or for some reason you can't or won't use it, call the dermatologist about it — or if you're a kid ask your parent to call. Don't wait.
  • You forgot to ask certain questions during your appointment. Call the dermatologist rather than waiting until your next appointment.
  • You need refills or you lost a prescription or medication. Possibly you lost the actual prescription or you left the medication at your grandparents' house, at a camping trip site, or your dog ate it. Often the receptionist or nurse can take care of refills over the telephone. (If your dog ate your prescription, you may also need to call or visit the vet!)More often that not, when you call to ask for a refill, you'll find that there is a specific policy that is carefully followed. Most dermatologists, as well as many other healthcare providers, are more liberal when it comes to refilling topical medications. However, oral drugs carry greater risks and the policy regarding refilling them will necessarily be much stricter.Many dermatologists insist that you be seen in their office if more than a year has elapsed since your last office appointment before mailing you or telephoning your pharmacy for a refill. This is especially the case when the dermatologist isn't very familiar with your case and perhaps has only seen you on one or two occasions.
  • You need a different prescription. Maybe you can't afford the prescription and need a generic substitute.
  • You lost information about the medication. Maybe you forgot how often to take the pills or your PCP wants to give you a medicine for another condition and you want to know if that drug can be taken along with your acne medication.
  • You're concerned about side effects. Maybe the stuff the dermatologist gave you smelled horrible, made your dog sick, upset your stomach, gave you a yeast infection, bleached your nice blouse, irritated your skin, or made you itch like crazy!
  • You need a referral. For instance, you're moving to Albuquerque and you want the name of a dermatologist in that city.
 
You can switch dermatologists if you don't have a good communication with the dermatologist you're seeing or if you're not satisfied with the progress of your treatment. You or your parent might speak to the dermatologist about these issues and maybe give her and the medication(s) more time or another office visit or two before deciding to change doctors.

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