3 ways to streamline your health care visits

How many days a year do you spend getting health care outside the home? A recent Harvard Medical School analysis found the average was 21 days among people ages 65 or older in traditional Medicare — mainly for office visits, tests, imaging studies like x-rays, and treatments. And it was 50 or more days a year for 11% of these adults. That's nearly one out of every five weekdays.

Committing a lot of time to health care visits can be challenging, especially if you have to take time off from work or if you have mobility or transportation issues. The study authors recommend reducing your health care visit load when possible.

"Clinicians should be the ones thinking about how we can make health care more efficient. But if they don't, remember that you have some power in the process," says the study's lead author, Dr. Ishani Ganguli, who is an associate professor of medicine at Harvard Medical School and an internist at Harvard-affiliated Brigham and Women's Hospital.

Dr. Ganguli recommends three strategies for reducing the number of days you devote to medical appointments.

1. Eliminate unneeded care

Some health care might not be necessary or effective. Examples include imaging or screening tests for people at low risk of certain conditions (such as a stress test for stable coronary artery disease) or surgery for a joint problem when physical therapy would be just as effective.

How can you jettison unneeded care? The Choosing Wisely campaign, from American Board of Internal Medicine's ABIM Foundation, suggests asking your doctor these questions:

• Do I really need this test or procedure?
• What are the risks?
• Are there simpler, safer options?
• What happens if I don't do anything?
• How much does it cost?

Dr. Ganguli suggests adding another question to understand if a test is really helpful: How will the results of this test change our plan?

2. Consolidate appointments

Find out if it's possible to consolidate appointments or coordinate various doctor visits, tests, or imaging for the same day.

"For example, if a patient of mine comes in because she's having knee pain, and I notice that she's due for routine blood work for diabetes, I get that done on her visit instead of having her come in for a second visit," Dr. Ganguli says. "If I didn't offer that option, it would be entirely appropriate for the patient to say, 'I'm here for new knee pain, but I know I'm due for a diabetes check as well. Is that possible?'"

It's also appropriate to ask your doctor about new health concerns you have, even if you're there for something else. Just make a list of your questions and concerns in advance, so you can be as efficient as possible. Then, at the start of the visit, tell your doctor that you'd like to discuss concerns about a possible new health condition, so the doctor will allow time for your questions.

"Keep in mind that if you ask about new health concerns during an annual wellness visit, the doctor is often supposed to charge an add-on fee to insurance, which may require a copay," Dr. Ganguli says.

3. Use telemedicine

Medicare and many insurers pay for medical visits conducted via a telephone or video call. The technology can be used in place of many types of appointments that would normally happen in person, such as mental health care visits or routine follow-ups for diabetes or high blood pressure.

"For example, if I see someone in person for high blood pressure, and we set him up with a home blood pressure monitor or advice on which monitor to get, the next visit to review blood pressure can be virtual," Dr. Ganguli says. "The patient will record the information from measurements taken at home and then share it with me. And that same process can be done with any data that can be collected at home, even for annual physicals in many cases."

What telemedicine doesn't always replace is the social element. "Many people like seeing their doctor in person and prefer it," Dr. Ganguli says. "But I have other patients who are busy and can't or don't want to spend time getting to and from an appointment."

How to talk to your doctor

You might feel uncomfortable about discussing the issue of reducing your health care visits. But Dr. Ganguli urges you to speak up for yourself. One way to broach the subject is by bringing up this article. Mention it to your doctor, or give the doctor a copy of it.

Just know that many people have obstacles to coming to the office or hospital, such as getting time away from work or finding transportation. Don't be hesitant to tell your doctor about such problems, and to seek ways to make fewer office visits.

As Dr. Ganguli notes, "Doctors mean well, but they aren't always aware how hard it is for people to go in for a visit. It's within your rights to tell your doctor if it's a problem."

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