Medical Column: 4 Types of Doctor Appointments

By: Dr. Christian Edwards
Family Medicine Resident
Colquitt Regional Medical Center

“We will have to discuss that at your next visit.”  Many of us have heard this phrase from our primary care physician.  Some assume that the physician is in too big of a hurry to address all their needs, others might assume the physician is not taking their concerns seriously, but what might actually be going on is that your physician is trying to guide the conversation to remain within the bounds of your scheduled visit type.  What do I mean by this?  Did you know that every time you make an appointment with your primary care physician it is scheduled as a certain type of office visit?  There are approximately 4 different types of visits that you should be aware of: 1.  Acute care visit, 2.  Chronic care visit, 3.  Annual wellness visit, 4.  Hospital follow-ups.  In this article I will define for you the way your physician understands each visit type.  My hope is that it would help you understand why your physician might elect to discuss a nonurgent concern at a different time.

Acute care visit: In an acute care visit, you likely called the office with a specific new concern about your health.  The appointment was then made with this concern in mind (for example: Sore throat).  The concern you have will be communicated to your physician before the visit begins.  This helps direct the physician so that they can better serve you during your time together.  The content of the conversation on this visit should involve the concern which caused you to make the new appointment.  While evaluating your concerns, your physician will be using their knowledge to determine if your new concern might be linked to another condition you have already been diagnosed with, or linked to a medication you are currently taking.

Chronic care visit: In a chronic care visit it is likely that this appointment was given to you 3, 6, or 12 months from the visit before. This visit was probably scheduled for you by the physician’s office.  This appointment was scheduled with your current medical conditions in mind.  For example, if you have been diagnosed with high blood pressure, diabetes, and acid reflux, then this is the appointment to discuss those conditions.  It is likely that your physician will address each condition, ask about specific symptoms you might have if your condition was not under control, ask about how you are tolerating your medication, adjust these medications, and order any test that are required to assess the effectiveness of your treatment.  If you have several previously diagnosed conditions, your doctor may choose to address only two to three of these conditions per visit and schedule you for sooner follow up appointments so that closer attention can be given to each condition.

Annual wellness visit: At an annual wellness visit, this is the time where your physician might discuss with you any tests that are relevant for you based on your age, gender, weight, and current medical diagnoses.  There are recommendations that your physician uses to determine which tests are relevant for you and how often you should be receiving these tests.  These tests are often called screening tests.  A screening test is a test that is ordered not because your physician believes you have any specific condition but because testing someone of your age, gender, and weight has been shown to decrease the number of missed diagnoses for serious medical conditions.  For example, if you are a female who is 40 years old or greater, it is recommended that you receive a screening mammogram every 1 to 2 years.  This is not because your physician believes you have breast cancer, but because having this test regularly completedstarting at this age, has been shown to identify breast cancer in women earlier on in the disease process.  Your physician may also order annual tests to assess your overall health without a specific disease process in mind.

Hospital follow-ups: A hospital follow-up is an appointment given to you with your primary care provider after a hospital stay.  You will generally receive the appointment date before you are discharged from the hospital.  This appointment serves two purposes.  1. It informs your primary care physician that you have been hospitalized, what events took place during the hospitalization, what diagnoses were made, and what new medications were added to your medication list.  2.This visit allows your primary care physician to assess the effectiveness of any new medications you might have been placed on, and to assess that you have fully recovered from the condition that caused you to be hospitalized.  On this visit, your primary care physician will keep the conversation centered around the conditions that led to your hospitalization.  While you are conversing, your physician will be assessing whether your hospitalized condition is associated with any of your previously diagnosed conditions and how this might affect treatment and lifestyle in the future.

Overall, it is my hope that this article will help patient and physician expectations better align at future office visits. Your physician is willing to discuss any concerns you might have at any visit, but if you are wondering why your physician did not discuss your diabetes at a visit that you made for a sore throat, hopefully this article can be of help.