Here’s a situation that comes up for many people: Your older mother — or father, or other older relative — is moving to a new town.
Maybe it’s to an assisted-living facility near you. Maybe it’s to another location where she decided she’d like to age-in-place.
Such a move means that she’ll need to establish care with a new primary care doctor.
For most older adults, establishing a good working relationship with a new doctor is a challenge. If nothing else, it can take some time to feel that each party knows and understands the other.
But it’s also in many cases a terrific opportunity to review a person’s health and healthcare. Provided, of course, that everyone involved makes an effort, and has good information to work with.
In this post, I’ll share my list of the most useful health information that you should bring to that first visit with the new primary care doctor.
Do you have to bring this information? Of course not. In my own experience, most people bring nothing more than a medication list, if that. And they leave it to the new doctors to request health information from the previous doctors, which often arrives well after that first new patient visit.
But this is a problem, because it makes it quite difficult for that first visit to be truly useful.
Sure, the doctor can interview your loved one, and do a physical exam. Yet for many older adults, that interview and exam is often much more productive if a doctor can combine it with a review of the most useful health information.
I myself used to see a fair number of new older patients, when I was a primary care geriatrician at the Over 60 Health Center. Those first visits often felt like fumbling around in a dark room, feeling the walls and furniture and trying to get a sense of the overall layout.
But occasionally, a new patient would come with useful health information in hand. This generally made a big difference in how quickly we could ensure that our new patient was getting the right medical care from us, and from other involved doctors.
So if you want to help your older loved one have the best start possible with a new doctor, you’ll need to do a little advance preparation. This often requires some time and energy. But it will pay off, by ensuring that the new doctor has the information he or she needs, to provide your loved one with good healthcare.
10 Useful Types of Medical Information to Bring to a New Doctor
Here’s my list of what I ask patients and families to bring to me, in order to make that new patient visit most useful.
This list is especially suited to the primary care of aging adults with chronic medical problems. But most of this information can come in handy for first visits with specialists. It can also be very useful to clinicians in the emergency room, or at urgent care.
Note: If you or your loved one have been maintaining a personal health record, this is the type of information that I hope you’ve been keeping in your personal health record!
1. List of chronic health conditions. This would include any conditions that your loved one currently sees a doctor for. Bonus points if you include the year the condition was first diagnosed, or any other major milestones related to the disease. You can also include major past problems which are no longer being actively treated.
2. Medication list. Be sure to list all prescribed medications, along with any over-the-counter medications and dietary supplements. Also helpful:
- Highlight any new or recently started medications;
- List any recently stopped medications (e.g. from the past 6 months);
- List any medications you believe have been problematic in the past.
3. Laboratory results. Most commonly these are results from blood tests and urine tests. Any lab results from the past 1-2 years will be helpful.
- Specific tests that are likely to be useful include:
- Complete blood count (CBC)
- Electrolyte panel, which usually includes sodium, potassium, chloride, CO2
- Renal panel, which usually includes creatinine and blood urea nitrogen (BUN)
- Thyroid function tests, such as thyroid stimulating hormone (TSH) and/or free thyroxine (FT4)
- Urineanalysis
- Do bring any lab results you have. It is useful to see what other doctors have ordered and checked.
- Do bring results from different dates if at all possible. Lab results are much more useful when a trend or context can be evaluated. In many cases, comparing the latest results to previous results is extremely useful.
4. Radiology and imaging results. This includes x-ray reports, ultrasound reports, CT scans, MRIs, etc. Reports from the last 1-5 years are especially useful.
5. Other medical diagnostic reports. These might include pulmonary function tests, EKGs, cardiac catherization reports, biopsy results, neuropsychology evaluations, and so forth. It’s especially useful to have reports that are related to the diagnosis or management of a current chronic condition.
6. Hospital and emergency department reports. Try to get a copy of the narrative reports that clinicians create when a person comes the emergency room, or is hospitalized. Note: this is not same report as the patient discharge instructions that are always handed out. Usually you have to file a medical records request to obtain the narrative summaries that are most useful. Specific examples of useful reports include:
- Emergency room clinical note. This is the note dictated (or typed) by the emergency room doctor who managed your loved one’s visit.
- Hospital Admission History & Physical. This is the note dictated by the admitting doctor, when a person is initially admitted to the hospital.
- Hospital Discharge Summary. This is the note dictated by a discharging clinician, when a person is discharged to home or rehabilitation. It usually summarizes the patient’s hospital course.
7. List of involved clinicians. List the doctors and healthcare providers who were previously involved in your loved one’s care. I often learn about important problems by finding out just why a person was seeing a given specialist! For each specialist, it’s helpful to know when your loved one established care, and how often he or she had been seeing each provider.
- Primary care provider
- Medical specialists, such as cardiologists, pulmonologists, urologists, neurologists, etc.
- Behavioral medicine clincians, such as psychologists, counselors, and therapists
- Skilled nursing facility doctors, if relevant (meaning, your loved one is currently at the facility, or recently was discharged)
- Other skilled medical therapists, such as for physical, occupational, or speech therapy
- Any other health professional who is significantly involved in your loved one’s care.
8. Clinical visit notes. Visit notes written by the primary care doctor, and the medical specialists, can be useful. At a minimum, try to get a copy of the last note.
- I recommend starting by requesting notes from the last 3 visits, or the last year. If it’s easy to get more notes from each provider, you can do so as well.
9. List of other providers of supportive or eldercare services. Have you or your loved one been getting help from a care manager? In-home aides? A patient navigator? A good primary care provider should be interested in knowing who has been involved, and what kind of help they’ve been providing.
10. Advance care planning documents. These include any advance directives, living wills, pre-hospital DNRs, and/or POLST (Physician Orders for Life-Sustaining Treatment) forms.
How a Personal Health Record Can Help
Long list, eh? Well, you probably won’t be surprised to hear that so far, I’ve had very few patients arrive with most of this information.
But this is the medical information that we doctors should know, in order to provide your family with better care for your aging loved one.
The ideal process, of course, is to collect medical information into some kind of personal health record system as you go along, so that you have all the information handy if your loved one ever needs to switch doctors. So for instance, every time you or your loved one gets a blood draw, you would ask to get a copy of the results, and then you would file these results in your paper or digital personal health record. (For more on how to maintain a personal health record, see this post.)
But if you haven’t been maintaining a personal health record, an older loved one’s switch to a new doctor is the perfect time to start one.
So if you have the time, energy, and interest in being proactive, gather up this information and bring it to that new patient visit. Your new doctor will hopefully thank you, and your older loved one should be able to get better healthcare.
Questions? Comments?
Have you ever had to switch an older relative to a new doctor? Do you have any questions or suggestions related to getting the right health information to new doctors?
I’d love hear from you below.
Thank you so much for the very informative site. You are filling a need.
You’re very welcome! I’m so glad you are finding the information helpful and very much appreciate your taking the time to comment.
I have started to prepare for the next step in my Mother’s living situation, if her health and ability to be independent require a move. I recently began to consider the change in pcp and insurance providers if she moves to a different county, closer to me. Thank you for this information. I have shared your site on Facebook with friends my age.
Glad you’re helping your mother plan ahead. Even if she doesn’t change PCPs, keeping copies of her key health information can help your family. Thank you for the comment, and for spreading the word about the site.
Leslie, people who go out on their own for the first time should be made aware of this list. I remember, years ago moving out and going to a medical centre on my own for the first time. I couldn’t fill out all the questions on the papers they have you fill out. I’ve also had friends who have had a similar experience. Luckily, each of us had our phones to call and ask our parents for help.
Yes, it helps to be prepared. Probably we should be teaching everyone when they are young to keep a record of their health, along with keeping a record of finances and other important life records. But this is especially important for older adults.
This article was really helpful, especially the part about bringing a list of medications that you take or have stopped taking within the last 6 months. I’ve recently moved to the city, and I want to find a doctor I can go to if I end up staying here for a while. I’m on a few drugs, so maybe I should spend time making a list before I make an appointment.
Yes, it’s very important to bring a complete medication list. It’s even better to bring in all the medication bottles.
A couple weeks ago, my fiance and I moved into a new neighborhood and home. We are looking for a new medical center near us so that we will be prepared in the future if we need one. When we go to our new doctor we will be sure to take your advice and let them know any hospital or emergency department reports we have.
I like that you mention bringing a list of medication that you are currently taking or have recently stopped taking. Even if you’re not taking that medication anymore, it’s important that your new doctor knows so they can adjust accordingly. I just moved to a new city, so I’m now looking for a new doctor. This was a helpful post in things that I should remember when I do find someone.
My parents are gone, and my sister handled my parents’ medical care, so in a way this doesn’t apply to me. I’m more than happy with my PCP, and in my early 70s. I live in a CCRC retirement home so I’m not planning to move. I like her very much, and she’s not near retirement. Still, your list is wonderful, and I think it still applies to people my age who are concerned about our own health, and that of family in our own generation. One thing I’d add is to compile a medical history of your family. For instance, breast cancer runs in my maternal family, so my doctor needs to know that. Even more, my sister, knowing that, gets mammograms every six months, and has had multiple lumps (benign, thankfully) removed. I was just diagnosed with osteoporosis, which shouldn’t have surprised me, as my mother and hers both had it. Knowing that, I can work on treating it. I also had ulcerative colitis, ultimately requiring a complete colectemy. I’ve since learned that IBD runs in my father’s family, though not so closely as the breast cancer does. A 3rd cousin whose hobby is medical research examined our mutual great great grandfather’s 1884 death certificate carefully and concluded he had IBD as well, and one of my first cousins on that side, at least, has it. My sister and our half sister on our father’s side have needed their thyroid removed, though both were benign. In all these cases, my PCP is grateful for the extra information, and does extra testing, or ignores it, based on the information I give her. The 4 siblings all have low blood pressure, even those who are overweight, and very low “normal” temperatures. That means we have to remind doctors when our temperatures are around 99,6, and we feel feverish, that we probably do have a fever.
I’ve been on lots of meds since my colon was removed. Once I was taken to the ER with heart symptoms and couldn’t list my meds, while they waited to get me in for an EKG. I was fine, but went home and created that list. Nobody’s ever asked for the bottles, but I pull out the list at every visit. Since most of my doctors are part of the same network, they can pull up their copy and we just check that it’s current. Very handy.
I will definitely complete the rest of your list for myself, and encourage my siblings and cousins to do the same. Sorry that this is so long. I’m basically affirming what you’re doing, for whatever generation, even your kids if they live at home.
Thank you for sharing your story, and glad you found this list helpful.
I didn’t include family history on the list because as people get older (e.g. aged 75 and older), it becomes less useful. Almost every significant health problem becomes more common or quite common with age, and by late-life, an older person’s lifestyle and chronic health conditions and apparent state of health are better predictors of what to worry about than what their family history is.
I do ask patients in person about their parents’ health and what they died of, but that’s more because I like to learn about them as a person and also it can provide insight into what a person might worry about regarding their own health.
All that said, it’s certainly not a bad idea to bring in one’s family history, and to be informed about it. Thank you once again for your comment and best wishes maintaining your health!
Thanks for explaining what kind of medical information could be good to tell your new doctor. It’s good to know that you should bring them a list of medications that are prescribed to you and over-the-counter ones. You also said that you should give medications that were problematic in the past. It sounds beneficial to continue to add to a record of sorts so that you can refer to it later and help better inform the doctor of what didn’t work. It seems like a good way for them to understand your situation more.
Yes, I absolutely recommend keeping your own health record, so that you can provide a new doctor with information about your past medical history.
Hi Dr. Leslie, I’m grateful for your advice about keeping our health records. My cousin exactly has the same concern when he moved into his new location. He’s been looking for a new doctor, however, he can’t find all his records on hand. I guess I need to forward this information to him so he’ll be guided, thanks.
Although you really didn’t explain its importance, I appreciate it when you mentioned bringing a list of the previous healthcare providers when the person takes a loved one to the hospital. My brother has been seen and checked by a few doctors back then, so I might as well take the records with me. Sure he only needs urgent care, but we can’t be too certain that these things won’t be needed.
Thanks for pointing out that you should bring a list of the medications you take when you go to a new primary care doctor. My husband and I just moved to a new home, so I’m currently looking for a primary care doctor in the area. I take a lot of medications and don’t think I could list them all from memory, so thanks for reminding me that I should take a list to my first visit!
Thanks for these really informative tips for establishing a working relationship with a new doctor! I especially liked how you explained that it is still imp=ortant to include major past problems that aren’t being treated anymore. My aunt recently moved to a new state following her divorce, and she has had a long bout with breast cancer during her youth. I’ll be sure to share this article with her so she can be better prepared when meeting with her new physician.