Visiting the doctor can be a frustrating experience. Time off of work, excessive paperwork, confusion with insurance coverage, long wait times, and distracted doctors. Sound familiar?
Having clear expectations prior to your first urologist visit can prevent some of these frustrations.
As an experienced board-certified urologist, here are the top things I want patients to expect at their first visit with a urologist:
Verify Insurance Information Prior to the Visit
Nothing is more frustrating than having a delay at your first urologist appointment because of insurance troubles. I won’t begin to try and explain the U.S. health insurance situation. It is a mess.
First, confirm that your urologist is indeed in-network with your insurance carrier. If the urologist is out-of-network they may not be able to see you or worse, you may be stuck with a surprise bill. Despite the thousands of dollars you may already pay for health insurance, you may still have significant out-of-pocket expenses if your urologist is not in network.
Next, call your insurance company to confirm your co-pay which will be collected at the time of the visit. Most co-pays range from $0 to $100 for a specialist. Paying with a credit or debit card is your best bet to document your payment. It’s amazing how easy it is to misplace cash and checks these days.
While you’re on the phone with the insurance company, find out if you have a remaining deductible. A $20 co-pay is one thing. A bill for $424.15 because insurance didn’t cover any of your visit is not a welcome surprise.
Provide Past Medical History and Medications
Despite the fact that we live in the 21st century, most doctor’s offices still rely on fax machines to receive your medical records. An utterly antiquated system that works none too well. Thus, it is possible that when you arrive for your first urologist appointment, the office may not have all of your medical history.
Before your first urologist appointment, type up a list of your:
- Medications with doses (generic or name brand is fine)
- All previous surgeries (yes, even the appendix removal when you were 6)
- Current medical conditions (if you take blood pressure medication, you still have high blood pressure)
- Family history of illnesses (parents, siblings and children)
- Social habits (alcohol and tobacco use)
Most offices can then scan this copy into your medical record, thereby saving you time on paperwork.
Now you might be asking yourself: why is all of this necessary?
First, in order to submit a claim to your insurance company, your urologist needs to document your ENTIRE medical history. This includes that list of 50 questions starting with “have you experienced any of the following symptoms in the past two weeks . . . ?” Don’t kill the messenger: it’s their rules.
More importantly, an accurate medical history allows us to better care for you! Let’s walk through a couple of examples of how your medical history impacts your urology care:
- Urinate too much at night? That water pill you take for high blood pressure is the culprit
- Trouble with erections? The main causes are diabetes, hypertension and cigarettes
- Keep getting kidney stones? Your Crohn’s disease is to blame
- Trouble reaching orgasm? That’s a common side effect of your antidepressant
Focus On The Main Urology Issue
A urologist is a specialist of the male genitourinary and female urinary tract. Think of us as plumbers who also treat the male “private area.” Prior to the visit, make sure not only that you’re seeing the right doctor (urologist vs. nephrologist – link to future blog post), but that you’re going to focus the conversation on your urology issues.
Our time together is limited and we want to help! If you go off on a tangent and talk about your sore back and knees for 5-10 minutes, this gives us less time to help you. Now if it’s relevant to your urology complaint, then by all means please share.
It’s not unusual for patients to have multiple urology issues. Enlarged prostate AND erectile dysfunction. Bladder leakage AND urinary tract infections. Pick the one that is of more importance to you, not the doctor, and make sure that your questions are answered.
If you’re seeing a busy urologist, you may need to table one of the discussions for a follow-up visit. Better yet, see if there’s an online patient portal for you to submit any follow up questions for the doctor.
Expect Testing or Procedures
After spending 5-6 years in a surgical residency, urologists are experts in diagnosing and treating kidney stones, urinary tract infections, bladder/prostate difficulties and prostate cancer. However, that doesn’t mean we will not need further testing or procedures.
Even a very detailed history cannot predict whether the blood in the urine you’re having is due to an enlarged prostate or a serious cancer. Don’t be surprised if your doc recommends further testing at your first urologist appointment.
At the very least, you can expect a physical exam at your first urologist appointment. Yes, this means we need to look at your private area. If you’re self-conscious, bathe and groom accordingly. But don’t worry, we examine “down there” all day and probably won’t notice.
Next, a urologist will often require a urine sample. Blood in the urine may be a sign of something serious going on such as bladder cancer or a kidney stone. We also need to rule out a urinary tract infection prior to any procedures.
Imaging such as an ultrasound, CT scan or MRI are used to investigate if there are any abnormalities of the kidneys or ureters. If you have an allergy to intravenous CT scan contrast or difficulties with MRIs because of claustrophobia, be sure to let your urologist know.
In select situations a urologist will perform a cystoscopy or an endoscopy of the bladder in the office. This involves inserting a flexible scope in the urethra and bladder. Don’t worry, most offices these days offer some kind of sedation to help with anxiety and discomfort.
Prepare Questions and Goals
This is the MOST important piece of advice. Ask questions!
This isn’t the “good old days” where doctors expect patients to blindly accept everything we have to say. At least that’s not how we care for patients at VirtuCare. Expect, and if necessary, demand time at your first urologist appointment to ask questions and give your input.
Many urology issues are not life-threatening. Only you can decide if you want to take “the little blue pill” or cut back on your coffee intake (OMG not my coffee!). A good doctor will want your input as well.
Prior to your first urologist appointment, please spend time asking yourself:
- What is my main goal for my first urologist appointment?
- What scares me about my condition?
- What am I willing to do to improve this situation?
Sometimes it helps to bring a family member or friend to your first urologist appointment. Not only can they advocate for you but they may think of different questions.
Leave With a Care Plan
At the end of your visit, you should have answers to the following questions:
- Is a follow-up visit necessary, or will I follow up as needed?
- When and where is my next visit?
- Is my visit with the same doctor or someone different?
- Will I need any tests prior to the next visit?
- Will I be having any procedures at the next appointment?
- Am I starting any medications? What are the side effects? Are they being e-prescribed? Which pharmacy were they sent to?
- When will I be scheduled for my surgery?
We don’t do a great job in healthcare of providing a clear written care plan for patients. Electronic medical records are helping with “aftercare summaries” but often these are very generic.
Your best bet is to be your best advocate. Take notes during the visit. If you need help with some medical jargon, just ask your urologist for some assistance.
How is a VirtuCare Telemedicine Visit Different? What Should I Expect?
At VirtuCare, our primary goal is getting you the care you deserve. Without the distractions of a traditional office visit, we can stay focused on you and nothing else. A virtual visit from home eliminates travel, excess paperwork and rude staff. Sounds nice!
Within 5-10 minutes you can be logged in to our secure video platform. From the privacy of your home, you will visit with a board-certified urologist. VirtuCare urologists are able to take a detailed history, perform a visual physical exam when necessary and prescribe medications.
Unfortunately the U.S. healthcare system is set up such that traditional urologists are financially incentivized to recommend procedures, even when not absolutely necessary. As a telemedicine expert, your VirtuCare urologist is only incentivized to make recommendations that are right for you.
Now that’s the sort of healthcare we all deserve!
How Do I Have a Visit With a VirtuCare Urologist?
First, make sure that we are licensed to practice medicine in your state. We’ll be in all 50 states soon enough. A doctor has to be licensed in your state of residence to provide healthcare via telemedicine.
Next, select your VirtuCare urologist. Our specialists are not only picked for their expertise, but also for their bedside manner. We pick doctors that we would want caring for our family.
Lastly, create an account and select your visit. We bypass the middle men like insurance companies and receptionists. All you need is your calendar and your credit card.
What Should I Expect After My VirtuCare Visit?
You’ll have immediate access to your records and the ability to communicate with your doctor via a secure messaging system.
If you feel like you’ll need ongoing urology care, we offer annual memberships so you can continue seeing the same doctor.
Should you need in-person care, our VirtuCare specialist will help you find the best urologist for your needs.
Your healthcare doesn’t stop when our visit ends. We are here for you!
