The Patient’s Agenda: How to Take Control of Doctor Visits and Manage Chronic Conditions Better

The idea for this column first sparked somewhere over the middle of the U.S., on a long flight where I was toggling between two very different books: 5 Voices by Jeremie Kubicek and Steve Cockram, and Good Energy by Dr. Casey Means. The first was teaching me how to be a strong, effective communicator as a leader, and the second was about new approaches to fighting chronic conditions.

“The doctor–patient relationship is such a power imbalance.” Dr. Casey Means

Then I hit a line in Good Energy that stopped me: “The doctor–patient relationship is such a power imbalance.” Oof. True. We sit in a vulnerable position, in crinkly paper gowns on freezing tables, being talked at instead of with. And I thought: what if I applied leadership skills to my healthcare interactions?  What if I worked on being a strong and effective communicator with my care team – my new approach to fighting my chronic condition?

That’s what this column is about. I’m testing out leadership lessons in real-life doctor–patient encounters. I’ll share the wins, the flops, and the awkward in-betweens. And if you try some of these strategies, I’d love to hear about your results. We’re all in this together.  

Now let’s get our leadership gown on.

Setting An Agenda

At work, I never schedule a meeting without including an agenda. It informs everyone about the topic, what we need to accomplish, and whether anyone needs to prepare anything in advance. 

Imagine if patients did the same for doctors’ appointments. No more fumbling through a mental checklist while whispering, “Don’t forget to ask about that weird pain in your side.” Instead, what if we sent a clean agenda ahead of time?

The Harvard Business Review offers a wealth of valuable advice on agendas, including the tips outlined in the article “How to Design an Agenda for an Effective Meeting.”  This phrase “effective meeting” stood out in the title – shouldn’t the goal of a doctor appointment be to have an “effective meeting”?  

Here are two tips from the article I thought could transfer over to a doctor’s appointment:

Prioritize the top issues

You may have a lot you want to cover. List your concerns in order of importance. If time runs short, the most critical issues are covered first.

Clarify your desired outcome

For each topic, know what success looks like: a prescription, a test order, a treatment plan, or advice.

Now let’s see how it worked……

The Attempt

So I tried it. Before a specialist appointment, I drafted a simple agenda in MyChart: concerns, questions, priorities—bullet-pointed and organized to perfection. I polished it a few times, hit send, and within a day got a nurse’s reply: she’d pass it along. Success! Or so I thought.

The Result

Fast-forward to appointment day: me, shivering in my gown, waiting for my doctor to say, “Thanks for the agenda, let’s dive in.” But it appeared she had not seen it beforehand. Not a word. Apparently, MyChart is less of a “collaboration tool” and more of a “yelling into the void.”

Going into my appointment, I was trying to remember everything I wanted to ask.  My nerves definitely got the better of me.  Flustered but determined, I asked, “Can we pull up MyChart? I listed my questions there, in an agenda.” As soon as we did that, my nerves went away. We worked through my list, and my questions were answered and concerns addressed.  I left with a clear plan for the next few months. Because I had written everything out ahead of time, I wasn’t scrambling to remember everything from the last few months since my last appointment.  My written questions on the page were clear and to the point as opposed to the ones rambling in my head.

 “I had control over how my appointment was run.” 

What’s Next

Even though my original plan didn’t go as I had planned, I felt I made progress. I had control over how my appointment was run. I decided to continue sending agendas. And if they don’t bring them up, I’ll ask them to pull it up, and we can walk through it.  It will help set the tone, ensure I don’t forget any important questions, and I will leave satisfied that my comments and questions were addressed.

And you can try it, too. Some ideas to get you started:

Item 1: How I’ve been doing, feeling, and managing my condition.  What’s working and what isn’t.   

Item 2: Here are the concerns I need addressed (prioritize the list)

Item 3: These symptoms have changed for the better or worse

My additional item – The Question That Ends Every Appointment

One of the most important agenda items I will end my appointments with is the following question:  “What symptoms should make me go straight to the ER, and what symptoms mean I should just call you?” It’s a simple question, but it clears up a lot of confusion. Instead of guessing or Googling in a panic at 2 a.m., I leave the office knowing what’s urgent and what can wait. It’s peace of mind—and it’s my own safety net.

So let’s add this to the end of our item list:

Ending Item:  When to Call vs. When to Go to the ER

The end goal is that the appointment isn’t something being done to us—it’s something happening with us. 

Try it out and report back!

The end goal is that the appointment isn’t something being done to us—it’s something happening with us.  So, try it out. Send your doctor an agenda for your next appointment, and then let me know how it went. Like agile, we’ll iterate, compare notes, and refine. Let’s figure out what actually works together.