Are you sure it' a question of the Dr. not knowing vs. a little testing of the elderly patient's understanding of his condition?

Maybe you could discover by asking your elderly relative if he understands the reason for the medication adjustment and follow up visits - might be an insight into why the Dr. asks.

Cam down. The doctor wants to actually hear the elderly patient express himself. If the patient is unable to express himself, then you may answer for him. But if the patient is confused, the doctor can pick up on that.

It might just be that doctor's way for saying "Good morning'.

oh patient knows why he's there and he also noticed the question but his reaction was more like, this doc was running an assembly line practice. I have said nothing when present at the visits. Patient is in 100% full use of faculties but I handn't considered that it might be a way for a Dr to test that he is indeed all there. I guess I'm basing it on how my female drs treat me. I hadn't seem my dermatology for two years and when she entered room she made a reference as to something we discussed two years ago. She probably read it from my chart or maybe she remembered. that is why I'm seeking input, before I open my mouth and make something out of nothing OR exercise my (his) right to be well attended.

A primary care physician may be seeing 4 or more patients an hour, maybe 7 hours a day? How many days a week? Not all charts are reviewed in depth before the appointment, often it's just a glance

Many don't rely on their office help to get a story straight. Is the note on the top of the chart (whether electronic or paper) accurate, or perhaps it's more likely s/he thinks the summary from the nurse or appointment clerk is often wrong.

From the experience of a family member, I can say that med schools emphasize highly the importance of the discussion between physician and patient to get a clear understanding of the patient's situation and to see that nothing is overlooked or missed. For an elderly patient, indeed the question may be a test of cognition.

I agree with the calm down advice. I see nothing wrong with this doctor's manner as you've described it.

okie dokie. I will chill

I think this is now protocol as I hear all doctors say this, and I have no problem with a push for clarity.

I see many doctors, some are like this trying to start up a conversation, like are you hear again? he was like this with my husbands mom. She liked this and though he is a lovely doctor it gets us at ease in his office. He always shakes our hands. He will sit and listen to me and my husband who usually will give him all my problems correctly. When I am not feeling well, I don't always tell him exactly how I have been feeling. Though I have tried too. So that is when my husband will take charge. My other doctors do seem to know, what is up with me when I am in the exam room. He has taken the time to read my chart. Another thing is I try to be one of the first patients of the day, so he is fresh and his nurse too. I think they all rely on their nurses to know ahead of time what each patient is there for. You should like some one else has mentioned is Chill out. Be calm, answer if the patient needs your assistance or need to add anything.

Just for the heck of it, have your gent respond, "Why do you think I am here today?"

@jim, that would be funny but relative is not one for smart aleck comments. But Ill save it for future use, lol.

That's always the first question asked of me, my mom, my son, right after, name and date of birth. I think they're just verifying to make sure everyone is on the same page. Standard protocol.

It reminds me of the questions my surgeon asked before my knee arthroscopy. As I was laying on the table he asked me why I was there, the second question was to ask which knee. Then he used a Sharpie to draw an X on my knee. I think this is fairly standard.

you guys have saved me from going ballistic on the poor Doc

Maire- I had the sharpie used as well during a surgery, they also had me initial next to the x.

I totally agree that a medical person asking you for your input is doing a good job. All too often you make an appointment, tell the office staff your symptoms, but you may forget an important additional symptom. The practitioner should hear it from you. If they glance at your chart and don't ask your input, I feel like they are not doing all they can for you.

A patient should always be asked why they came. Who knows what might have happened since the last visit? It's protocol to ask. It does not mean the doctor doesn't know or care about you that he/she asks..it is good practice.

Joann

I appreciate your responses and seems the overwhelming response is to relax. But, but, but, the DR was the one who ordered the follow up visit. Wasn't he supposed to at least know that? it wasn't like we set the appt. I do see where asking the patient promotes clarity. I simply forgot that 4 patients x hr x 7 hrs, etc. and he's not the only patient Doc has. I am also a little uptight about the prospect of something serious going on with relative, who has so far been in excellent health. Just scary to me.

"...the DR was the one who ordered the follow up visit. Wasn't he supposed to at least know that? it wasn't like we set the appt."

Possible scenario --

You know that the doctor asked for your relative to come back for a follow-up visit so that the effect of the medication change can be evaluated; and you made the follow-up appointment either before you left the office that day, or by phone shortly thereafter. I am doubting that the doctor himself scheduled the next appointment. It was more likely someone on his staff. The doctor actually has no knowledge as to whether or not you adhered to his request to make another appointment.

Now, you're back at the doctor's office with your relative for that follow-up visit. The doctor, even if he has only taken a cursory glance at your relative's chart, knows that he requested that the patient return for a re-check, but he doesn't know if that is actually why the patient came in, or if the patient is there because he is having another issue that needs to be checked. So, the doctor asks the patient, "And what are you here for today?"

Possible answers to the question are:

1. "I'm here for a follow-up as you requested at the last visit."

2. "Well, doc, I've been experiencing [fill in the blank] and wanted to see you about it."

3. "I'm here for a follow-up as you requested, and I also wanted to ask you about [fill in the blank]."

Whatever your relative responds lets the doctor know what's going on with the patient, which will dictate how he proceeds.

How long has the patient been on medications, bodies change especially when elderly and so they must be watched and medications change plus some may not work or they react to them. Many patients won't let anyone know what is going on or how they feel? They go through alot of patients and when they started using their computers/notebooks they start pounding away and reading and I find they haven't got a clue and must look up and here you are stuck with your doctor as there is no other doctors to change too, its going to the ER and spend five hours there waiting and then for the doctor to say you can go and leave. Or the clinic and wait hours there unless you happened to be early. I was early but the ones ahead of me took forever and ever with doctor but they will tell you it will be such and such wait and many and I Have too go away and come back and wait. Doctors don't seem to know anyone I find. Neither do vets, they are too busy pounding away and reading and its like hello you used to know all of this before and now none of you know anything and no they do'nt seem to take the time to read up on you and know and then see you so they don't have a clue except what they put in the computer last time.

All of my doctors have nurses who go over my records, questions, changes, etc BEFORE the doctor even comes in....and the doctors all seem to know why I am there from reading the notes the nurse has made.

kathleen, Medicare has mandated the use of electronic health and medical records (known as EHR and EMR). There were incentive payments from the government for early adopters, and there are now fee reductions as a penalty for not having switched over to electronic records.

Comprehensive medical records are important. Electronic records require more information to be entered so that the process can't be shortcut. They also can't be misfiled or lost like paper charts can and electronic billing is facilitated. Large practices (as most docs are in these days) can't successfully and meaningfully manage the overwhelming volume of paper that manual records produce, plus having them accessible in different locations is essentially impossible.

If you feel like your doctors and vets are inattentive, you have the wrong doctors and you maybe should look for new ones. It has nothing to do with their record keeping systems.

In the medical practice I go to and the veterinary practice I take my dog to, an assistant asks the "why are you here" question in advance of the doctor entering the room.

Yeah to save time a doctor may not review the file before going into the room, but like everyone has said, they are not going to assume a patient's condition. There are reasons they ask the questions and field for answers. My concern is that there seems to be a lack of trust in the doctor and I'm wondering if his opening question is the only reason. Have there been other reasons to question the quality of care? If so, it's time to have a chat but if the doctor has always provided good care and given the amount of time his patients need, I think you should just allow him/her to do their job.

EMR programs have now begun to really streamline quality of care and help doctors to have information more readily available to them. It is so much more efficient that a paper chart that many times is not properly kept. When the doctor logs into your record all of the more pertinent information is right there on the front page. And if a doctor updates the records while you are still sitting there it's actually better because he/she will ask questions as they go instead of updating from memory.

Lukkirish is exactly right. EMR is the future of medicine. The biggest obstacle to this process are physicians who'll keep the patient's info in their head or only in their office chart, leaving all other providers in the dark! So using the electronic version and going through every step keeps it all together in one place.

Sign my name to Lindsey_CA post. They usually (the nurse, esp.) will ask me. Which is fine as sometimes I have something to ask them not pertaining to the reason of my visit.

In medicine, there is doctor-patient confidentiality, just as in law there is attorney-client confidentiality. What folks don't realize, however, is that the doctor's staff, and the attorney's staff, are often privy to that information, but are also bound by the confidentiality laws. Regardless, it is not uncommon for a patient to be asked by the nurse (or medical assistant), "what are you seeing the doctor for today" only to have the patient not respond fully or truthfully. The patient may be embarrassed to tell the nurse/assistant, but will confide in the doctor. Never assume that whatever the patient responds to the nurse/assistant is the whole story.