The follow-up appointment: fifteen minutes, three questions, one page

Pick your three questions in the car park

Write your questions down before you go in, on one card, ranked. Not ten questions — three, with the rest underneath in case there is time.

Rank them ruthlessly. If you only get an answer to one, which one? Ask that one first, before you sit down properly, before the small talk uses the minutes.

Collect questions between appointments rather than inventing them in the waiting room. Keep a running page in the binder headed "ask at the next appointment" and add to it as things come up at home. By the time the appointment arrives you will have eleven, and the useful work is choosing three of them.

Give the card to your parent to hold if they are the one being seen. It is their appointment. If they would rather you asked, agree that in the car park too, out loud, so that neither of you is talking over the other in the room.

And write one line at the top of the card: what would make this a good appointment? Sometimes the honest answer is "leave with the next appointment booked and a phone number," and knowing that changes how you use the fifteen minutes.

What to bring

Bring the printed versions, not the remembered versions. Everything on this list fits in one folder and it is the same folder every time.

The medication list is the one that matters most, and it must be printed and current — not a photograph from March, not what you can recall. If you are not certain it is current, ring the pharmacy the day before and ask them to print the current list for you to collect.

Add one thing that people forget: your notes from the last appointment. Fifteen seconds of "last time you said we would hear from the hospital within a month and we have not" is often the most valuable sentence of the visit.

• The current printed medication list, including anything bought over the counter
• The log of dates: appointments attended, admissions, and anything else with a date on it
• Your notes from the last appointment with this person
• Any letter or discharge paperwork you were sent since then, in the envelope it came in
• The insurance card and the pharmacy name and address
• Your card with three ranked questions
• A pen and a blank appointment sheet to write on
• Your parent's glasses and hearing aids, and the list of what they want to ask
• A note of anything you have observed at home, with dates — what happened and when, not what you think it means

The questions worth asking at almost every follow-up

These are the administrative questions. They are the ones that fall through the gap, because everyone assumes someone else asked them, and they determine what happens in the eleven weeks between this appointment and the next.

Ask them at the end, quickly, once the clinical part is done. They take ninety seconds together and they save several phone calls each.

• "What is this appointment for, and what are we expecting from it?"
• "Has anything changed since last time? Can you print the current list before we leave?"
• "Who do I ring with a question between now and the next appointment, and what is the direct number?"
• "What should we be writing down at home before we come back, and on what?"
• "Is anything being booked as a result of today — who books it, when should we hear, and what do we do if we have not heard by then?"
• "When is the next appointment, and do I book it at the desk now?"
• "Who else gets a copy of today's notes — does it go to the doctor's office, and can it go to me?"
• "Is there anything you want us to bring next time?"
• "Is there anything you need from another department, and who chases that?"
• "Can I read back what I have written, to check I have it right?"

Write it while you are still in the room

Do not plan to write it down in the car. You will remember it wrongly by then, confidently.

Use one page per appointment, always the same layout, so that a stack of them reads as a history. Date at the top. Who we saw and their role. What was said, in short lines. What changes. What is being booked, by whom, and when we should hear. Who to ring, with the number. Next appointment date.

Then do the single most useful thing available to you in that room: read it back. "Can I just read back what I have written, to check I have it right?" Nobody objects to this, it takes forty seconds, and it catches the misunderstanding while the person who can correct it is still in front of you.

If your parent is the one being seen and is answering, do not correct them in the room unless it matters. Write down the difference between what was said and what you have observed, with dates, and ask at the end whether it is worth them knowing.

If you cannot write and listen at once, ask whether you may record the summary at the end. Ask first, always.

The twenty minutes afterwards

This is where an appointment turns into something that happened, or dissolves. Do it before you drive home.

Book the next appointment at the desk before you leave the building. Booking it later means ringing a queue.

Go to the pharmacy, or ring it, if anything changed. Ask them to confirm what they now have on file, and get the printed current list.

Update the binder: the new appointment page goes in front of the last one, the printed medication list replaces the old one, and the old one is kept behind it rather than thrown away — a dated series of lists is genuinely useful later.

Send one message to your siblings. Four lines, the same shape every time: date and who we saw; what was said; what changes; what is booked next and when. Send it every single time, including the boring ones. The sibling who receives twelve unremarkable updates is a sibling who cannot later claim they were not told.

Put any "we should hear by" date in your calendar with an alarm. That alarm is the only thing standing between you and a referral that quietly did not happen.

If your parent goes to the appointment alone

You will not be at all of them, and your parent may prefer to go alone. Both facts are manageable with paper.

Send the questions in their pocket, written on a card, in large enough print to be read across a desk. Three questions, and a space under each one for an answer. Ask them to hand the card over rather than trying to remember to ask — most clinicians will simply take it and answer down the page.

Put a line at the bottom of the card: "Please could you write the next steps here." It gets filled in surprisingly often.

Ask the office in advance what it needs on file for you to be told things or to ring on your parent's behalf, what that form is called, and how long it takes to process. That is an administrative question with an administrative answer, and it is much easier to sort out on a calm day than on the day you need it.

And agree with your parent, in advance, what they will do with the card when they come out: put it back in the folder, or photograph it and send it to you from the car park. Agreeing the last step is what makes the first one work.

Questions