By JENNIFER PASS

Special to the Record

We can muse about the days when one鈥檚 general practitioner and his or her office staff managed our medical tests and exams and procedures.

When we got a call for an 鈥渁nnual physical鈥� and calls about tests and appointments鈥� from a human being, usually a pleasant receptionist at our doctor鈥檚 office. We can muse about the time when we were younger and maybe did not have so many medical issues, but we were busy and took this external management for granted.

All this has changed. If you are an older (50-plus) person, you probably have more medical issues than you did 10 years ago. There are more specialist appointments, more diagnostic tests, more appointments made over a year in advance. And you are less likely to actually have a general practitioner now than 10 years ago. You may also be managing the care of your 鈥渟ignificant other.鈥� But most importantly, if you are not computer savvy, you are feeling more than a bit 鈥渁t sea鈥� with the increasing computerization of our health care. You may not get calls from your doctor鈥檚 office reminding you of appointments. You may not get reminders of certain tests at the very time in your life that you really need reminders! (For example, women over 73 do not get reminders to schedule an annual mammogram, not because they don鈥檛 get breast cancer, but because (I was told) 鈥渨omen die of so many other things when they are old.鈥� You may have several appointments more than a year in the future; appointments may be dependent on other appointments and tests being done first. You may have appointments cancelled and now the whole 鈥減ack of cards鈥� of interdependent tests and appointments seems to be collapsing.

What to do about this? Our local Elders Take Action group has discussed this problem, and has come up with some aids. So here they are (please share them):

The main aid is to get a three-ring binder with some lined sheets of paper and also some dividers with tabs you can write on. The tabs will separate the notes from different medical specialists. The first tab could be a schedule of all upcoming appointments. Use a strong paper clip to attach upcoming tests (lab requisitions and appointment documentation) inside the cover of the binder. Also buy a one-year appointment book (daytimer) with enough room to write several items on each date. Keep this somewhere convenient. Every appointment goes into your daytimer,(some people use stickies, but they can fall out and get lost). If the appointments are in the next calendar year write them on the last page of the daytimer so they can go into the next year鈥檚 book. Take your daytimer to your medical appointments. If you need a follow-up appointment that can be scheduled, you are ready to write it in your book.

Also take notes when you are talking to your GP and specialists. Make sure you understand what they are saying. You are likely stressed in the appointment and may not remember important details later. (Keep these notes in your medical binder under the tab for that doctor. Some questions will just be clarifying your understanding. E.g. 鈥淪o you want me to come back after I have had that test? How will that happen? Do I phone your office or will your office call me?鈥� It is important that you clarify matters before you leave, or you will often find that there is a misunderstanding. Maybe her office does not take calls鈥� you just get an answering machine, and you don鈥檛 get a call back. Much of your future worry can be alleviated by asking good questions during the consultation.

The annual physical has gone. (Apparently it was not productive.) And the meshing of computer technology, and patient-triggered medical management with busy workplace medical services is becoming the norm. While our society pushes forward to a 鈥減atient-managed鈥� computer model of care with My Health and other computer programs, it is important that we do not ignore those who have not become computer savvy and leave them unsupported. In this new age of patient-managed care, a simple 鈥減aper and pen鈥� system used by a patient can be an effective alternative to computer management and can also provide good medical schedule management.

Jennifer Pass is the Co-ordinator of Comox Valley Elders Take Action (ETA)