by Bernadette Martin, M.D. Clinical Assistant Professor of Medicine, The University of Arizona College of Medicine and specialist in internal medicine, The University Physicians North Hills Center

For today's two-wage-earner families, balancing work and home responsibilities can be difficult enough without scheduling time for doctor visits. A visit to the doctor can be frustrating if you don't have enough time to discuss all of your health concerns or make sure you understand your doctor's advice.

In order to make the most of your and your doctor's time, it's important for you to be organized ahead of time and to understand what your doctor must do during your appointment to determine a diagnosis and devise a treatment plan. Establish Your Agenda

Plan your appointment with your doctor the same way you plan your business meetings. Start by organizing your thoughts and making a list of everything you'll want to discuss with your doctor. Write down all of your symptoms and note how long you have had them, what causes them or what is happening when they occur, and what makes them better or worse.

Decide what your goals are for the appointment -- are you looking for a diagnosis? Do you need advice about how to cope with your existing illness or feel your current treatment needs to be changed? Do you want a referral to a subspecialist?

To make it easy to jot down symptoms and concerns as you think of them, keep the list in your appointment book. Once you've scheduled a visit to your doctor, attach the list to the appropriate page of your appointment book so you'll remember to bring it along.

You also should make a list of all medications you are taking, both prescription and over-the-counter drugs, including how often they are taken and the amount of each dose. It also is important to list medications to which you've had allergic reactions or side-effects, and what the reactions were. If more than one doctor is prescribing medication for you, reviewing your list with all of your doctors will help you keep your regimen simple and avoid drug interactions. Not only should you bring a medication list with you to your appointment, but you should always carry a current list with you in case of emergency. Prioritize, And Be Flexible

After making your list, decide what two problems you most want to discuss during your appointment. If you have a long list of symptoms and/or several health concerns to discuss, you may need to schedule a longer appointment or make a second appointment to address the less urgent problems. Your doctor's appointment schedule generally is broken into 15-minute blocks. When calling to make an appointment, consider asking the receptionist to schedule a longer visit for you. At the beginning of your visit, be sure to tell your doctor how many problems you wish to discuss.

To arrive at an accurate diagnosis, it's important to allow your doctor adequate time to evaluate your symptoms and perform an examination. If another family member has symptoms you'd like the doctor to evaluate, don't try to save time by asking her for a diagnosis based on your description of that person's symptoms during your appointment. Instead, try to schedule a visit for that family member immediately before or after your appointment or at a later date. (The same applies when accompanying your child or spouse to their appointment; schedule a separate appointment for yourself if you need to discuss your symptoms.)

Present The Facts

• When making a business decision, you consider the facts, define the problem, then prepare a plan of action to achieve results. To determine a diagnosis and formulate a plan of treatment, your doctor first listens to your history and then performs a physical exam.

  Therefore, it's important to tell your doctor everything you feel is significant at the beginning of your appointment so he or she can concentrate on what is found during the exam. (Having your list of symptoms and concerns with you during your appointment will help ensure that you don't forget anything you want to communicate to your doctor.) Your doctor needs time to analyze your symptoms and the exam findings, so if your doctor appears to be deep in thought, allow some quiet time so you don't interrupt that process.

  Clarify and Summarize

• As your appointment comes to a close, ask your doctor to clarify anything about your diagnosis and treatment you don't understand. Make sure you've heard your doctor correctly by summarizing what he or she has said. Ask your doctor to write down complicated information or anything you think you may have difficulty remembering.

  Your relationship with your doctor is like any partnership -- communication is the key to maintaining a long and mutually satisfying association. Establishing a long-term relationship with a primary care doctor who provides you with continuity of care is important in maintaining your health and preventing disease. Ideally, your primary care doctor should provide almost all of your health care. If specialty care is needed, your doctor's knowledge about your health history will make it easier to coordinate your care with specialists he or she knows are most likely to meet your needs.

  Just as business partnerships sometimes fail despite our best communication efforts, patient-doctor partnerships may not succeed either, so if you feel frustrated after most of your visits to your physician, it's probably time to find a new doctor.