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With all the talk of health care reform dominating the news and halls of government for the better part of the last decade, much can be done to help wellness without fancy legislation, or costing billions of dollars.

Doctors at the grass-roots of all medicine, the primary care level, recommend a number of measures that can benefit any patient, and help improve long-term health outcomes.

Avery Wood, a private practice family physician from North Bennington, Vt, took it from the top.

"First, make a list of your concerns," Wood said after a busy day of seeing patients. "Be prepared to review this list at the beginning of your visit so you and your doctor can set priorities about what you want to cover during that visit."

This list could include things like new symptoms, follow up on a new medication, a progress report in a long-standing illness or medical forms that need to be filled out, Wood said.

Wood continued by urging that patients should be sensitive to the time limits of their appointments. One of the things that can help with that is to bring along as much of your own medical information, both current and historical, as possible.

"Bring all your medications and supplements either in their original bottles or write down the dose and how you take them, and include all of the ingredients of your supplements," Wood said. "If you have seen other doctors or had other testing done since your last visit either bring those results with you or be sure that they've been forwarded to your doctor [beforehand]."

Wood went on to list other information for updates, such as blood pressures logs, blood sugar counts, and, if the course of one's illness has been complicated, to also write up a chronology of symptoms, tests and treatments since the last primary care visit.

"Having this information organized saves time tracking down details during your visit and makes sure that your doctor has the most accurate information," Wood said.

Robert Tarnas, a family doctor at the Pownal campus of the Southwest Vermont Medical Center agreed with Wood's recommendations, and discussed further patient initiatives.

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Tarnas concurred strongly with a complete medication update, "even if that means putting every bottle of pills into a big old grocery bag and bringing them with you."

"The most accurate way to get information about medications, even if a bit cumbersome, is to physically examine those labels on pill bottles." Tarnas said. "It's time consuming, but thorough."

Tarnas added that a patient should "rehearse the history of their current ailments, along with knowing their long-term family history."

"Be aware acutely about the problem you are coming in for, with as much detail as possible," Tarnas said. "A big part of that might also be your family history. If this is a problem that's been coming on or could be hereditary, your doctor needs to know that. Our health is not something happening in isolation. It's a lifelong continuum and very much based on our genes."

Being that methodical takes time, according to Tarnas, and so a patient should also be attuned to the logistical matter of the visit length. Timeliness, he noted, maximizes that. Tardiness does the opposite and can have a negative accordion effect.

"We can't get around it, so today there is far more to a visit that just the time with the doctor," Tarnas said. "Being a bit early to an appointment helps to properly address front desk registration, update of contact information and other information nurses must gather. This could carry over afterward to referrals, and testing, and checkout."

Being late for an appointment, Tarnas continued, not only cuts down your own face time with the doctor, but also backs up the entire schedule of patients after you.

In conclusion, Wood added that with knowledge, determination must also follow in order to get a favorable appointment outcome. She said much of that has to do with making sure questions are answered, which often involves "courage, and faith in yourself."

"To get what you need out of your medical appointment, it's important that you are able to speak up and tell your doctor if you were misunderstood or your concerns are not being addressed or the answers that you're getting don't make sense to you," Wood said. "If your visit does not address your needs, be prepared to come back and try again. There's no need to be angry or hostile but it is important to be clear and persistent."

Reach award-winning freelance journalist Telly Halkias at or on Twitter: @TellyHalkias