Questions to help you at your next doctor’s appointment
An interview on how to make the most of the time you get with a health care provider. Plus: What are the different types of anesthesia? + Do you know how to appeal an insurance denial?
Welcome to Doing Well. Today:
An interview on how staffing shortages affect health appointments
Word of the week: “anesthesia”
Do you know how to appeal an insurance denial?
Let’s get started.
We Asked: How do we make the most out of a short doctor’s appointment?
In the U.S., 76 million people live in places where there are too few health professionals to give them the care they need. Across the country, people wait weeks or months for doctor’s appointments: on average, six weeks to see a gynecologist, more than a month to see a cardiologist, and more than three weeks to see a family medicine doctor, according to a recent survey. To fill these gaps, we need to rapidly train thousands more health professionals—by one estimate, we need at least 187,000 new physicians by 2037.
In the meantime, staffing shortages mean that doctors and other health care providers are able to spend less time with their patients. Changes in the health care system itself also mean they have additional burdens to carry—from navigating complex insurance reimbursement set-ups to managing online patient portals. Health care workers have to answer for frustrations with the health system that are often outside their control, and tragically, they are five times more likely to experience violence than workers in other sectors.
Addressing the health care provider shortage will take time, money, and lots of high-quality training. But while those larger challenges are addressed, patients need tools to get the most out of the limited time we have with health care providers now. To explore those tools, and how staffing shortages affect both patients and providers, we spoke to Dr. Joseph Sirven, chair emeritus of the Arizona Mayo Clinic’s department of neurology and a professor at ASU’s College of Health Solutions and John Shufeldt School of Medicine and Advanced Medical Engineering. Our conversation has been edited for length and clarity.
Short on time? Here’s what to know:
Health care shortages mean providers have to see more patients in less time. To make the most out of your time, it’s important to prepare beforehand. Ask yourself: What are the top things I want to get addressed today? Then, practice how you’ll describe your priorities and challenges to your provider. Consider: What’s the headline?
If you’re seeing a new provider, see if you can fill out your patient intake forms ahead of time. This will help you think through your health and what you want to prioritize, and it reduces stress while you’re waiting for your appointment. If you want to address a specific problem, consider bringing a log of information related to your health: When did symptoms start, how often do they come up, how are they affecting you?
In the appointment, check-in with yourself. Ask: Does this make sense to me? If it isn’t clear why your symptoms led to a diagnosis, or what the treatment plan is, ask a follow-up question. You can also repeat back what your provider told you to make sure you understand: So, you’re telling me I should ______. Is that right?
If you can, find someone who can come to the appointment with you to help listen, remember, and ask questions. You also can take notes and ask to record.
Mia Armstrong-López: How do shortages in the health care workforce affect patient experiences?
Joseph Sirven: When you have a shortage of doctors and other folks that see patients—nurse practitioners, physician assistants—more people have to be seen by those who are currently working. There’s only a certain amount of time in a day. The number of people that you have to see increases, and you end up seeing a lot of patients in a short amount of time. The doctor is not always happy with that. The patients aren’t happy, because they feel rushed. So it affects the whole system; it makes appointments shorter and more stressful
MAL: More stressful for everyone. I think it’s fair to assume that most health care providers go into the profession because they want to help people, they want to make them feel better. But the nature of the system means they have a lot of other work to do, a lot of other people and tasks that they have to respond to. How do these stressors affect your experience as a provider?
JS: Number one, there’s pressure to see a lot more people in a given day. If you’re sick [as a provider], you feel guilty. Someone has to answer phone calls, and eventually, those questions come to you. There’s a patient portal you have to answer. If you’re in a situation where you also have hospital-type work, there may be on-call duties and splitting your time between different locations. You can see how suddenly [it] becomes an easy ride to burnout.
Some will immediately counter with, “Well, yeah, but doctors and providers are compensated well.” That may be true, but if you ever look at the loan burden for students—they’re up there. You are very much trying to just keep your head afloat. I love what I do, but that is a reality.
The other thing that’s happened is that it used to be that doctors were very much in private practice settings, in little offices. Those still exist, but many, many more have now been purchased by large health groups, hospitals, even insurance companies. That puts extra pressure to balance budgets—and sometimes in that pressure, things get lost.
MAL: Many people have had the experience of waiting months to see a specialist for a 15-minute appointment, or being in a hospital and waiting all day for the five minutes that a physician might have on rounds to see you. How can we make the most of the limited amount of time that we may have with a health care provider?
JS: Here’s a sad truth about the entire system: We spend more time waiting for the doctor than talking to the doctor. We have to find a way to fix it. Having said that, there are things that can make those visits really important. The way I view it is that it’s not about getting the appointment, it’s owning the appointment. The first thing I always say: Be prepared. That means have in your head: What are my top two or three things that I want to get addressed today? Not a novel—you’re gonna have to kind of think journalistically: What’s the headline?
Before you get into that office, those forms you have to fill out—medications you’re on, history, allergies—those are gold. Don’t fill them out in the office, have them prepped before you get there. If you’re talking about blood pressure, have a log of [your] blood pressure; if you’re talking about migraine headaches, [create] a calendar showing how often. Those are data points.
I think of my mom—I remember she’d always get dressed up for the doctor, and then I told her, “Well, how’d it go?” “It went great.” “Well, what about this?” “Oh, I didn’t talk about that. I didn’t want to ruin his day.” I’m like, “Well, that’s not going to get us the answer.” Don’t worry about our feelings and how you look, just tell us what you need to address. You have to have your questions outlined, in front of you, those top two or three questions. What are my symptoms [due to]? What if it gets worse?
Take notes, or bring an advocate or an ally. I truly believe in having an extra pair of ears. When you’re stressed because you’re meeting someone, or it’s so personal, or maybe it’s painful, sometimes you forget stuff. So bringing that person or taking notes really makes a difference.
The last thing I’d say is: Understand the plan. In other words, when you hear whatever they suggest in the treatment, say, “So, you’re telling me: Do XYZ.” That’s a way of checking for misunderstanding, especially with medications and things of that sort. If you have a follow-up, that’s a good reason for the patient portal.
MAL: There’s nothing more frustrating than waiting for an appointment, and then driving home and realizing you didn’t get what you needed. One thing I’ve felt was helpful in the past is to practice talking about my issue with a family member or friend beforehand.
JS: I love that idea. The other piece to this is just making sure you jibe with the [provider]. Even if you waited for a while, if they’re not going to listen to you, then that may be a reason to search for someone else. You don’t have to put up with feeling not heard.
MAL: You’re a neurologist, you specialize in epilepsy care. Epilepsy and a lot of other neurological conditions like stroke require quick care and decision-making. For patients and family members, that can be scary. How can family members make sure they get the information they need while also ensuring providers can do their jobs?
JS: In emergency settings, I’m going to double down on having someone with you. Someone who’s going to be extra eyes and ears, an advocate. When you don’t have that, one of the other sources is nurses. They’re extremely busy too, but one of their roles is to connect in that manner. Treat them as an advocate for your safety. If you don’t have someone, take notes and ask to record things.
MAL: If I am the advocate, what should I focus on to do the best job I can for the person I’m trying to support?
JS: The best thing is asking [yourself]: Does it make sense? Asking for something to be repeated: Can you say that again? Can you go over that? The medication, how long will [they] be on it? Can you explain those symptoms?
It’s almost like that check: Is this logical? Is this making sense? Is there something that’s missing? You don’t want to speak for the patient, because we want to hear from them, but you may want to say, Hey, so-and-so, what about that thing you told me the other day? As long as it’s not breaking confidence, that helps to put out the whole picture.
MAL: The question Does this make sense to me? is really straightforward, but so useful. Many of us are taught to see providers as this authority, and we nod along, and we’re listening to terms, but then we don’t take a step to say, “OK, wait, am I actually understanding what is going on?”
JS: When you’re in the middle of it, there’s an emotionality to it—this is a very personal moment. So in that regard, making sure that you’re comprehending is huge.
MAL: What do you wish all patients knew about the pressures health care providers are carrying?
JS: Number one, we are under immense time pressures. Until the system changes—and I’m still optimistic it will, to where we’re off of time-based billing and more about outcomes—there’s a lot of pressure. Number two, know that in the vast, vast majority of cases, the doctor wants to help.
Learn more about ASU Health’s efforts to expand and strengthen the health care workforce and the new John Shufeldt School of Medicine and Medical Engineering.
Well-Informed: Related stories from the ASU Media Enterprise archives
Across the country, the labor and delivery units of American hospitals are closing their doors. As of 2022, 1 in 3 urban hospitals did not offer obstetric services; the residents of half the country’s rural counties have no obstetric care. In this essay for Zócalo Public Square, obstetrician John McHugh writes about his hospital’s labor and delivery unit closing, and the danger these gaps in services pose for pregnant patients and their families.
Well-Versed: Learning resources to go deeper
Interested in expanding your knowledge of medical terminology? Or maybe you want to become a physical therapy aide, a phlebotomy technician, a clinical medical assistant, or an EKG technician? ASU’s Career and Professional Learning platform offers programs in all these areas and more. You can also learn more about pursuing joint degrees in medicine and medical engineering at ASU’s new John Shufeldt School of Medicine and Medical Engineering.
Well-Read: Articles we’ve found useful this week
“Is There Any Truth To the ‘Feed a Cold, Starve a Fever’ Adage?” by Melinda Wenner Moyer, Oct. 21, 2025, The New York Times
“The U.S. Blood-Donation System Is Broken. Here’s How Doctors Want to Fix It,” by Christopher Tedeschi, Oct. 21, 2025, Slate
“Out-of-Network and On Your Own? What to Do If Your Insurer Drops Your Doctors,” by Bram Sable-Smith, Oct. 27, 2025, NPR
Well-Defined: Word of the week
Anesthesia
Anesthesia is a process that uses medications to reduce or block pain or other sensations during a medical procedure. There are different types of anesthesia:
General anesthesia is used during major medical procedures, such as heart surgery. It puts your entire body into a temporary, controlled state of unconsciousness, while a specially trained provider tracks your vital signs to ensure you’re safe. Most people recover from general anesthesia without serious issues.
Monitored anesthesia care (also called monitored sedation) involves giving sedatives and pain medication to help a patient relax during a medical procedure. There are different levels of sedation, and sometimes sedation can cause a patient to fall asleep (although unlike general anesthesia, the patient is not unconscious). It’s often used during procedures like colonoscopies.
Regional anesthesia is used to block sensation in a large part of the body while you remain awake or lightly sedated. A common example of regional anesthesia is an epidural used for pain during childbirth.
Local anesthesia numbs a smaller area of the body and is used for minor procedures such as stitches or dental work.
Understanding how anesthesia works can help ease your nerves. Don’t be afraid to ask your care team any questions you have—they’re there to ensure your safety.
-Kitana Ford, health communication assistant
Well-Engaged: Do you know how to appeal an insurance denial?
U.S. insurance companies denied an average of 20% of health insurance claims in 2023, according to the health research organization KFF. Americans who have a hard time paying their medical bills highlight denied claims as one of the challenges.
Your health insurance promises you certain benefits, and a health insurance claim is the path to request those benefits. If your health insurance denies your claim, you have the right to appeal the decision. Your health insurance is required to share their reasoning for refusing to pay a claim.
You can appeal an insurance denial in two ways: an internal appeal or an external review.
An internal appeal—an appeal directly to your insurer—generally begins with your health care provider filing a claim with your insurance. The provider is asking the insurance to pay its part of the care. If your insurance denies you coverage, you can file an internal appeal directly with your insurer within 180 days of the denial. To do this, you would need to fill out the forms required by your insurer. (You can also seek help from the consumer assistance program in your state). Your insurer must make a determination on an internal appeal within 30 or 60 days of its filing, depending on whether you’ve received care already. If you disagree with the result of your insurer’s internal review, you can then file for an external review.
In an external review, a third party evaluates your insurer’s decision to deny coverage. Your insurer must accept the decision this third-party reviewer makes. While an external review is a way to appeal the result of an internal review by your insurer, you can also file for an external review before the internal review process is complete if you need coverage urgently.
Here are some tips for this process:
Collect the details of your coverage, typically found on your insurance provider’s website or your insurance ID card.
Investigate why you may have been denied: Look at the breakdown of services you received on your bill from your provider and review the Explanation of Benefits (EOB) document provided by your insurer.
Get support from your provider by asking them to explain to your insurer why the treatment you were denied coverage for was medically necessary.
Gather all necessary documents, including your medical history, past treatments for the condition being addressed, and research on why this treatment was necessary.
File your appeal before the deadline.
-Mel Moore, health communication assistant
Expert review provided by William Riley, professor for the science of health care delivery at ASU’s College of Health Solutions