What to Expect During Your Initial Visit

Most often patients come to me to establish a relationship with a primary care physician and for me to perform a full physical exam and obtain a complete medical history. Sometimes a new patient will come with an acute illness. In that case, I will give the patient the option of trying to address the acute issue or doing a complete history and physical. I feel, though, that except for the most minor complaints, doing a thorough work-up is the best way to diagnosis and treat the issue.

 

Medical History

For both men and women I try to obtain a complete medical history. Sometimes the questions I ask may seem a bit invasive, but knowing about your sexual practices, exercise, employment, social support, alcohol, tobacco, and illicit drug use is critical to my being able to understand your health risks. I will also ask about your family medical history, any medical problems you may have, surgeries you’ve had performed, medications, herbal supplements you are taking and drug allergies of which you are aware of. I also like to take this opportunity to ask about your hometown, hobbies, educational background, etc. While these questions are probably not super-medically relevant, it helps me understand you as a person, and to see you as the individual you are.

 

Physical Exam

Men’s physicals entail:

•Measuring your height, weight, blood pressure, and temperature
•Asking you to remove all clothing but your underwear (I provide a gown to preserve patients’ modesty)
•Examining your eyes, ears, throat, lymph nodes, lungs, heart, abdomen, liver, spleen, neurologic function, peripheral pulses (the ones in your feet and wrist.)
•For men under 40 I perform a hernia check which requires you to briefly remove your underwear. I also perform a testicular exam, as testicular cancer is a fairly common malignancy in younger men.
•For men over 40 I perform a rectal exam, as prostate cancer is a concern as men age.
•I will also typically do an electrocardiogram. Information about electrocardiography is on the previous page.

Women’s physicals entail:

•Measuring your height, weight, blood pressure, and temperature
•Asking you to remove all clothing but your underwear (I provide a gown to preserve patients’ modesty)
•Examining your eyes, ears, throat, lymph nodes, lungs, heart, abdomen, liver, spleen, neurologic function, peripheral pulses (the ones in your feet and wrist.)
•I will also typically do an electrocardiogram. Information about electrocardiography is on the previous page.

 

Lab tests

In my new office, I personally draw blood, if needed, for all patients. This saves them the hassle of going to another facility, and before practicing medicine, I worked in a clinical laboratory, hence I have drawn thousands of blood samples, so in addition to not having to go somewhere else for a blood-draw, I can assure you that I will likely be be more proficient in obtaining a blood sample from you quickly and with less pain than the typical Quest/LabCorp blood-draw mill.

 

Communication

I hope that you will be as honest with me as possible. I can’t remember a time when a patient told me something that made my treat them differently.

The following comment from a patient reassure me that my efforts to be non-judgmental are sincere:

Dr. McNiff also made me feel more comfortable than any previous doctor about discussing touchy topics–to where I was completely candid about some things I have kept to myself with other docs.

 

Preparation

Please try to refrain from applying any body lotion the day of you appointment. It makes the EKG leads not be able to adhere to your skin.

If at all possible, try not to eat before your appointment. That way We can get your cholesterol, and glucose tests done while you’re fasting. At least 6-8 hours is best, preferably 10-12. If you have an afternoon appointment, I understand that that is probably not realistic, so I will give you a slip to return to the lab some other time when you have fasted.

 

Wait Time

I value your time and I sincerely strive to minimize the amount of time patients have to wait for me. I never double-book, and I allow 30 minutes for new patient visits. My average wait time is less than 10 minutes, and I strive to see patients as soon as they arrive.

Sometimes I will ask you wait more than I am comfortable with. Sometimes 30 minutes is not enough time to discuss a grave illness. I always take as much time as necessary to answer every question, assuage any fears, and construct a plan to deal with illnesses in a collaborative manner. Sometimes that makes me run late, and if I could predict when I need extra time, I would. If I am ever more than 15 minutes behind schedule, I will ask you if you want to reschedule, suggest that we speak on the phone later if the issue is solvable that way, or I will give you my best estimate as to when I will be able to see you.

If you are running late, it would be so gratefully appreciated if you could call the office and let us know. I completely understand that things happen: trains break-down, kids have melt-downs, one can’t find his keys.