New patients
Your first visit.
What to bring, what happens in the room, and roughly how long it takes.
What to bring
Seven things, one of which matters most.
- 01
Your imaging, on a disc or a share link
This is the single most important item. The films are reviewed directly rather than from the radiologist's report, because the surgical question is different from the one a report answers. A report alone is much less useful.
- 02
Photo identification and your insurance card
Needed to register and to verify coverage.
- 03
A list of your medications and doses
Including anything bought over the counter, and any blood thinners in particular.
- 04
Prior operative notes, if you have had surgery before
What was done, at which levels, and when. This changes the interpretation of everything else.
- 05
A short written history
When symptoms started, what makes them better or worse, what treatment you have already had and for how long. Written down, because it is easy to forget details in the room.
- 06
A referral or authorisation, if your plan needs one
Some plans require it and some do not. Checking beforehand avoids a wasted trip.
- 07
Your questions, written down
Genuinely. Patients routinely remember the question they most wanted answered on the drive home.
What to expect
Four parts to the appointment.
The history
What you are feeling, where, since when, and what has changed. Most of what matters comes out of this part, before anyone looks at a scan.
The examination
Strength in specific muscle groups, reflexes, sensation in specific territories, and how you move and walk. This is what identifies which nerve is involved.
The imaging, together
Your films on the screen, gone through with you, not summarised at you. The question being asked is whether what is on the film explains what you described.
The plan
What the diagnosis is, what to do about it, and what would change the recommendation. Most patients leave without a surgical date.
Preparing for the appointment
Write down when the symptoms started and what has changed since. Note what makes them better and worse, and how far you can walk or how long you can sit before they begin. Those details are more diagnostically useful than most patients expect, and they are hard to reconstruct on the spot.
If you are coming for a second opinion, bring what you were told, ideally in writing. The specific operation recommended, and at which levels, is the starting point for reviewing it.
Questions before a first visit
- Do I need a referral?
- It depends on your plan rather than on the practice. Some plans require a referral or prior authorisation before a specialist visit and some do not. Call the office with your insurer and plan name before you come and you will get a straight answer.
- How long does the first visit take?
- Longer than a typical appointment, because the history and the examination carry most of the diagnostic weight and reviewing imaging properly takes time. Allow more time than you think you need, particularly if you are coming for a second opinion.
- What if my imaging is at another hospital?
- Request a copy on a disc or as a share link before your visit, and bring it. Most imaging centres will provide one, though it can take a few days. If you cannot get it in time, come anyway and tell the office where it is held.
- Can I bring someone with me?
- Yes, and it is a good idea, especially if surgery is likely to be discussed. Two people remember more of a conversation than one, and having someone to talk it over with afterwards helps.
- Will I get a diagnosis on the first visit?
- Frequently yes, when the history, examination and imaging agree. Sometimes the honest answer is that the source has not been identified yet and the next step is a specific test to narrow it down. Being told that is more useful than being given a confident guess.
- Will I be told I need surgery?
- Most patients seen for neck or back pain do not need an operation, and are told so directly. When surgery is recommended it is explained in terms of a specific structure and a specific problem.