What to tell your family doctor about 360Care

You waited five weeks for the appointment. You get about fifteen minutes of it.

Somewhere in the middle your doctor looks up and says, so what is this program you are on. And you find yourself explaining an app, a nurse you have never met in person, a scale that sends numbers somewhere, and a dietitian who has opinions about your breakfast. It comes out sounding either trivial or like you have gone behind their back.

It is neither. But the version of it that lands in fifteen minutes is a specific version, and it is worth having ready before you sit down.

Start with what does not change

The single most useful sentence is the one that says what stays the same.

Your family doctor is still your family doctor. They hold the whole record: the things that have nothing to do with diabetes or blood pressure, the history from before any of this, the referrals, the specialists. And they are the prescriber. Nobody at 360Care writes or changes your prescriptions. Your care team is registered dietitians, nurses and health coaches, and the work is monitoring, coaching, food, habits and keeping an eye on your readings between visits.

Said out loud, it is one line. Something like: it is a program through my benefits, a nurse and a dietitian I message in an app, they watch my readings, and everything about medication still comes to you.

Most doctors relax at that point, because the worry underneath the question is usually that somebody else has started adjusting things without telling them.

Offer them the summaries

With your permission, 360Care sends progress summaries to your family doctor, so everyone is working from the same picture. That permission is yours to give and yours to withdraw, and it is worth doing deliberately rather than leaving it as a box you half remember.

Two practical things. Make sure your care team has the right fax number or address for the practice, because a summary sent to the wrong clinic is a summary nobody reads. And tell your doctor the summaries are coming, so they arrive as something expected rather than as unfamiliar paper from a company they have not heard of.

The worry underneath the question is usually that somebody else has started changing things without telling them.

What is actually worth bringing

Fifteen minutes rewards paper. Bring, on one page or on your phone:

• Your readings, as a pattern rather than a pile. Not every number. The ones from the last two weeks, or whatever your care team has summarised, with a note of anything unusual going on that week.
• Your current medication list, including anything you buy without a prescription, and any supplements. Your pharmacist can print this list, and it is more accurate than memory.
• What has changed since you were last there. New symptoms, a new job, a new schedule, a medication you have been skipping and why.
• The one or two questions you actually want answered, written down before you go in, because they are the first thing to fall out of your head.

If you keep home blood pressure readings, bring the average your monitor gives you or the one your care team has worked out, not the single highest number that frightened you. An average over a week is the thing a clinician can act on.

The overlap worth catching

Two teams looking at the same person is mostly a good thing. It has one predictable failure, and it is worth naming.

Information can go stale in one place while it changes in another. Your family doctor adjusts a blood pressure medication in October. Your care team is still working from what they were told in August, and your readings suddenly look different for reasons that have nothing to do with your walking or your salt. Or the reverse: you have been feeling lightheaded standing up for a fortnight, mentioned it in the app, and it never reaches the person who could act on it.

The fix is unglamorous. When a prescription changes, tell your care team. When something changes in the app that matters, tell your doctor. Your pharmacy is the third point in this, and often the best one, because it is the only place that sees every prescription you fill regardless of who wrote it. A pharmacist can review the whole list with you, usually without an appointment.

If you do not have a family doctor

Plenty of people in Canada do not, and it is not a failure of organisation on your part.

Say so to your care team rather than working around it. It changes what they can and cannot arrange, and it changes what they will suggest. Walk-in clinics, nurse practitioner led clinics and provincial registries for finding a doctor all exist, and your care team can help you work out which applies where you live. Keeping your own copy of your readings and your medication list matters more in this situation, because there is no single practice holding your history for you.

Worth a word with your care team

Message your care team, rather than waiting for your next appointment, if a prescription has been started, stopped or changed by anyone. That is the single update that most changes what your readings mean.

Some things should not wait for either team. Call your doctor or go to an emergency department for chest pain or pressure, sudden weakness or numbness on one side, trouble speaking, sudden vision change, or a severe headache that comes on out of nowhere. For a blood sugar low you cannot bring up with fast-acting sugar, or repeated lows you do not understand, contact your prescriber promptly rather than adjusting anything yourself.

And if the two sets of advice you are getting genuinely contradict each other, say that plainly to both. It is not rude. It is the useful thing to do, and it is how it gets sorted out.

One small place to start

Before your next appointment, write two lines on a scrap of paper: what the program is, in one sentence, and the one question you most want answered. Put your medication list in the same pocket.

If you are a 360Care member, message your care team a few days beforehand and ask them for a short summary you can hand over. Tell them the date of the appointment, and tell them afterwards what changed.