Although this was previously posted elsewhere, the link wasn't working for everyone (maybe due to the length of the journal title I heard) so here it is again.
I'll likely do more about communicating with health field professionals in the near future too - some of it about how to tell what they are thinking.
COMMUNICATING WITH YOUR DOCTOR:
You know, it occurs to me that one of the things I learned in medical school is that very few medical schools spend any time teaching the students how to really communicate. It is really only in the very modern era that some schools are beginning to pursue this with any diligence. That being said, all US medical schools do teach the students a pretty consistent format to take a history. Maybe if I share that basic outline it will help you formulate the history you need to share with any specialists.
With that in mind, many clinic visits are now forced to be streamlined by docs who simply don't have the time to meet the needs of their patients/staff/etc... Anything that helps to streamline the process is going to be appreciated by a doctor in any specialty, and the most efficient way to accomplish this is to use the same format. That said:
Chief Complaints: Essentially, try and limit this to three major problems at most. State that these are the priorities for you right now, but you have other concerns to get to as well. A summary statment can also be useful here, such as "I am frustrated by the conflicting medical opions I am given and need a fresh opinion to help sort through my symptoms."
History of the present concerns: This is where having a written list of symptoms with you is handy. If you want to maximize efficiency organize it by system and label each symptom with a start date and how pervasive it is. Ex:
Lungs- Labored breathing since 2000, most days, worse after exercise
Rib pain- since 2006, comes and goes with no real pattern.
Joint pain - since 1998, my knees are the worst, they swell only sometimes but hurt nearly every day. Hips are bad too.
Face numbness - started in 2002 and comes and goes, but when it is present people notice a facial droop and a squinty eye.
Current medication list - include dosages and how long you've been on it (estimates are fine)
Allergies to medications
Past Surgeries- what and when (year)
Past hospitalizations - for what and when (year)
What tests have been done in the past and what results - and when they were done
What other illnesses do you have (if you have diabetes, seizures, high blood pressure or bipolar this is something they will want to know as it might mean certain treatments are not a good idea)
Try to avoid labelling yourself with diagnosis that haven't been proven. You can tell them you are concerned about sarcoidosis (or another non-verified condition) but don't pass yourself off as having it already. Likewise, try to avoid clustering your symptoms into a class of diseases such as autoimmune or infectious. This might generate some defensiveness in the doctor. As one of my most admired mentors used to teach me about reaching good diagnoses: "Question everything the last quack wrote in the chart - even if he has your name." To be honest, this has proven true for me many times and I requestion my own work as well as other physicians all the time, sometimes with dramatic new realizations (like the 33 year old woman who we suddenly realized wasn't having a history of TIAs but was likely MS - was she pleased to get off all the blood thinners and get the right tests to make a diagnosis)
What's been tried in the past - diagnoses that didn't pan out, treatments that didn't work
A list of all current symptoms by body system - you can even include symptoms that you don't have or have never had but seem to always be asked about (for instance - night sweats but never with fevers). The doc is going to ask for these anyway.
What you are hoping to get from the visit.
I can pretty much guarantee that most docs will appreciate if you have that information ready when you meet with them for the first time. A more streamlined version is fine for docs you already know. And it is ok to tell a doc what you want them to focus on. If worse comes to worse you can try saying that you would rather discuss depression issues with your GP or counsellor and would like to focus more on the somatic complaints as you are not at all convinced there isn't a physical cause.
I hope this is helpful to you in some way. It certainly should at least take some of the defensiveness out of all but the most egotistical physicians.