Your First Consultation

I judge a first appointment by what you can repeat afterwards, not by how thorough it felt at the time. There are five things you should be able to say when you walk out.

One: what I think is going on, in plain words, and how confident I am. Two: what I propose — the part I do and the part you do, which is usually the more important half. Three: how many sessions before we should know whether this is working, which is generally four. Four: what that will cost in total. Five: what would make me change the plan or send you elsewhere.

To get there, the hour goes roughly: history in detail, including the systems that seem unrelated and usually are not; examination, with movement testing for anything musculoskeletal and pulse and tongue for anything internal; treatment if it is appropriate; then a re-test, so we are both looking at something measurable rather than at how you feel after an hour in a quiet room.

What I ask you to bring, and it genuinely changes the appointment: imaging reports and specialist letters, recent blood results, a written list of everything you take including vitamins and anything bought online, and three months of cycle dates where relevant.

If the answer turns out to be that you need your GP and a specific test rather than me, that is what I will say. The clinic is in Lane Cove, opposite the library.

Mostly questions, and better ones than you expect

A first appointment is largely conversation. Where the problem is, what makes it worse, what it stops you doing, and how it has behaved over weeks rather than days. Then the questions that seem unrelated and are not: how you sleep, how you digest, what your energy does across the day, what changed around the time this started.

That last one matters more than most people expect. Problems rarely begin on the day they become noticeable.

The part that is not talking

Depending on what you have come for, there is some form of examination — movement testing, palpation, looking at how you stand or hold yourself. It is explained before it happens, and it stops the moment you want it to.

You stay dressed unless there is a reason not to, and if there is, you are told why first and given privacy to change.

How long it takes

A first appointment runs longer than the ones after it, because most of it is the history. Follow-up sessions are shorter and more focused. The exact time varies by practitioner and by what you have come for — ask when you book, and you should get a straight number.

What you should leave knowing

Three things, and if you do not have them, ask before you go:

• What they think is going on, in words you can repeat to someone else.
• What they propose, and roughly how long that usually takes.
• What would change the plan — including what would make them send you elsewhere.

A practitioner who cannot say what would make them change course has not really made a plan.

What will not happen

Nobody will tell you to stop a medication your doctor has prescribed. Nobody will tell you that a scan or a specialist appointment is unnecessary. And nobody will promise you a particular result in a particular number of visits, because that is not something anyone can know.

If something you describe needs medical assessment rather than this kind of treatment, you should be told so in the first session rather than the sixth.

What comes next

Usually you leave with a treatment plan — what is proposed, how often, and when it gets reviewed.