If you have had a long run with acne, and tried (I mean honestly tried- months atleast) many treatments, its okay to go to the derm seeking an Accutane treatment.
However, depending on the derm, he may want to let you try some prescription stuff out first. That's generally the procedure, but Accutane disposals have gained in recent years.
If your then at the prescription step, here's when you can speak up, you are patient! Ask him questions if you want regarding treatments you've read on the internet, what is his most prescribed treatment, will there be any oral antibiotics involved. Not only that, but if you have had bad experiences with certain products (retinoids for example) tell you want to avoid those things.
Basically, a good dermatologist will not see you for 2 minutes and then rush you out the door. He should listen to your special needs, concerns, and then proceed accordingly.
SOURCE: Went to the same derm for 2 years
light wash with Acne.org cleanse
Aveeno Daily SPF 15
Aczone (As only spot treatment)
medium wash with Acne.org Cleanser
Medium application of Aczone
layer of Acne.org lotion