My friend Mary was scheduled for surgery to address a chronic condition she has struggled with for years. It caused severe discomfort and Mary was ready for relief. A month before her surgery, she started feeling better, the pain was gone and her range of motion improved. I asked her if she had cancelled the surgery and she didn’t think she could. She was afraid that if she cancelled it now, her insurance wouldn’t cover it if she needed it later. This struck me as odd.
Another friend of mine disliked the primary care physician (PCP) assigned to her by her HMO. She developed a concerning infection and swelling in her knee, but couldn’t get in to see her doctor for two weeks. Throughout her treatment, he would cancel appointments, not return calls, and made her feel bad for requesting a prescription change when her medication seemed ineffective. I asked her why she didn’t change doctors and she said her HMO wouldn’t let her. Now that, I thought, is crazy.
So I did some research and spoke with a few local health care providers about the prevalence of these scenarios and realized that many people rely on their doctors and insurance companies to be their advocates. What seems forgotten is that — when it comes to health care — YOU are the customer. You pay good money for your insurance (or have paid for it throughout your life) and your doctors work
Finding a doctor you like should be your first priority. This is especially important with your PCP as he or she is the one to oversee your care when other doctors are involved. If you develop a chronic condition, your team of doctors usually grows, creating opportunity for lack of information, misplaced records, and duplication. According to a recent report in the Journal of the American Medical Association, your state of well-being can actually decrease as the number of doctors you see increases due to overtreatment and poor coordination by multiple practitioners and health care systems.1
When it comes to managing our own health, what can we do to help achieve successful and
Remember, YOU are the customer.
Insurance and health care are services you purchase and for which you pay. You are the customer. Regardless of your type of insurance coverage (or lack thereof) know that you have treatment options and it is in your best interest to know what those options are by asking questions.
Understand your condition.
Being diagnosed with an illness can be scary and overwhelming. But those feelings often subside when you have a full understanding of the condition. “If you don’t understand what your doctor is telling you, ask for clarification,” says family physician, Dr. Ed Ruiz of La Quinta. “Don’t be afraid to say ‘tell me in layman’s terms, I don’t quite get it.’” Dr. Ruiz also recommends researching your condition online or at the library (using reliable sources) to increase your understanding. Make a list of questions and bring them to your next appointment with pen and paper to take notes. If you need extra time to ask questions, request that when you make your next appointment. Doctors are able to code double appointment time for insurance reimbursement. Advanced scheduling simply needs to be arranged with respect to other patients’ time.
Don’t become the victim.
“Many people unfortunately fall into ‘I’m sick’ mode with a diagnosis, which doesn’t help your body,” adds Ruiz. “It is important that you maintain a healthy diet and keep up with exercise because the healthier your immune system remains, the better your body will be able to overcome the illness.”
Coordinate your care.
You are the ‘Team Leader’ of your condition. For best results, take on the responsibility of managing all of the information, appointments, and processes. Create a binder. List all your medications and supplements; include a calendar to note doctor visits and medications prescribed. Ask each practitioner for a copy of your reports and labs, or a CD of CT Scans and MRIs. Having all this information at your fingertips is beneficial for both you and your doctors, and allows you to maximize each appointment. This is especially beneficial for snowbirds and those who travel.
Keep your PCP informed.
Primary care physician Dr. Thomas Reynolds M.D. of Palm Desert states, “A specialist I send you to may send you to another specialist and I may not be informed of that visit or sent reports. If you go to urgent care or emergency, call your PCP the next day so he or she can request your records.” Your PCP is the one to tie it all together for you and the better informed he is, the more he can help you.
Involve your family.
Second hand medical information doesn’t always translate well. “Involving family improves your care because it paints a clearer picture for everyone,” adds Reynolds. “We encourage family to attend appointments and get involved.” Or, bring a recorder to appointments (available on most smartphones) so others can hear the information directly from your doctor’s mouth.
Follow up and follow through.
“Doctors are task oriented, and timely tests, labs and appointments are scheduled accordingly for a reason–to keep your progress moving forward,” adds Ruiz. He advises that you follow through on all instructions and document your progress.
Each of these things will help your entire medical team – and most importantly YOU – move forward towards a healthier tomorrow.
Reference: 1) Orly Avitzur, MD “Too many doctors can spoil your care,” Consumer Reports on Health, Aug 2012, p11