Tuesday, August 10, 2010
Excuse the missed weeks
Please excuse the missed weeks that I have not been posting. I have recently lost a close friend to liver and kidney failure and was very much invovled in procuring adequate care until his passing on 8/8/10. I am certain to have many things to say about his care and final care in general. However, for now, please allow me the time to grieve in private.
Saturday, July 17, 2010
Who's In Charge, Part Four
Who's in charge when I'm billed incorrectly?
First you should contact the billing department of the Practice, Hospital, or other entity that billed you incorrectly. Then follow-up all phone conversations with a written summary of the conversation, and send it to whomever you spoke with. If you cannot get resolution from the initial contact, then I suggest asking to speak with the Supervisor, and/or person in charge of the Billing Dept.
I would also ask for a complete, itemized billing, for all services provided, whether they are services covered by your insurance company or not. I would then contact the insurance company's benefit coordinator, and ask for an explanation of benefits as it pertains to this particular billing. In a lot of cases, the insurance company will direct to you to contact the Physician's Group to handle billing inquiries and problems. They generally don't get involved until there is an unresolvable situation.
After that, I would recommend that you contact of their Physicians, Hospitals, Radiological groups, etc., that provide the same services you received, and ask for their rates for services if provided by them, including use of your insurance and the capitated or contracted pricing. If there is any difference in the rates charged by two or more entities, then bring it to the attention of both the company that originally billed you, and your insurance company or physicians group. Ask if you can negotiate the rates down to equal what the other companies are charging, and offer to pay in full at the lower rate, today.
If they don't cooperate, you may have to issue a complaint to the company, the physician's group, the insurance company, any local advocacy groups, plus any known associations they may be governed by.
Ask for and thoroughly read all pamphlets and handouts for dealing with complaints and /or negotiations. Usually they are handled through binding arbitration. At any rate, they are required to provide you with step by step instructions on how to file a complaint, and whom to send it to.
Depending on the amount of monies involved, you may want tot contact the Department of Corporations, Health Care Division. They are very slow to respond, but they are very thorough in their investigations.
Additionally, this is one of the few times I would recommend bringing in the Media. Almost every T.V. station has some form of consumer watchdog to assist people in dealing with multi-layered corporations. Take advantage of their assistance and guidance.
The most important thing is to be persistent. Do Not leave everything up to someone else. Follow up with every person involved and keep meticulous notes regarding all conversations, phone calls, etc., including names, dates, times, a brief summary of what was discussed, along with any and all copies of correspondence from or to you regarding this matter. Not letting things fall through the cracks is vitally important right now. Stay on top of all correspondences, and return all calls as soon as possible!
Reread all correspondences with dates and deadlines. This is very important. Do not let a deadline lapse, or you could automatically lose your case. If there is any discrepancies regarding days and/or dates, ask for clarification in writing. Ask that any letters be rewritten to clarify the error. I almost lost my case over a supposed "typo". So don't be fooled by their tactics -- always keep your notes and records current. Meet all deadlines. And don't accept anything is final until you've reached the final binding arbitration.
These companies are large and can easily afford to jerk you around. And they will. They will repeatedly ask for the same information and swear they never received it. I strongly recommend that all correspondence be sent certified. That way, you have a signed receipt for everything sent, including tracking numbers. It's a lot more difficult to say they didn't receive something when you have their signature and the date saying they did! Keep all receipts attached to your copies of the correspondence, etc., sent. Keep a chronological file or notebook with all information from beginning to current.
I know that it seems an awful lot of wasted time, space and money. But believe me it will be beneficial in the end. However, having said that, if you're fighting over $10 - $20 , you may want to consider all the time, money, and effort you'll put into fighting. While I believe in fighting on principle, you do have lots of things you could better spend your time and money on. So, please at least consider whether the fight is really worth the effort or not.
Trying to keep track of your health care when things are handled properly can be a full time job. Especially for those of us whom are trying to say ahead on the health wheel of life, it can be a daunting and overwhelming job! So, when something out of the ordinary needs extra attention, or something wasn't dealt with properly to begin with, you've put yourself behind the eight ball to keep up with all the phone calls, and correspondence necessary to correct the problem. For instance -- I had a balance billing problem from a capitated plan item.
If this was only once out of every 10-20 times I get billed, I wouldn't complain so much. But, it's gotten so bad that I pay my PCP by carbon check and still ask for a receipt. Even then, I am still regularly billed by the bookkeeper for payments I've already paid. It's quite frustrating to have to always be the one person who provides all the evidence either way. If I pay, I paid. Copies of cancelled checks should be sufficient. If I haven't paid because I wasn't billed correctly, well shouldn't I deserve all the same courtesies? Just move on! But no, that's too simple. I have to make several calls to different people to clarify the issue. Then when they don't agree, then I have to appeal their ununanimous decision in writing! And, just to be fair, there's a time limit for appeals. So no taking your time. You either appeal now or forget it.
But it's not just health care anymore that has this attitude. Try to talk with your local Tax assessor about a billing error where you've been over assessed, plus never actually received a bill to begin with. Talk about being stuck up to your neck in red tape, plus a tax code bible you have to read through to find a reason for them to consider listening to an appeal, to begin with. It doesn't make any difference if they screwed up or not, they assume it will eventually be corrected, and until then you have no recourse, unless you can find a loop hole in their code book. Just what I've always wanted, to read up on Tax Code Assessments! Yippee!
First you should contact the billing department of the Practice, Hospital, or other entity that billed you incorrectly. Then follow-up all phone conversations with a written summary of the conversation, and send it to whomever you spoke with. If you cannot get resolution from the initial contact, then I suggest asking to speak with the Supervisor, and/or person in charge of the Billing Dept.
I would also ask for a complete, itemized billing, for all services provided, whether they are services covered by your insurance company or not. I would then contact the insurance company's benefit coordinator, and ask for an explanation of benefits as it pertains to this particular billing. In a lot of cases, the insurance company will direct to you to contact the Physician's Group to handle billing inquiries and problems. They generally don't get involved until there is an unresolvable situation.
After that, I would recommend that you contact of their Physicians, Hospitals, Radiological groups, etc., that provide the same services you received, and ask for their rates for services if provided by them, including use of your insurance and the capitated or contracted pricing. If there is any difference in the rates charged by two or more entities, then bring it to the attention of both the company that originally billed you, and your insurance company or physicians group. Ask if you can negotiate the rates down to equal what the other companies are charging, and offer to pay in full at the lower rate, today.
If they don't cooperate, you may have to issue a complaint to the company, the physician's group, the insurance company, any local advocacy groups, plus any known associations they may be governed by.
Ask for and thoroughly read all pamphlets and handouts for dealing with complaints and /or negotiations. Usually they are handled through binding arbitration. At any rate, they are required to provide you with step by step instructions on how to file a complaint, and whom to send it to.
Depending on the amount of monies involved, you may want tot contact the Department of Corporations, Health Care Division. They are very slow to respond, but they are very thorough in their investigations.
Additionally, this is one of the few times I would recommend bringing in the Media. Almost every T.V. station has some form of consumer watchdog to assist people in dealing with multi-layered corporations. Take advantage of their assistance and guidance.
The most important thing is to be persistent. Do Not leave everything up to someone else. Follow up with every person involved and keep meticulous notes regarding all conversations, phone calls, etc., including names, dates, times, a brief summary of what was discussed, along with any and all copies of correspondence from or to you regarding this matter. Not letting things fall through the cracks is vitally important right now. Stay on top of all correspondences, and return all calls as soon as possible!
Reread all correspondences with dates and deadlines. This is very important. Do not let a deadline lapse, or you could automatically lose your case. If there is any discrepancies regarding days and/or dates, ask for clarification in writing. Ask that any letters be rewritten to clarify the error. I almost lost my case over a supposed "typo". So don't be fooled by their tactics -- always keep your notes and records current. Meet all deadlines. And don't accept anything is final until you've reached the final binding arbitration.
These companies are large and can easily afford to jerk you around. And they will. They will repeatedly ask for the same information and swear they never received it. I strongly recommend that all correspondence be sent certified. That way, you have a signed receipt for everything sent, including tracking numbers. It's a lot more difficult to say they didn't receive something when you have their signature and the date saying they did! Keep all receipts attached to your copies of the correspondence, etc., sent. Keep a chronological file or notebook with all information from beginning to current.
I know that it seems an awful lot of wasted time, space and money. But believe me it will be beneficial in the end. However, having said that, if you're fighting over $10 - $20 , you may want to consider all the time, money, and effort you'll put into fighting. While I believe in fighting on principle, you do have lots of things you could better spend your time and money on. So, please at least consider whether the fight is really worth the effort or not.
Trying to keep track of your health care when things are handled properly can be a full time job. Especially for those of us whom are trying to say ahead on the health wheel of life, it can be a daunting and overwhelming job! So, when something out of the ordinary needs extra attention, or something wasn't dealt with properly to begin with, you've put yourself behind the eight ball to keep up with all the phone calls, and correspondence necessary to correct the problem. For instance -- I had a balance billing problem from a capitated plan item.
If this was only once out of every 10-20 times I get billed, I wouldn't complain so much. But, it's gotten so bad that I pay my PCP by carbon check and still ask for a receipt. Even then, I am still regularly billed by the bookkeeper for payments I've already paid. It's quite frustrating to have to always be the one person who provides all the evidence either way. If I pay, I paid. Copies of cancelled checks should be sufficient. If I haven't paid because I wasn't billed correctly, well shouldn't I deserve all the same courtesies? Just move on! But no, that's too simple. I have to make several calls to different people to clarify the issue. Then when they don't agree, then I have to appeal their ununanimous decision in writing! And, just to be fair, there's a time limit for appeals. So no taking your time. You either appeal now or forget it.
But it's not just health care anymore that has this attitude. Try to talk with your local Tax assessor about a billing error where you've been over assessed, plus never actually received a bill to begin with. Talk about being stuck up to your neck in red tape, plus a tax code bible you have to read through to find a reason for them to consider listening to an appeal, to begin with. It doesn't make any difference if they screwed up or not, they assume it will eventually be corrected, and until then you have no recourse, unless you can find a loop hole in their code book. Just what I've always wanted, to read up on Tax Code Assessments! Yippee!
Friday, July 9, 2010
Who's In Charge, Part Three
Who's in charge when I have a legitimate complaint that's being ignored?
First, we'll need to know who or what you're complaining about! If your complaint has to do with an employee of your PCP, Specialist, Hospital, Clinic, or other professional services, then I'd direct my complaint directly to the Personnel Manager and the highest ranking staff member available. I would also follow-up my complaint in writing to all parties you've previously discussed the situation with. Keep clear and concise notes regarding the dates, times, and places, as well as names, position/title of all persons involved, and any witnesses, including other patients. Additionally, keep notes regarding anyone you discuss the matter with, their response and any actions taken or promised. Along with the dates, times and locations, plus names and titles/positions within the firm/practice, etc. This applies to any and all complaints. Keep those notes! Without them you'll be sunk before you ever start!
The lead Doctor(s) should also receive a copy of your written complaint, outlining all offenses, your attempts to resolve the matter, the persons with whom you spoke to and their actions or promises for action. Include any attempts or actions taken along with those promised, but not put into action, along with any results or failures associated with said actions.
Give them a time frame in which to respond and rectify the problem(s) before seeking further actions. 10 days to two weeks should be sufficient. Make certain to send all correspondence certified, so you'll have a record that it was received, with attached copies and notes. Keep a chronological file of everything! From initial complaint actions, until full resolution!
If after the allotted time period has passed, and no action has been taken or any response or outline of action to rectify the situation, then I would proceed further.
If the complaint is directed toward the Doctor, the head of the Hospital or a particular Dept., then the highest ranking person available at that location would be a good place to start. I would still contact the Personnel Manager and try to follow-up with anyone whom might have authority over the Doctor or person you've a complaint against.
There are also the State Medical Boards and State Medical Associations, as well as Federal Medical Boards and Federal Medical Associations for you to direct your complaints to, however, I would use caution and discretion before involving either the State or Federal levels until you feel you have exhausted all other means of resolving the matter and have no other resources left to contact.
Remember to keep your complaint clear and concise. Give the offending person one final opportunity to rectify the situation, while letting them know your next step will be to contact the State or Federal Medical Boards and Associations. Generally, just the threat of contacting them will bring about a response and typically some form of a resolution. But, if not, at least now they know how serious you are with your complaint.
Always include your local Health Care Advocacy groups in all complaints, whether large or small. It is their duty to keep records of the number of complaints against each individual Doctor, their staff members, and their practice. All this information is available for public record and can be easily accessed. Consider it a blemish on the reputation of each Doctor and their practice. Enough of them will cause them some patients and eventually effect their wallets.
If you still can't find resolution, then by all means contact the State and Federal levels of the Medical Boards and Associations. Send them a letter outlining your complaint, all attempts you've made to resolve it, plus copies of any and all correspondence between you and the offending parties, in chronological order. Keep your feelings to a minimum -- just state the facts as clearly and without emotion, as possible. Keep to the truth and try not to add opinions rather than facts. Be concise, yet keep it brief and to the point.
After that you'll just have to wait until they respond. You may wish to contact only the State, first. See what they do or how they respond. Then, if you're still not satisfied, you can proceed with contacting the Federal Boards and Associations with your complaint. Either way, you'll receive at minimum some type of an investigation and written response.
I don't recommend bringing in the media. They tend to muck -up the problem and use their own version of the truth to slant it towards how they or their readers/viewer see it. Besides, they can create more problems that they're worth. The very last thing you want is to have them, the media, catch you off guard, making a statement that can be taken out of context and makes you seem foolish. Or worse yet, causes you a legal battle down the road. There is a very fine line between complaint and slander, so keep to the facts and mind that your temper stays in check.
Try to accept that the inevitable may be less than what you deserve. But this is how life works. It isn't always fair, and truthfully, there are very few reasons to keep someone from pursuing their chosen career. So, accept that the final decision of the State or Feds may be less than desired, and realize while they may only placate you, the person you've lodged the complaint against is probably going to be on the receiving end of some fairly stern warnings and reprimands, that you won't ever hear about!
The truth is, mostly what goes around, comes around. I know it seems trite, but it also happens to be very true. People generally pay for their arrogance and disrespect in spades. It may be that you'll have to accept that they'll get theirs, what's coming and due for them, in the end, and accept that on faith. And, besides, who knows, may be you've hastened that end a little bit yourself!
First, we'll need to know who or what you're complaining about! If your complaint has to do with an employee of your PCP, Specialist, Hospital, Clinic, or other professional services, then I'd direct my complaint directly to the Personnel Manager and the highest ranking staff member available. I would also follow-up my complaint in writing to all parties you've previously discussed the situation with. Keep clear and concise notes regarding the dates, times, and places, as well as names, position/title of all persons involved, and any witnesses, including other patients. Additionally, keep notes regarding anyone you discuss the matter with, their response and any actions taken or promised. Along with the dates, times and locations, plus names and titles/positions within the firm/practice, etc. This applies to any and all complaints. Keep those notes! Without them you'll be sunk before you ever start!
The lead Doctor(s) should also receive a copy of your written complaint, outlining all offenses, your attempts to resolve the matter, the persons with whom you spoke to and their actions or promises for action. Include any attempts or actions taken along with those promised, but not put into action, along with any results or failures associated with said actions.
Give them a time frame in which to respond and rectify the problem(s) before seeking further actions. 10 days to two weeks should be sufficient. Make certain to send all correspondence certified, so you'll have a record that it was received, with attached copies and notes. Keep a chronological file of everything! From initial complaint actions, until full resolution!
If after the allotted time period has passed, and no action has been taken or any response or outline of action to rectify the situation, then I would proceed further.
If the complaint is directed toward the Doctor, the head of the Hospital or a particular Dept., then the highest ranking person available at that location would be a good place to start. I would still contact the Personnel Manager and try to follow-up with anyone whom might have authority over the Doctor or person you've a complaint against.
There are also the State Medical Boards and State Medical Associations, as well as Federal Medical Boards and Federal Medical Associations for you to direct your complaints to, however, I would use caution and discretion before involving either the State or Federal levels until you feel you have exhausted all other means of resolving the matter and have no other resources left to contact.
Remember to keep your complaint clear and concise. Give the offending person one final opportunity to rectify the situation, while letting them know your next step will be to contact the State or Federal Medical Boards and Associations. Generally, just the threat of contacting them will bring about a response and typically some form of a resolution. But, if not, at least now they know how serious you are with your complaint.
Always include your local Health Care Advocacy groups in all complaints, whether large or small. It is their duty to keep records of the number of complaints against each individual Doctor, their staff members, and their practice. All this information is available for public record and can be easily accessed. Consider it a blemish on the reputation of each Doctor and their practice. Enough of them will cause them some patients and eventually effect their wallets.
If you still can't find resolution, then by all means contact the State and Federal levels of the Medical Boards and Associations. Send them a letter outlining your complaint, all attempts you've made to resolve it, plus copies of any and all correspondence between you and the offending parties, in chronological order. Keep your feelings to a minimum -- just state the facts as clearly and without emotion, as possible. Keep to the truth and try not to add opinions rather than facts. Be concise, yet keep it brief and to the point.
After that you'll just have to wait until they respond. You may wish to contact only the State, first. See what they do or how they respond. Then, if you're still not satisfied, you can proceed with contacting the Federal Boards and Associations with your complaint. Either way, you'll receive at minimum some type of an investigation and written response.
I don't recommend bringing in the media. They tend to muck -up the problem and use their own version of the truth to slant it towards how they or their readers/viewer see it. Besides, they can create more problems that they're worth. The very last thing you want is to have them, the media, catch you off guard, making a statement that can be taken out of context and makes you seem foolish. Or worse yet, causes you a legal battle down the road. There is a very fine line between complaint and slander, so keep to the facts and mind that your temper stays in check.
Try to accept that the inevitable may be less than what you deserve. But this is how life works. It isn't always fair, and truthfully, there are very few reasons to keep someone from pursuing their chosen career. So, accept that the final decision of the State or Feds may be less than desired, and realize while they may only placate you, the person you've lodged the complaint against is probably going to be on the receiving end of some fairly stern warnings and reprimands, that you won't ever hear about!
The truth is, mostly what goes around, comes around. I know it seems trite, but it also happens to be very true. People generally pay for their arrogance and disrespect in spades. It may be that you'll have to accept that they'll get theirs, what's coming and due for them, in the end, and accept that on faith. And, besides, who knows, may be you've hastened that end a little bit yourself!
Tuesday, June 29, 2010
Who's in charge? Part Two
Who's in charge when I don't agree with my Doctor or my options?
The easiest answer would be, you are. You're the person in charge of your own destiny, whether it be medical or otherwise.
Where to start depends on a lot of other considerations. Number one is, what exactly are you in disagreement about? If it's an opinion regarding specific care or treatment, it can usually be resolved by getting other opinions. Also, doing research on the success and failure rates for a particular treatment may help convince those with opposing opinions.
If you still can't resolve the issues, then I'd consider checking into support groups. A lot of patients become a part of these support groups because they've stood in your shoes, filled with the same confusion and mistrust. That no one can understand what it's like from your prospective. But, you'd be wrong. There are lots of people whose life story so eerily resembles your own, you'd be shocked that it's not your own.
Try not to wage a personal campaign against your Doctor. Even in this day and era, there are still many things Doctor's don't fully understand.
In my own personal experience, I've had to explain my medical condition, it's symptoms, effects, and standard treatments so often that I find it strange when I don't have to. My PCP didn't quite understand the complications and intricacies of my pain condition. It's a very complex and complicated disease, affecting each person a bit differently, although most symptoms are similar.
For instance, my condition make me very susceptible to changes in the barometric pressure. Increases cause my skin to feel as though I'm in a vise grip; like wearing a wetsuit that's 5 sizes too small! Decreases cause my skin to feel too loose. As though I'm melting into a puddle. Either way, they make the pain of my condition overwhelming, yet there is nothing that can be done to treat it.
My biggest frustration was getting my PCP to understand that this affected so much more in my life. More pain means less ability to move and reduced desire to do anything, including basic care. I don't like taking pain medications, and I try to limit them to the minimum needed to get me through the day. I don't want to become another statistical pain patient that becomes a drug addict. I know that sounds harsh, but it is too often too true. Abuse of pain killers is becoming the fastest addictive substance out there. But that's for another blog. I don't want to become one of those statistics, so I limit my pain medications. I try to minimize my medications as best I can, but there are some days I can't fight the good fight. This is where the PCP and I come to a great divide of opinions.
That is, until five (5) years later, when he was diagnosed with the exact same condition as mine. Now he has an entirely different opinion about how I choose to control my pain.
Of course, we can't all be that fortunate. It's not very likely your Doctor will suddenly understand you or your disease fully, or experience your life as you live it from one day to the next. Nor is it likely you'll have my luck and find a Doctor with your exact condition to treat you.
There are Doctors who specialize in care for specific conditions. A quick search on the Internet will guide you toward them. But sometimes it's not possible to get to a Doctor who specializes in the particular field you need. So, spend time talking with your contacts from the support groups. Print out articles that you find for your Doctor. Help to educate them as best you can.
Also, you can contact your Insurance Company and/or Physician's Group for referrals to other Doctors, Specialists, etc., to help manage your condition. Additionally, there is always the health care advocacy groups. They ask lots of questions and delve deep into your health records, but they can be very knowledgeable and helpful.
The best course of action may be just to change your PCP or Doctor. But, you're very likely to find yourself in the same predicament. My experience has often shown that you can learn more with a clear mind and a calm demeanor. Try to understand why your Doctor wants you to follow a particular path of treatment or care. Try placing yourself into their care and give their opinions and suggestions at least a minimal try. Then, at least they can't say you are continually uncooperative or uninterested in any type of care or treatment.
Who knows, maybe they know something you don't, or hadn't considered. Maybe they prefer you to start out slowly with baby steps and see how well you respond to the least invasive treatments, first. Then they can gradually up the ante and move you toward more aggressive treatments. This isn't necessarily a bad thing. And while I know it seems like mostly wasted time. I have discovered that Doctors can glean a lot of useful information from treatments that don't work, as well as those that do. Perhaps, sometimes, even more from failures.
It's the same with life. You can't learn anything by being right all the time. And so it is with health care. A great deal of trial and error. Sometimes the long way around may be what's best for you in the end.
But, only you can decide that for yourself. You need to talk with your Doctor. Make them understand your concerns and reservations. Talk to them about your planned approach for care and treatment. It's very possible that you can reach some sort of compromise that honors both opinions and covers an even broader spectrum of treatments and care. Until you can be reasonable and speak plainly with information and research to back you up, then you're probably wasting both your time and efforts.
Become as knowledgeable about your disease and/or illness as possible. Education is vital to understanding what step comes next. Until you're there, put your trust in your Doctor's care. That is until they give you reason to not trust them.
When you have concerns or just don't understand, or are afraid -- talk to your Doctor! Let them know all the things that bother you, that concern or worry you. Because until you do, they are in the dark and without communication you're doomed to be frustrated and unhappy with any and all care you receive. Communication with any Doctor about even the smallest concern can make a huge difference in your overall care. But, until you voice them, the Doctor has no idea you're concerned or just worried.
So, find someone you feel comfortable with. Try to follow their advice, but most importantly, talk to them about everything regarding your concerns and opinions. Let them know how you feel about their suggested treatments, your worries, and options you'd like to consider. Remember, letting them and yourself become a team will be the best form of treatment you'll ever receive!
The easiest answer would be, you are. You're the person in charge of your own destiny, whether it be medical or otherwise.
Where to start depends on a lot of other considerations. Number one is, what exactly are you in disagreement about? If it's an opinion regarding specific care or treatment, it can usually be resolved by getting other opinions. Also, doing research on the success and failure rates for a particular treatment may help convince those with opposing opinions.
If you still can't resolve the issues, then I'd consider checking into support groups. A lot of patients become a part of these support groups because they've stood in your shoes, filled with the same confusion and mistrust. That no one can understand what it's like from your prospective. But, you'd be wrong. There are lots of people whose life story so eerily resembles your own, you'd be shocked that it's not your own.
Try not to wage a personal campaign against your Doctor. Even in this day and era, there are still many things Doctor's don't fully understand.
In my own personal experience, I've had to explain my medical condition, it's symptoms, effects, and standard treatments so often that I find it strange when I don't have to. My PCP didn't quite understand the complications and intricacies of my pain condition. It's a very complex and complicated disease, affecting each person a bit differently, although most symptoms are similar.
For instance, my condition make me very susceptible to changes in the barometric pressure. Increases cause my skin to feel as though I'm in a vise grip; like wearing a wetsuit that's 5 sizes too small! Decreases cause my skin to feel too loose. As though I'm melting into a puddle. Either way, they make the pain of my condition overwhelming, yet there is nothing that can be done to treat it.
My biggest frustration was getting my PCP to understand that this affected so much more in my life. More pain means less ability to move and reduced desire to do anything, including basic care. I don't like taking pain medications, and I try to limit them to the minimum needed to get me through the day. I don't want to become another statistical pain patient that becomes a drug addict. I know that sounds harsh, but it is too often too true. Abuse of pain killers is becoming the fastest addictive substance out there. But that's for another blog. I don't want to become one of those statistics, so I limit my pain medications. I try to minimize my medications as best I can, but there are some days I can't fight the good fight. This is where the PCP and I come to a great divide of opinions.
That is, until five (5) years later, when he was diagnosed with the exact same condition as mine. Now he has an entirely different opinion about how I choose to control my pain.
Of course, we can't all be that fortunate. It's not very likely your Doctor will suddenly understand you or your disease fully, or experience your life as you live it from one day to the next. Nor is it likely you'll have my luck and find a Doctor with your exact condition to treat you.
There are Doctors who specialize in care for specific conditions. A quick search on the Internet will guide you toward them. But sometimes it's not possible to get to a Doctor who specializes in the particular field you need. So, spend time talking with your contacts from the support groups. Print out articles that you find for your Doctor. Help to educate them as best you can.
Also, you can contact your Insurance Company and/or Physician's Group for referrals to other Doctors, Specialists, etc., to help manage your condition. Additionally, there is always the health care advocacy groups. They ask lots of questions and delve deep into your health records, but they can be very knowledgeable and helpful.
The best course of action may be just to change your PCP or Doctor. But, you're very likely to find yourself in the same predicament. My experience has often shown that you can learn more with a clear mind and a calm demeanor. Try to understand why your Doctor wants you to follow a particular path of treatment or care. Try placing yourself into their care and give their opinions and suggestions at least a minimal try. Then, at least they can't say you are continually uncooperative or uninterested in any type of care or treatment.
Who knows, maybe they know something you don't, or hadn't considered. Maybe they prefer you to start out slowly with baby steps and see how well you respond to the least invasive treatments, first. Then they can gradually up the ante and move you toward more aggressive treatments. This isn't necessarily a bad thing. And while I know it seems like mostly wasted time. I have discovered that Doctors can glean a lot of useful information from treatments that don't work, as well as those that do. Perhaps, sometimes, even more from failures.
It's the same with life. You can't learn anything by being right all the time. And so it is with health care. A great deal of trial and error. Sometimes the long way around may be what's best for you in the end.
But, only you can decide that for yourself. You need to talk with your Doctor. Make them understand your concerns and reservations. Talk to them about your planned approach for care and treatment. It's very possible that you can reach some sort of compromise that honors both opinions and covers an even broader spectrum of treatments and care. Until you can be reasonable and speak plainly with information and research to back you up, then you're probably wasting both your time and efforts.
Become as knowledgeable about your disease and/or illness as possible. Education is vital to understanding what step comes next. Until you're there, put your trust in your Doctor's care. That is until they give you reason to not trust them.
When you have concerns or just don't understand, or are afraid -- talk to your Doctor! Let them know all the things that bother you, that concern or worry you. Because until you do, they are in the dark and without communication you're doomed to be frustrated and unhappy with any and all care you receive. Communication with any Doctor about even the smallest concern can make a huge difference in your overall care. But, until you voice them, the Doctor has no idea you're concerned or just worried.
So, find someone you feel comfortable with. Try to follow their advice, but most importantly, talk to them about everything regarding your concerns and opinions. Let them know how you feel about their suggested treatments, your worries, and options you'd like to consider. Remember, letting them and yourself become a team will be the best form of treatment you'll ever receive!
Tuesday, June 22, 2010
Who's in Charge? Part One
Who's in charge is a very loaded question, and one that would take an entire lifetime to fully answer, especially as it pertains to health care. So, I decided to touch on the top five (5) questions I usually get about "who's in charge?"
Who's in charge when I need help and answers, but can't get them?
First, I'd start at the source. Ask your Doctor. Tell him/her what it is that you need help or answers to? I've found most Doctors to be very intelligent, patient, and full of unexpected guidance when looking for answers. Remember, most Doctors have heard and seen just about everything. Plus, contrary to popular belief, they are human and do experience problems very similar to our own. If the Doctor doesn't have the answers themselves, I wouldn't be surprised if they at least didn't offer sound advice as to how to find the answers you seek. If not, keep your head up, there are several more places for answers, depending on the specific question. Let's assume that you need answers regarding specific medical treatment. Well, then your PCP should be a wealth of information, or they should have some idea about who would. Let's say they recommend that you consult with a Specialist. This is a good start, but don't get too overconfident. Specialists are like opinions, and believe me, they each have their own, unshakable opinion about what is and isn't the perfect thing for you! So, you meet with a Specialist, and they either give you the answers you want, or they add to the confusion, giving you more questions than answers. Shake it off and return to your PCP for another referral to a different Specialist. Explain why you felt that you and the Special you saw, seemed to have differing opinions, and you would prefer an alternate opinion before deciding what to do. Be determined. You are entitled to secondary opinions, especially when it involves any type of surgery or invasive treatment. You can also, while you're waiting to see this second Specialist, use the Internet to do some research. You should have formed some specific questions by now, after consulting with two different Doctors on the subject. Look for websites that are technical in terms about your specific situation or condition. But, also search for support groups having any relationship with your specific condition. These are average people from around the globe who have had or are dealing with the same problems you're facing. They sometimes can be your greatest resource guide. A lot of times, these people have stood exactly in your shoes, with lots of questions, and very few answers that aren't technical and unsympathetic toward your plight. These people understand that you not only need answers, you need reassurance that you're not alone. That there are others who've been where you are now and somehow they got though all of it.
Now while I strongly recommend listening to the advice and experiences of others, especially if they have or they are experiencing the same issues you're trying to deal with yourself. However, please use caution before wholeheartedly heeding someone else's advice, alone. This is the same as only looking at one side of a coin. There may be something vital and important on the other side. I would take the advice given as a starting point. Use their previous experiences and failures to guide you in the direction that's right for you, personally. This way, combined with your technical research, you can go see the second Specialist with a better understanding of what lies ahead. And, can now formulate questions of what's still bothering you.
If however, after all this, you are still unsure or can't get the answers you need. Then I would begin contacting other resources. For instance, maybe after all your research and talking with the Doctors, you've come to a conclusion on which treatment, etc., to pursue, however, you still have questions about where to go?, which Doctor to use?, how much will you have to payout of your own pocket?, Will you stay at the hospital or will this be outpatient care?, or What about after care and/or physical therapy?
These questions should be directed to the insurance company and/or the physician's group. Both phone numbers for customer care or service should be listed on the reverse side of your insurance card. If not, they PCP's office staff can find the phone numbers for you. Just ask.
When contacting either the insurance company and/or the physician's group, ask for customer service, or a benefit coordinator. Tell them you need a specialist for an explanation of your benefits. They should be able to answer all your questions or direct you to whomever can. Keep asking any and all questions until you are satisfied. Even if that means several calls over several days. It's better to know the answers up front, rather than be shocked with the bills arrive. Additionally, the Insurance company and/or Physician's group may require you to have certain tests and/or other treatments before you can proceed with surgeries or more expensive treatments, etc. They may also request recommendations from several Doctors and send you to see more Specialists for testing and opinions. Try to relax, and understand this is part of the process. However, don't allow yourself to be treated without care or concern for your condition or well being. If you are in pain and all the poking and prodding makes it worse, then demand to be given medication to help you cope and control your pain. If you feel no one is listening, then by all means stop them and make them listen.
If you still feel you're not being treated fairly or with respect or concern, then I would contact the local health care advocacy group. They are usually local by city or state and are part of a government run oversight. However, they do a lot of good. Generally, they are staffed by knowledgeable volunteers and others paid for their expertise. They can be a wealth of information and help. Just keep in mind, they are partly government run and therefore not always easy to get through to on the first few tries, and they do require lots of information from you before they'll proceed in assisting you. They may also have their own suggestions as to how to deal with your situation -- and I mean writing letters!, more specifically. So, call them, but be prepared for lots of advice, phone numbers, local support groups, other advocacy centers, addresses, etc.
Another place to contact, if you're truly still desperate for answers is the Dept. of Corporations, Health care division. They deal with HMO's, PPO's, and other health insurance groups. They take their time responding, and generally you'll be required to put your complaint or problem in writing from beginning to present.
Also, if you are covered by Medicare, or a Medicare provided insurance, then you can also contact them for general assistance, however, they will most likely refer you back to the Insurance company or Physician's group or another advocacy group. But, again they may have some helpful information.
In any case, asking questions can only be helpful. There are no stupid questions and every one's entitled to know the full story, especially when it pertains to your own body and the care of that body. You cannot make an informed decision or consent without being first fully informed to your own satisfaction. Do not allow the Doctors, the Insurance companies, etc., to bully you into making decisions without understanding why. While I realize some situations warrant urgency, I still believe you can be fully informed within a matter of minutes when one so chooses to do so. I've been in several urgent situations where I've had to make a choice with very little understanding. But, as I've also learned, if you continue to ask questions and voice your real concerns, most Doctors and staff do feel compelled to answer them as best they can. Unfortunately, only you can determine when you know enough to make an informed and educated choice. So, until you're there, stick to your guns and get those answers!
- Who's in charge when I need help and answers, but I can't get them?
- Who's in charge when I don't agree with my Doctor or my options?
- Who's in charge when I have a legitimate complaint that's being ignored?
- Who's in charge when I'm being billed incorrectly?
- Who's in charge when I get denied?
Who's in charge when I need help and answers, but can't get them?
First, I'd start at the source. Ask your Doctor. Tell him/her what it is that you need help or answers to? I've found most Doctors to be very intelligent, patient, and full of unexpected guidance when looking for answers. Remember, most Doctors have heard and seen just about everything. Plus, contrary to popular belief, they are human and do experience problems very similar to our own. If the Doctor doesn't have the answers themselves, I wouldn't be surprised if they at least didn't offer sound advice as to how to find the answers you seek. If not, keep your head up, there are several more places for answers, depending on the specific question. Let's assume that you need answers regarding specific medical treatment. Well, then your PCP should be a wealth of information, or they should have some idea about who would. Let's say they recommend that you consult with a Specialist. This is a good start, but don't get too overconfident. Specialists are like opinions, and believe me, they each have their own, unshakable opinion about what is and isn't the perfect thing for you! So, you meet with a Specialist, and they either give you the answers you want, or they add to the confusion, giving you more questions than answers. Shake it off and return to your PCP for another referral to a different Specialist. Explain why you felt that you and the Special you saw, seemed to have differing opinions, and you would prefer an alternate opinion before deciding what to do. Be determined. You are entitled to secondary opinions, especially when it involves any type of surgery or invasive treatment. You can also, while you're waiting to see this second Specialist, use the Internet to do some research. You should have formed some specific questions by now, after consulting with two different Doctors on the subject. Look for websites that are technical in terms about your specific situation or condition. But, also search for support groups having any relationship with your specific condition. These are average people from around the globe who have had or are dealing with the same problems you're facing. They sometimes can be your greatest resource guide. A lot of times, these people have stood exactly in your shoes, with lots of questions, and very few answers that aren't technical and unsympathetic toward your plight. These people understand that you not only need answers, you need reassurance that you're not alone. That there are others who've been where you are now and somehow they got though all of it.
Now while I strongly recommend listening to the advice and experiences of others, especially if they have or they are experiencing the same issues you're trying to deal with yourself. However, please use caution before wholeheartedly heeding someone else's advice, alone. This is the same as only looking at one side of a coin. There may be something vital and important on the other side. I would take the advice given as a starting point. Use their previous experiences and failures to guide you in the direction that's right for you, personally. This way, combined with your technical research, you can go see the second Specialist with a better understanding of what lies ahead. And, can now formulate questions of what's still bothering you.
If however, after all this, you are still unsure or can't get the answers you need. Then I would begin contacting other resources. For instance, maybe after all your research and talking with the Doctors, you've come to a conclusion on which treatment, etc., to pursue, however, you still have questions about where to go?, which Doctor to use?, how much will you have to payout of your own pocket?, Will you stay at the hospital or will this be outpatient care?, or What about after care and/or physical therapy?
These questions should be directed to the insurance company and/or the physician's group. Both phone numbers for customer care or service should be listed on the reverse side of your insurance card. If not, they PCP's office staff can find the phone numbers for you. Just ask.
When contacting either the insurance company and/or the physician's group, ask for customer service, or a benefit coordinator. Tell them you need a specialist for an explanation of your benefits. They should be able to answer all your questions or direct you to whomever can. Keep asking any and all questions until you are satisfied. Even if that means several calls over several days. It's better to know the answers up front, rather than be shocked with the bills arrive. Additionally, the Insurance company and/or Physician's group may require you to have certain tests and/or other treatments before you can proceed with surgeries or more expensive treatments, etc. They may also request recommendations from several Doctors and send you to see more Specialists for testing and opinions. Try to relax, and understand this is part of the process. However, don't allow yourself to be treated without care or concern for your condition or well being. If you are in pain and all the poking and prodding makes it worse, then demand to be given medication to help you cope and control your pain. If you feel no one is listening, then by all means stop them and make them listen.
If you still feel you're not being treated fairly or with respect or concern, then I would contact the local health care advocacy group. They are usually local by city or state and are part of a government run oversight. However, they do a lot of good. Generally, they are staffed by knowledgeable volunteers and others paid for their expertise. They can be a wealth of information and help. Just keep in mind, they are partly government run and therefore not always easy to get through to on the first few tries, and they do require lots of information from you before they'll proceed in assisting you. They may also have their own suggestions as to how to deal with your situation -- and I mean writing letters!, more specifically. So, call them, but be prepared for lots of advice, phone numbers, local support groups, other advocacy centers, addresses, etc.
Another place to contact, if you're truly still desperate for answers is the Dept. of Corporations, Health care division. They deal with HMO's, PPO's, and other health insurance groups. They take their time responding, and generally you'll be required to put your complaint or problem in writing from beginning to present.
Also, if you are covered by Medicare, or a Medicare provided insurance, then you can also contact them for general assistance, however, they will most likely refer you back to the Insurance company or Physician's group or another advocacy group. But, again they may have some helpful information.
In any case, asking questions can only be helpful. There are no stupid questions and every one's entitled to know the full story, especially when it pertains to your own body and the care of that body. You cannot make an informed decision or consent without being first fully informed to your own satisfaction. Do not allow the Doctors, the Insurance companies, etc., to bully you into making decisions without understanding why. While I realize some situations warrant urgency, I still believe you can be fully informed within a matter of minutes when one so chooses to do so. I've been in several urgent situations where I've had to make a choice with very little understanding. But, as I've also learned, if you continue to ask questions and voice your real concerns, most Doctors and staff do feel compelled to answer them as best they can. Unfortunately, only you can determine when you know enough to make an informed and educated choice. So, until you're there, stick to your guns and get those answers!
Monday, June 14, 2010
How Sick?
Prologue
Please remember the following entry is the personal opinion of the writer. No medical advice should be construed as fact. Always follow professional medical advice when seeking medical attention. The writer has no medical training or expertise, other than their own personal experiences as a patient. You should always consult trained and accredited medical personnel for any and all medical situations.
How Sick?
Of course, the age old question in dealing with Doctor, etc., is just simply how sick am I, and when does it warrant further investigation? I don't know about everyone else, so we'll use my barometer to measure:
If you're too sick to go to work, school, etc., you're probably sick enough to stay home and in bed.
If, however, you're running a high temperature, have nausea, diarrhea, or a blinding headache, then you should at the very least consider going to see your Primary Care Physician.
If you feel too sick to drive, or make any decisions, I'd recommend an Urgent Care facility.
If you can't make heads or tails about what to do, I'd consider visiting the Emergency Room.
Now, I realize these are oversimplified instances and each person should determine their own comfort level when seeking medical treatment, but a lot of the time, things aren't quite so easy to decide.
Usually for myself, if I can make sound choices about my care, then I keep to my home or see my PCP. Especially if "it" doesn't seem to want to leave. If, however, I start wondering aloud and not making much sense, then I tend to believe I'm a lot sicker than I'd realized. That's when I consider the Urgent Care facility.
Not always, but occasionally, I've gone to see the PCP and have been sent on to the Urgent Care or Emergency Room. But mostly, I try to keep my choices clear and direct. If something seems broken, such as an arm or toe, or if I need stitches for a deep cut --- those are obvious Urgent Care visits. But, if I also hit my head, plus I believe I've broken a bone, well then I'm headed straight to the Emergency Room asap!
These are basics. Everyone has their point of a slip -up vs a disaster. The really difficult test comes when you're not sure what's happening! For instance: you have an upset stomach with a little pain. Now what? Well, first, I'd call the PCP's office and ask them what they'd recommend. Unfortunately, as we've already discovered and discussed, a great many times your attempts to call a PCP go unheeded or ignored altogether.
If it's something completely new, and doesn't appear to have any reasons for it, I'd at least go to an Urgent Care facility. It may waste a great deal of time, but you never know when it could be serious. If you can't decide, a bit of waiting and some Internet research may be very helpful. Who knows, maybe the potato salad didn't agree with you today, or after the third day in a row. Or, it could be the virus plaguing all your co-workers.
The truth is you'll never know all the right choices ahead of time. Only in hindsight can we make error free choices. So, what to do? Ask yourself some basic questions, and be honest!:
Does it hurt bad enough to warrant being poked and prodded?
Is this worse than anything you've ever had before?
Does this seem different from the countless times you've been sick before?
Do you feel you need a Doctor's opinion?
Are you worried or overly concerned about how you feel?
Does your spouse, significant other, or friends feel you should see medical attention?
If someone else had the exact same symptoms, what would you advise them to do?
Are you only putting off a visit to the Urgent Care facility or Emergency Room or PCP's office, because of the amount of time you'd be waiting?
What's the worst that could happen if you go see a Doctor?
What's the worst that could happen if you don't go see a Doctor?
Can you tolerate the symptoms comfortably until tomorrow, or when you can get an appointment with your PCP?
Is there anything you can do to relieve or alleviate your symptoms right now?
If you answered all these questions truthfully and honestly, and without any guilt, then you should have a pretty good idea about what to do. I find, for the most part, common sense, and knowing yourself well, is the best barometer in determining when something needs further attention. If you're truly uncertain, then a dose of caution is usually the best course of action.
Just remember, your health is a life and death matter! No amount of joking or glossing it over can change that one fact. So, keep that in mind the next time you wonder whether you're wasting every one's time and efforts. Even the smallest molehill can become a mountain, left to it's own devices! Besides, just consider it as a small repayment towards all the hours you've wasted waiting for the Doctor to get around to you.
Wednesday, June 9, 2010
Is anybody listening?
Another truly irritating fact in dealing with health care is everyone talking, having their own opinions, while nobody seems to be listening to what anyone else is saying. Is anybody truly listening?
Take for instance the case of my family member -- They scheduled an appointment to discuss with the Doctor that they were finally willing to have the recommended surgery form the previous year. The request came with another hopeful scheduling request, so that a visiting family member could be there to help out during recovery. The response to that request wasn't met with to much enthusiasm. Stating that 2-3 weeks was impossible! Now the most ironic thing is that the appointment took almost 5 weeks to schedule, which would have given them sufficient time to perform all pre-operation tests, plus the operation. Here is where the rubber and road meet to no effect. Now the next step as required by the doctor, is to have an MRI scheduled and done before any thought of surgery could be considered. So, paperwork was sent to the insurance company for authorization. It was processed and approved by May 18th; sent to the patient on May 22nd; and received by the patient on May 26th. With the holiday weekend looming, the patient waited until the following week to call for an appointment. When they did call the approved testing facility, they were told it could not be scheduled as they had not received the instructions from the Primary Care Physician's office.
After six (6) phone calls to five (5) different people: the doctor's assistant, the referral dept. clerk, the scheduling clerk (all at the PCP's office) and the MRI scheduling clerk and office manager (at the MRI facility), I was only able to leave six (6) separate messages regarding this situation. This is a typical problem where someone dropped the ball in doing their paperwork, creating a log-jam for everyone else. But the real travesty is when you're trying to get it corrected or dealt with, and they don't listen.
Trying to find the right person, department, and/or the right placed to call for help seems daunting. But, help is out there, it just takes a lot of working the phones, asking questions, and not giving up!
In the particular case described, the representatives from the Doctor's office, instead of listening to what the problem actually is, quickly take offense toward the patient and them pointing out that they haven't done their job properly. I personally don't care whose right, wrong or purple -- just fix the problem, please! Additionally, the MRI facility could have just as easily made the appointment and called the PCP's office for the needed information, themselves. Not only were they not listening, they were stating very clearly that is was not their job. How petty we've become when dealing with health care.
The simple truth is there isn't enough time to get your point across when you're at the doctor's office, and when you're not, you can't get anyone to talk to you. Most questions and problems could be very easily dealt with if the parties involved would just check their personalities and insecurities at the door. Most people don't try to point out other's faults. It's impolite and ill mannered. The majority of us don't care enough to correct a stranger, so why should we care to point out anything? The truth is they just want to get from point A to point B with as little problem as possible. Unfortunately, the insurance company and Doctor's groups say the PCP has to be involved along every step of the way. So, until they say it's OK for you to go to point B, you're stuck waiting at point A.
So, what to do? Keep calling. Keep talking. Keep trying to get your point across to the Doctor's staff. Eventually you'll get somewhere. Even if it just because they're tired of hearing from you. In any case, in my particular situation, the log became very quickly unjammed when I suggested to the MRI scheduling clerk that they try to contact the PCP, as I obviously was not getting any results from my attempts to get the situation corrected. (There is more than one way to skin a cat..) Within 20 minutes, I not only had an appointment scheduled, but scheduled for the following day! Plus receiving a phone call from the Doctor/PCP's office to verify that all was well and taken care of.
It's just that simple. All it takes is one person to listen to the problem and react with proper action, to make all the problems disappear! Just think how much simpler our lives would be if everyone stopped long enough to listen to the problem at hand and just fix it!
Take for instance the case of my family member -- They scheduled an appointment to discuss with the Doctor that they were finally willing to have the recommended surgery form the previous year. The request came with another hopeful scheduling request, so that a visiting family member could be there to help out during recovery. The response to that request wasn't met with to much enthusiasm. Stating that 2-3 weeks was impossible! Now the most ironic thing is that the appointment took almost 5 weeks to schedule, which would have given them sufficient time to perform all pre-operation tests, plus the operation. Here is where the rubber and road meet to no effect. Now the next step as required by the doctor, is to have an MRI scheduled and done before any thought of surgery could be considered. So, paperwork was sent to the insurance company for authorization. It was processed and approved by May 18th; sent to the patient on May 22nd; and received by the patient on May 26th. With the holiday weekend looming, the patient waited until the following week to call for an appointment. When they did call the approved testing facility, they were told it could not be scheduled as they had not received the instructions from the Primary Care Physician's office.
After six (6) phone calls to five (5) different people: the doctor's assistant, the referral dept. clerk, the scheduling clerk (all at the PCP's office) and the MRI scheduling clerk and office manager (at the MRI facility), I was only able to leave six (6) separate messages regarding this situation. This is a typical problem where someone dropped the ball in doing their paperwork, creating a log-jam for everyone else. But the real travesty is when you're trying to get it corrected or dealt with, and they don't listen.
Trying to find the right person, department, and/or the right placed to call for help seems daunting. But, help is out there, it just takes a lot of working the phones, asking questions, and not giving up!
In the particular case described, the representatives from the Doctor's office, instead of listening to what the problem actually is, quickly take offense toward the patient and them pointing out that they haven't done their job properly. I personally don't care whose right, wrong or purple -- just fix the problem, please! Additionally, the MRI facility could have just as easily made the appointment and called the PCP's office for the needed information, themselves. Not only were they not listening, they were stating very clearly that is was not their job. How petty we've become when dealing with health care.
The simple truth is there isn't enough time to get your point across when you're at the doctor's office, and when you're not, you can't get anyone to talk to you. Most questions and problems could be very easily dealt with if the parties involved would just check their personalities and insecurities at the door. Most people don't try to point out other's faults. It's impolite and ill mannered. The majority of us don't care enough to correct a stranger, so why should we care to point out anything? The truth is they just want to get from point A to point B with as little problem as possible. Unfortunately, the insurance company and Doctor's groups say the PCP has to be involved along every step of the way. So, until they say it's OK for you to go to point B, you're stuck waiting at point A.
So, what to do? Keep calling. Keep talking. Keep trying to get your point across to the Doctor's staff. Eventually you'll get somewhere. Even if it just because they're tired of hearing from you. In any case, in my particular situation, the log became very quickly unjammed when I suggested to the MRI scheduling clerk that they try to contact the PCP, as I obviously was not getting any results from my attempts to get the situation corrected. (There is more than one way to skin a cat..) Within 20 minutes, I not only had an appointment scheduled, but scheduled for the following day! Plus receiving a phone call from the Doctor/PCP's office to verify that all was well and taken care of.
It's just that simple. All it takes is one person to listen to the problem and react with proper action, to make all the problems disappear! Just think how much simpler our lives would be if everyone stopped long enough to listen to the problem at hand and just fix it!
Friday, May 28, 2010
Becoming Visible
I've found the most frustrating part of dealing with health care, is being treated like a number, not a person. It begins innocently enough - "here, fill out forms x, y & z, then take them to Window B." So, you do. Then Window B asks you to have a seat, "they'll call you, shortly." 20 minutes and two tattered magazines later, you get to show your identification and insurance card, sign some release papers, and then again are asked to wait. When you try to inquire as to how much longer it will be, you're met with sarcasm and disdain. "They'll check, but it looks as though they're a little behind, so it shouldn't be more than 20 minutes or so." It hasn't occurred to anyone yet that you've already been there waiting for an hour, and the appointment you scheduled was well over 30 minutes ago. Still they have no answers for the delay. It's always some vague reference to being behind schedule. Are they ever on schedule?
If I'm waiting patiently. That is without causing a scene, then don't I deserve the right to ask reasonable and legitimate questions? And, if so, then why does the staff look at me as though I'd grown horns or a third eye in the center of my forehead? If they don't want patients to ask questions or be vocal, then they should attempt to communicate with them. Offering an apology now and then doesn't hurt either. We are, after all, the paying customer. A fact they are often too quick to forget. If they were in any other business, the thought of any customer waiting for more than 20 minutes is simply unheard of -- especially without offering profuse apologies, detailed explanations and often associated with generous discounts and/or freebies. But the health care industry feels no such compunction. They regularly eat up hours of our personal time without thought or care. You truly begin to feel very invisible!
Don't allow yourself to be taken in by such bullying tactics. If you are made to wait beyond your appointment time, ask why? And keep asking why and how long you are expected to wait. Ask if you can reschedule when they're having a more productive day. Or, if you can just have them ring you on your cell when they're ready, so you can go take care of a few errands? While I GUARANTEE you'll get some of the worst responses to these suggestions, you're not being unreasonable! Stand up for yourself and be prepared to walk out. Now, I know this seems a bit extreme. But, if more people became proactive instead of reactive towards how health care treats us, and the tremendous amount of waiting we're forced to endure, we would have a more streamlined system. Did you know that the appointment that you scheduled was also given to at least 5-8 other patients? They call it patient loading. I call it something else, but that's another blog story. This way they figure all patients arrive at varying times before the scheduled appointment time, and can be dealt with in the order that they arrive. That is if everything goes according to plan, which rarely happens. So, while you've taken yet more time away from your job, family, and other priorities, they want to jam you into an impossible appointment schedule. Just the math boggles the mind. One doctor seeing 5-8 patients every 15 minutes? That's less than 2 minutes each. It doesn't work, which is why you're in this holding pattern for over an hour.
Stand up for yourself and your time. Become visible! Ask when you check in, how long the wait will be. If they say 10 minutes, add at least 15 more onto that. If you've been waiting longer than 20 minutes, ask why and if you can reschedule. Now most staff members can be rude, busk, unprofessional, and argumentative. You should generally expect some form of frost in their tone and manner. Unfortunately, the sorry truth is they are overworked, overburdened with paperwork, and you're probably the 20th person today to infer they're not doing their job. And, that 's exactly how they see it.
Most of the blame for all you're complaining about can be lain at the door of the insurance companies and physician's groups. They create the environment that causes doctors to overbook patients on a daily basis. Add to that, all the incentives they're given to limit care to just seeing your Primary Care Physician, and you have the current situation. A mess without end.
The key to becoming visible is to become known to your doctor's staff. Some people use bribery - cookies, candy, etc., others engage in personal conversations with staff members, creating a "friend" environment, while still others gain attention in all the wrong ways. Now while I recommend that you stand up for yourself, a little self restraint never hurt anyone and may be to your advantage later on.. Please do keep in mind that these are the few people whom can become your greatest ally and asset or your worst nightmare and adversary. If you can make your point without pissing off your allies, then please do so. You should be commended as truly gifted. But if you are like the other 99.9% of us, take time to consider life from their prospective. A never ending parade of impatient, rude, busk, and sarcastic patients. They have zero authority over who gets seen when, or whom waits longer or not. But.....if you can get them on your side, say as a friend or mutual acquaintance, they can be a wealth of information. Regarding the best days and times to schedule appointments, or even better, the worst possible times you should avoid at all costs. Some have even managed to squeeze me in a slot that didn't actually exist, just so I didn't have to wait.
Just counting to ten and calming your own temper can be the huge asset in gaining visibility. You can still ask to reschedule, but without the anger and defensive manner, you're more likely to get a better time slot and a lot less waiting. It doesn't always work, especially when visiting the radiological or speciality doctors that you see only rarely. But a few wise tips can help. Ask when the best time is for the least of amount of waiting. Also, go prepared to wait. Bring a book, magazines, that unfinished crossword puzzle, or whatever makes the time pass more quickly for you. Anything that distracts you from the amount of time you're wasting is great. So find something productive to do with your waiting time. With all these electronic gadgets in pocket size, I'd almost bet you could get the same amount of work done in the waiting room as you normally would at work.
If I'm waiting patiently. That is without causing a scene, then don't I deserve the right to ask reasonable and legitimate questions? And, if so, then why does the staff look at me as though I'd grown horns or a third eye in the center of my forehead? If they don't want patients to ask questions or be vocal, then they should attempt to communicate with them. Offering an apology now and then doesn't hurt either. We are, after all, the paying customer. A fact they are often too quick to forget. If they were in any other business, the thought of any customer waiting for more than 20 minutes is simply unheard of -- especially without offering profuse apologies, detailed explanations and often associated with generous discounts and/or freebies. But the health care industry feels no such compunction. They regularly eat up hours of our personal time without thought or care. You truly begin to feel very invisible!
Don't allow yourself to be taken in by such bullying tactics. If you are made to wait beyond your appointment time, ask why? And keep asking why and how long you are expected to wait. Ask if you can reschedule when they're having a more productive day. Or, if you can just have them ring you on your cell when they're ready, so you can go take care of a few errands? While I GUARANTEE you'll get some of the worst responses to these suggestions, you're not being unreasonable! Stand up for yourself and be prepared to walk out. Now, I know this seems a bit extreme. But, if more people became proactive instead of reactive towards how health care treats us, and the tremendous amount of waiting we're forced to endure, we would have a more streamlined system. Did you know that the appointment that you scheduled was also given to at least 5-8 other patients? They call it patient loading. I call it something else, but that's another blog story. This way they figure all patients arrive at varying times before the scheduled appointment time, and can be dealt with in the order that they arrive. That is if everything goes according to plan, which rarely happens. So, while you've taken yet more time away from your job, family, and other priorities, they want to jam you into an impossible appointment schedule. Just the math boggles the mind. One doctor seeing 5-8 patients every 15 minutes? That's less than 2 minutes each. It doesn't work, which is why you're in this holding pattern for over an hour.
Stand up for yourself and your time. Become visible! Ask when you check in, how long the wait will be. If they say 10 minutes, add at least 15 more onto that. If you've been waiting longer than 20 minutes, ask why and if you can reschedule. Now most staff members can be rude, busk, unprofessional, and argumentative. You should generally expect some form of frost in their tone and manner. Unfortunately, the sorry truth is they are overworked, overburdened with paperwork, and you're probably the 20th person today to infer they're not doing their job. And, that 's exactly how they see it.
Most of the blame for all you're complaining about can be lain at the door of the insurance companies and physician's groups. They create the environment that causes doctors to overbook patients on a daily basis. Add to that, all the incentives they're given to limit care to just seeing your Primary Care Physician, and you have the current situation. A mess without end.
The key to becoming visible is to become known to your doctor's staff. Some people use bribery - cookies, candy, etc., others engage in personal conversations with staff members, creating a "friend" environment, while still others gain attention in all the wrong ways. Now while I recommend that you stand up for yourself, a little self restraint never hurt anyone and may be to your advantage later on.. Please do keep in mind that these are the few people whom can become your greatest ally and asset or your worst nightmare and adversary. If you can make your point without pissing off your allies, then please do so. You should be commended as truly gifted. But if you are like the other 99.9% of us, take time to consider life from their prospective. A never ending parade of impatient, rude, busk, and sarcastic patients. They have zero authority over who gets seen when, or whom waits longer or not. But.....if you can get them on your side, say as a friend or mutual acquaintance, they can be a wealth of information. Regarding the best days and times to schedule appointments, or even better, the worst possible times you should avoid at all costs. Some have even managed to squeeze me in a slot that didn't actually exist, just so I didn't have to wait.
Just counting to ten and calming your own temper can be the huge asset in gaining visibility. You can still ask to reschedule, but without the anger and defensive manner, you're more likely to get a better time slot and a lot less waiting. It doesn't always work, especially when visiting the radiological or speciality doctors that you see only rarely. But a few wise tips can help. Ask when the best time is for the least of amount of waiting. Also, go prepared to wait. Bring a book, magazines, that unfinished crossword puzzle, or whatever makes the time pass more quickly for you. Anything that distracts you from the amount of time you're wasting is great. So find something productive to do with your waiting time. With all these electronic gadgets in pocket size, I'd almost bet you could get the same amount of work done in the waiting room as you normally would at work.
Thursday, May 20, 2010
Trying to get in.
For most of us, finding the right doctor is a moot point. We already have one we're relatively satisfied with, and knows our medical history. So, we fortunate souls can skip the initial consultation preparedness speech, and move directly on to our problems.
Why is it that once you're in, you can never get in? Or, get an appointment, that is without what seems like an act of Congress? Now, not all doctor's operate this way, but enough do to warrant further investigation.
What is the problem? The problem is that with the capitation HMO and PPO plans of insurance, most doctors are squeezed into a Physician's Group. Each step further down the ladder away from the insurance company your doctor is, well the fewer direct dealing they have with the actual insurance company. Therefore, your monthly premium gets hacked up into bits for each rung on that ladder: Step one - the insurance company; Step two - the Administrative costs; Step three - the Physician's Group; and steps four, five and six are juggled between the Doctor, the laboratory, and radiological groups. That's a mighty thin slice of the pie left to your Doctor. Plus, there are incentives to all to save money by restricting (denying) care. So, to make up for this thinning paycheck, the Doctor's do what any good business person does. Take on more clients (patients). On average, most Doctors see only 25-30% of the actual total patients that are assigned to their practice. Even that percentage is high volume, averaging 75-150 patients per week or more. It becomes somewhat like visiting Disneyland during the height of summer, Saturday afternoon. Chances are you'll be in for a lot of waiting. Same principles apply to getting that appointment. The more patients they have to see within only so many office hours, tends to strangle both the amount of time allotted for each patient, and the number of openings for future visits gets pushed further and further apart.
If you don't regularly see your Doctor, chances are excellent that when you call to schedule that appointment, they won't have any times available for 6-8 weeks, if you're lucky. Need to schedule on a certain day or between specific hours, add another 2-3 weeks onto your wait. It's a fact of our health care industry - fewer Doctors, being paid less per patient, to do twice the paperwork on top of treating numerous new ailments, illnesses, plus all those new drugs being pimped to you via television.
While you're waiting for that 6-8 weeks or more to pass, here are a few excerpts from my previous blog regarding the initial appointment, that may be helpful:
1. Ask if you need to complete any forms. If so, have them mailed, faxed, or go pick them up. Then you can fill them out and return them before the 6-8 weeks.
2. Ask if you should have any tests done. Usually the Doctor will want to assess your condition before any tests, but it can't hurt to ask. It may be that you're due to have blood work done or a mammogram, EKG, etc. This way you can be doing something productive while waiting for the appointment.
3. Always ask to be called if there is an opening &/or cancellation before your scheduled appointment. You never know when someone may be hospitalized or change their mind or have a conflicting schedule. Don't be afraid to ask, it happens more than you realize, but if you don't let them know you'd be willing to accept an alternate appointment time, then they assume you're content with the one you have.
4. Be prepared with a brief synopsis of your health ailments since last seen, anything new, including medications, emergency room or urgent care visits, etc. Also, include a list of questions you'd like to discuss with the Doctor.
5. Bring any recent lab work results, x-rays, etc., with you. If you are unable to hand carry these items, make a note as to the date and place any tests &/or x-rays, etc., were performed, so they can get the results efficiently.
6. Review your notes and make a plan. Most Doctors are so overwhelmed they have little time for each patient. Have a plan ready - the most important information relayed early, along with the most important questions. It may feel as thought you've entered a race against time while trying to jam everything into the conversation with your Doctor. That's why making those lists, notes, and having a plan of attach are so vital. Now, I don't recommend pouncing on the Doctor like some hyena, but try not to waste any time hemming and hawing about why you're there. Be direct, clear and concise. State your case. Ask your questions. But do allow the Doctor the courtesy to speak now and again. They may even want to see your list and reorder items to what they consider most important. So try to write as clearly as possible. Remember you only have a short amount of time to convey your health concerns and questions to a busy Doctor - you don't want to stumble over poor hand writing.
7. Take notes. Listen to what your Doctor is saying. After all, you've waited all this time for their advice, so listen up and write down the important points. It something isn't clear, ask for clarification. It's very important you fully understand your Doctors' actions, whether that's sending you for tests or to another Doctor or Specialist. Ask why and what they hope to accomplish with these actions and if you need to relay any information or do anything further.
8. Follow-up. If you're being treated in any manner - medications, tests, or referrals, always follow up with the Primary Care Physician.
9. Make the follow up appointment today. Don't wait to call in, ask when to follow up and make an appointment to do so today.
The truth is, Doctor's need to hold back some appointment times to see returning patients who need to be seen on a timely basis. For medication refills that are restricted, or cast or stitches that need timely attention, etc., They don't put you off just to piss you off, it's just part of they necessary plan in seeing patients in the order of medical urgency. Remember that when you call to make the appointment. Sometimes the key is to what you relay to the scheduling clerk, and how serious sounding it seems. Who knows, it could shorten your wait time down to 2-4 weeks or even less.
Why is it that once you're in, you can never get in? Or, get an appointment, that is without what seems like an act of Congress? Now, not all doctor's operate this way, but enough do to warrant further investigation.
What is the problem? The problem is that with the capitation HMO and PPO plans of insurance, most doctors are squeezed into a Physician's Group. Each step further down the ladder away from the insurance company your doctor is, well the fewer direct dealing they have with the actual insurance company. Therefore, your monthly premium gets hacked up into bits for each rung on that ladder: Step one - the insurance company; Step two - the Administrative costs; Step three - the Physician's Group; and steps four, five and six are juggled between the Doctor, the laboratory, and radiological groups. That's a mighty thin slice of the pie left to your Doctor. Plus, there are incentives to all to save money by restricting (denying) care. So, to make up for this thinning paycheck, the Doctor's do what any good business person does. Take on more clients (patients). On average, most Doctors see only 25-30% of the actual total patients that are assigned to their practice. Even that percentage is high volume, averaging 75-150 patients per week or more. It becomes somewhat like visiting Disneyland during the height of summer, Saturday afternoon. Chances are you'll be in for a lot of waiting. Same principles apply to getting that appointment. The more patients they have to see within only so many office hours, tends to strangle both the amount of time allotted for each patient, and the number of openings for future visits gets pushed further and further apart.
If you don't regularly see your Doctor, chances are excellent that when you call to schedule that appointment, they won't have any times available for 6-8 weeks, if you're lucky. Need to schedule on a certain day or between specific hours, add another 2-3 weeks onto your wait. It's a fact of our health care industry - fewer Doctors, being paid less per patient, to do twice the paperwork on top of treating numerous new ailments, illnesses, plus all those new drugs being pimped to you via television.
While you're waiting for that 6-8 weeks or more to pass, here are a few excerpts from my previous blog regarding the initial appointment, that may be helpful:
1. Ask if you need to complete any forms. If so, have them mailed, faxed, or go pick them up. Then you can fill them out and return them before the 6-8 weeks.
2. Ask if you should have any tests done. Usually the Doctor will want to assess your condition before any tests, but it can't hurt to ask. It may be that you're due to have blood work done or a mammogram, EKG, etc. This way you can be doing something productive while waiting for the appointment.
3. Always ask to be called if there is an opening &/or cancellation before your scheduled appointment. You never know when someone may be hospitalized or change their mind or have a conflicting schedule. Don't be afraid to ask, it happens more than you realize, but if you don't let them know you'd be willing to accept an alternate appointment time, then they assume you're content with the one you have.
4. Be prepared with a brief synopsis of your health ailments since last seen, anything new, including medications, emergency room or urgent care visits, etc. Also, include a list of questions you'd like to discuss with the Doctor.
5. Bring any recent lab work results, x-rays, etc., with you. If you are unable to hand carry these items, make a note as to the date and place any tests &/or x-rays, etc., were performed, so they can get the results efficiently.
6. Review your notes and make a plan. Most Doctors are so overwhelmed they have little time for each patient. Have a plan ready - the most important information relayed early, along with the most important questions. It may feel as thought you've entered a race against time while trying to jam everything into the conversation with your Doctor. That's why making those lists, notes, and having a plan of attach are so vital. Now, I don't recommend pouncing on the Doctor like some hyena, but try not to waste any time hemming and hawing about why you're there. Be direct, clear and concise. State your case. Ask your questions. But do allow the Doctor the courtesy to speak now and again. They may even want to see your list and reorder items to what they consider most important. So try to write as clearly as possible. Remember you only have a short amount of time to convey your health concerns and questions to a busy Doctor - you don't want to stumble over poor hand writing.
7. Take notes. Listen to what your Doctor is saying. After all, you've waited all this time for their advice, so listen up and write down the important points. It something isn't clear, ask for clarification. It's very important you fully understand your Doctors' actions, whether that's sending you for tests or to another Doctor or Specialist. Ask why and what they hope to accomplish with these actions and if you need to relay any information or do anything further.
8. Follow-up. If you're being treated in any manner - medications, tests, or referrals, always follow up with the Primary Care Physician.
9. Make the follow up appointment today. Don't wait to call in, ask when to follow up and make an appointment to do so today.
The truth is, Doctor's need to hold back some appointment times to see returning patients who need to be seen on a timely basis. For medication refills that are restricted, or cast or stitches that need timely attention, etc., They don't put you off just to piss you off, it's just part of they necessary plan in seeing patients in the order of medical urgency. Remember that when you call to make the appointment. Sometimes the key is to what you relay to the scheduling clerk, and how serious sounding it seems. Who knows, it could shorten your wait time down to 2-4 weeks or even less.
Tuesday, May 11, 2010
Talk to the Doctor
It does matter what you say and how you say it.
Now while most doctor visits seem cruel and unnecessary punishment for most, there are ways to get though it all and still get the most out of each visit.
1. Be clear. Be clear as to why you came to the doctor's office today. Make a list of any symptoms you have, your general health since the last visit, along with any questions you specifically want to discuss with the doctor.
2. Present your case. Present your health case as if you literally were at a trial and are only allowed 60 seconds to make an opening statement. Focus on the most important items first. Be brief, yet concise. For example: I had a stomach ache with diarrhea 3 days ago, for 24 hours, off and on. I ate sushi about 3 hours before it started, etc. I took Imodium 2 times and drank Gatorade for 2 days. Today I'm feeling better, still weak, shaky, and my stomach is still feeling irritated and sore, etc.
3. Give a brief family history. Briefly add any pertinent information about the history of any family members health, as it pertains to your current conditions. i.e., My mom and brother have acid reflux disease, my Aunt has a Heyerdahl hernia, and my dad has a stomach ulcer. These are important pieces of a health care puzzle that the doctor is trying to piece back together.
4. Don't assume anything. Don't assume that just because you remember discussing possible medical conditions or treatment with the doctor 2 months ago, that the doctor will remember the conversation, much less any important factors. Also, don't assume the doctor remembers this is the 4th time you've had similar symptoms. There are many possibilities, remember each piece of information is like another puzzle piece. It makes the whole picture become more clear.
5. Keep things in prospective. Just because you're in pain, don't be too impatient. Most pain medications take away pain, but they also tend to make you sluggish and uncooperative. Also, they don't want any pain medications to mask any symptoms you're experiencing. That's why you'll feel as though you're being grilled by the police instead of the family doctor. They need to get as much useful information from you before any medication takes effect. So, refer back to Item #2, Present your case as clearly and concise as possible in the fewest words. When the doctor becomes satisfied they only need to treat the pain, and not send you elsewhere for more extensive testing, and the doctor is relatively certain as to what is happening to you physically, they probably won't give you anything to take away the pain. They may, however, if it's an extended time period needed to complete all tests, give you a small dose of some medications to ease the severity of your pain. Try to understand that they're trying to do their job effectively and aren't personally satisfied to see any patient in pain.
6. Keep your cool. While being sick and/or in pain is terrible itself, getting upset and angry doesn't help. It only make you feel worse, and makes those around you feel less like helping. No one wants to deal with anyone yelling or screaming at them. I know how difficult this can be, but trust me, you're doing yourself no favors by being grouchy and/or mean. If you are experiencing what you'd consider less than quality or prompt care, then ask someone with you to inquire as to the problem and/or delay. Their patience has not been compromised by pain and illness, so they are likely to approach the problem in a more dignified and tactful manner. Plus, the staff can hardly blame the patient if they're not the one complaining. It's important not to be labeled as being uncooperative or aggressive while being treated. Those two words can mean the difference of a 2 hour wait versus a 6+ hour wait. And, don't think that paperwork just magically becomes misplaced.
7. Be prepared. Like the boyscout motto, you should always go to the doctor prepared. Make certain you have a current insurance card and your personal identification with you. If you're dealing with medical care, be prepared to show both cards to almost everyone. Also, bring any reading glasses as you'll undoubtedly be handed several forms to complete and/or to read over and sign. Make sure you understand what it is you are signing. Also, if you have migraines, or regularly have nausea, then come prepared with an eye mask, ear plugs, ice packs, a wet wash cloth, a "barf" bag or bucket, tissues, or any thing else you can think of that you may need while you're waiting. Comfort items can make the difference between getting through the long wait or having to just grit your teeth and pull your hair out!
8. Try to relax. Conserving your energy whenever possible may be the only thing that will ultimately get you through until treatment arrives.
9. Ask questions. If you don't understand what someone is trying to explain to you about your health, the care you need, or the medications for you to take, then ask them to explain further. It serves no purpose if you don't comprehend the scope or magnitude of your care. You are the first line of defense for your body's ultimate healthy care, so make certain you know what that entails.
10. Follow-up. Always follow-up with your Primary Care Physician (PCP) after any illness, treatment , surgery, or testing. Even if you were seen elsewhere, such as an Emergency Room or Urgent Care facility, go see your personal physician to follow up afterwards. This is to make certain no other treatment, tests, or further care is necessary. Once a condition, illness, or surgery occurs, it can have long lasting effects on your overall health. So discuss what happened, what treatment was given, plus any medications prescribed, or any tests performed with your doctor. Keeping your Primary Care Physician in the loop is a vital part to keeping that puzzle whole and intact.
11. Listen to what your doctor says. Pay close attention to what your doctor says, especially if they are sending you for testing or to a Specialist. Make sure that you know what information is vital to relay to the testing facility and/or Specialist. Hemming and hawing about why you were sent there has negative effects on your health cause. "I don't know why my doctor sent me here.", will get you the least amount of care and/or concern from a Specialist. If they don't get the full story, including family history, the Specialist knows nothing except what they see before them. A person who's not certain why they're there, and who didn't bother to find out from their Primary Care. It you don't care, then why should the Specialist spend their precious time and resources to treat or aid someone who obviously doesn't participate in their own health care? It does matter what you say and how you say it. Most especially when relaying information between different doctors. You may not have all the answers, but what you do say can be the one factor that causes the Specialist or other doctor to pick up the phone and discuss your case with your Primary Care Physician, and/or other doctors. Withholding vital information irregardless of how embarrassing or personal can be the difference between care that's substantial versus minimal treatment that doesn't ultimately help you.
12. Make notes. Keep notes of important information from each Doctor you see. These will be very beneficial when seeking the help from a Specialist, or any health care facility, away from your Primary Care. Make a list of important points to discuss, pertinent information, tests, results, etc., to relay, plus any questions you may have.
Keep in mind, most doctors see on average 50 - 100 patients per week or more. After awhile they all begin to blur together, so forgive the doctor if they don't remember every detail of your health and care. You are your strongest and only advocate to enable you to receive the best care possible. Sitting silently, while waiting for the doctor to ask you questions won't get you much care. Be the patient, help your doctor to recall who you are, your current health concerns, plus any history you feel is necessary and important to bring to the doctor's attention. Then let them ask questions. Be your own ally. Help the doctor and their staff to help you by giving them what they need to provide you with the best care possible. Be vocal, but not aggressive. Be involved, but not in charge. Be aware, not taxing. Most of all, talk to your doctor and listen when they talk, too! Communication is the key to every great relationship. Remember you only get out what you put into it!
Now while most doctor visits seem cruel and unnecessary punishment for most, there are ways to get though it all and still get the most out of each visit.
1. Be clear. Be clear as to why you came to the doctor's office today. Make a list of any symptoms you have, your general health since the last visit, along with any questions you specifically want to discuss with the doctor.
2. Present your case. Present your health case as if you literally were at a trial and are only allowed 60 seconds to make an opening statement. Focus on the most important items first. Be brief, yet concise. For example: I had a stomach ache with diarrhea 3 days ago, for 24 hours, off and on. I ate sushi about 3 hours before it started, etc. I took Imodium 2 times and drank Gatorade for 2 days. Today I'm feeling better, still weak, shaky, and my stomach is still feeling irritated and sore, etc.
3. Give a brief family history. Briefly add any pertinent information about the history of any family members health, as it pertains to your current conditions. i.e., My mom and brother have acid reflux disease, my Aunt has a Heyerdahl hernia, and my dad has a stomach ulcer. These are important pieces of a health care puzzle that the doctor is trying to piece back together.
4. Don't assume anything. Don't assume that just because you remember discussing possible medical conditions or treatment with the doctor 2 months ago, that the doctor will remember the conversation, much less any important factors. Also, don't assume the doctor remembers this is the 4th time you've had similar symptoms. There are many possibilities, remember each piece of information is like another puzzle piece. It makes the whole picture become more clear.
5. Keep things in prospective. Just because you're in pain, don't be too impatient. Most pain medications take away pain, but they also tend to make you sluggish and uncooperative. Also, they don't want any pain medications to mask any symptoms you're experiencing. That's why you'll feel as though you're being grilled by the police instead of the family doctor. They need to get as much useful information from you before any medication takes effect. So, refer back to Item #2, Present your case as clearly and concise as possible in the fewest words. When the doctor becomes satisfied they only need to treat the pain, and not send you elsewhere for more extensive testing, and the doctor is relatively certain as to what is happening to you physically, they probably won't give you anything to take away the pain. They may, however, if it's an extended time period needed to complete all tests, give you a small dose of some medications to ease the severity of your pain. Try to understand that they're trying to do their job effectively and aren't personally satisfied to see any patient in pain.
6. Keep your cool. While being sick and/or in pain is terrible itself, getting upset and angry doesn't help. It only make you feel worse, and makes those around you feel less like helping. No one wants to deal with anyone yelling or screaming at them. I know how difficult this can be, but trust me, you're doing yourself no favors by being grouchy and/or mean. If you are experiencing what you'd consider less than quality or prompt care, then ask someone with you to inquire as to the problem and/or delay. Their patience has not been compromised by pain and illness, so they are likely to approach the problem in a more dignified and tactful manner. Plus, the staff can hardly blame the patient if they're not the one complaining. It's important not to be labeled as being uncooperative or aggressive while being treated. Those two words can mean the difference of a 2 hour wait versus a 6+ hour wait. And, don't think that paperwork just magically becomes misplaced.
7. Be prepared. Like the boyscout motto, you should always go to the doctor prepared. Make certain you have a current insurance card and your personal identification with you. If you're dealing with medical care, be prepared to show both cards to almost everyone. Also, bring any reading glasses as you'll undoubtedly be handed several forms to complete and/or to read over and sign. Make sure you understand what it is you are signing. Also, if you have migraines, or regularly have nausea, then come prepared with an eye mask, ear plugs, ice packs, a wet wash cloth, a "barf" bag or bucket, tissues, or any thing else you can think of that you may need while you're waiting. Comfort items can make the difference between getting through the long wait or having to just grit your teeth and pull your hair out!
8. Try to relax. Conserving your energy whenever possible may be the only thing that will ultimately get you through until treatment arrives.
9. Ask questions. If you don't understand what someone is trying to explain to you about your health, the care you need, or the medications for you to take, then ask them to explain further. It serves no purpose if you don't comprehend the scope or magnitude of your care. You are the first line of defense for your body's ultimate healthy care, so make certain you know what that entails.
10. Follow-up. Always follow-up with your Primary Care Physician (PCP) after any illness, treatment , surgery, or testing. Even if you were seen elsewhere, such as an Emergency Room or Urgent Care facility, go see your personal physician to follow up afterwards. This is to make certain no other treatment, tests, or further care is necessary. Once a condition, illness, or surgery occurs, it can have long lasting effects on your overall health. So discuss what happened, what treatment was given, plus any medications prescribed, or any tests performed with your doctor. Keeping your Primary Care Physician in the loop is a vital part to keeping that puzzle whole and intact.
11. Listen to what your doctor says. Pay close attention to what your doctor says, especially if they are sending you for testing or to a Specialist. Make sure that you know what information is vital to relay to the testing facility and/or Specialist. Hemming and hawing about why you were sent there has negative effects on your health cause. "I don't know why my doctor sent me here.", will get you the least amount of care and/or concern from a Specialist. If they don't get the full story, including family history, the Specialist knows nothing except what they see before them. A person who's not certain why they're there, and who didn't bother to find out from their Primary Care. It you don't care, then why should the Specialist spend their precious time and resources to treat or aid someone who obviously doesn't participate in their own health care? It does matter what you say and how you say it. Most especially when relaying information between different doctors. You may not have all the answers, but what you do say can be the one factor that causes the Specialist or other doctor to pick up the phone and discuss your case with your Primary Care Physician, and/or other doctors. Withholding vital information irregardless of how embarrassing or personal can be the difference between care that's substantial versus minimal treatment that doesn't ultimately help you.
12. Make notes. Keep notes of important information from each Doctor you see. These will be very beneficial when seeking the help from a Specialist, or any health care facility, away from your Primary Care. Make a list of important points to discuss, pertinent information, tests, results, etc., to relay, plus any questions you may have.
Keep in mind, most doctors see on average 50 - 100 patients per week or more. After awhile they all begin to blur together, so forgive the doctor if they don't remember every detail of your health and care. You are your strongest and only advocate to enable you to receive the best care possible. Sitting silently, while waiting for the doctor to ask you questions won't get you much care. Be the patient, help your doctor to recall who you are, your current health concerns, plus any history you feel is necessary and important to bring to the doctor's attention. Then let them ask questions. Be your own ally. Help the doctor and their staff to help you by giving them what they need to provide you with the best care possible. Be vocal, but not aggressive. Be involved, but not in charge. Be aware, not taxing. Most of all, talk to your doctor and listen when they talk, too! Communication is the key to every great relationship. Remember you only get out what you put into it!
Thursday, May 6, 2010
The Prescription Dilemna
It seems everyone, at sometime will need to fill a prescription of some type. Whether for your child's cold, your migraine headaches, or for your husband's thinning hair -- we all live with and by prescription medications. So much so that many are converted to OTC (over the counter) and no longer require a written prescription from the Doctor.
While we all use these medications occasionally or regularly, we all experience the same problems in getting them filled. First, no one can read them except for the Doctors and Pharmacists. Who's to say they're not just passing lurid jokes back and forth? It would seem they're worthless, anyway.
After that, finding a Pharmacy has become easier than finding a convenience store or gas station. There are several on every other corner, so that's not part of the problem. Those begin when you actually get up to the counter to request that your prescription be filled. Most Pharmacies are overwhelmed during particular hours: upon first opening, although this is usually only on Saturday's and Monday's, or following a holiday; next is between the hours of 10:30 am until 1:00 pm, due most in part to patients who've just seen their Doctor and received a new prescription or a newly written prescription order; then again, between 2:00 pm and 6:00 pm or later is extremely busy. Again, due to afternoon appointment patients, and those patients requesting refills that morning or the day before; The busiest days are Monday, Tuesday, Wednesday, some Thursdays, and always on Fridays. -- If you know or have a Pharmacy that is open on Saturdays, use that day, you'll save yourself a lot of time and frustrations.
Next, you'll need to present at pertinent insurance information, insurance I.D. card, plus your own personal identification, along with your date of birth, full address and telephone number. Now, don't relax just yet, the tough stuff is still to come. Two very important things, first. Different states have different rules regarding how long a prescription is accepted from the date on the prescription. So, if you aren't getting that prescription filled right away, be certain you know how long you can wait before you must fill the prescription or return to the Doctor for another one. Second, if you're concerned about the cost of your prescription, NOW is the time to ask the Pharmacist for an approximate pricing.
If for some unknown reason, your Doctor did not complete the prescription form correctly, well, just stop. Don't argue. It won't change anything. Take a deep breath and return immediately to your Doctor's office. I would even call ahead to alert them to the problem so they can write a correctly completed prescription by the time you arrive. Now, to be fair, the State and Government change the look and appearance of prescription pads regularly to decrease fraud. But, they also change the required information and where to put it on the form each time, also. So, take that few extra minutes while you're at the Doctor's office the first time, and read over every line and box of information required to make certain the Doctor didn't inadvertently miss a important requirement.
Once the prescription is deemed to have been completed properly, then you should expect a wait of at least 30 minutes, but more often 1 - 2 hours, for it to be filled. Consider using the Pharmacy at your local grocery or discount store that you frequent, that way you can do your shopping while you wait. Otherwise, if the wait is beyond 30 minutes, I would choose to run other errands and return at a later time.
Part of the delay is the Pharmacist generally has to contact the Doctor to verify the authenticity, the correct medication, dosage and frequency -- just to minimize fraud, again. They have found alot of patients change the number of pills, the number of refills, and sometimes the dosage or strength of the medications. Honesty is never just assumed, anymore. In fact, quite the opposite.
After that's verified, then they must verify your insurance coverage is valid and in effect, plus what medications are covered or not covered, and how much the insurance will pay toward each prescription medication. Some plans pay a flat rate for medications, while others have a tier-rate system. They pay so much for drugs from column A, a different amount for column B, different again for column C, and D, and so on. While others pay only for Generic medications, even when there is no Generic equivalent available. Some plans only discount a certain percentage off the cost of the medication, while others have an annual maximum they'll pay for all medications filled within the same calendar year. The manner that insurance companies pay towards prescription medications is as varied as the insurance companies, themselves. Even some plans within the same insurance company pay out benefits differently. Read you policy benefits or contact your insurance provider for full details as to how they calculate payment toward your prescription medications.
After all that, the Pharmacy may not have sufficient stock to fill every prescription right away. Most will offer to fill for less than the prescribed amount, temporarily, until they can restock the need medication. Of course, you'll need to return later to pick-up the remaining pills.
If you find a diligent Pharmacist, and most are, they usually try to shop around for the lowest price with their competitors, and will mostly match any lower price. If your Pharmacy doesn't offer this service, then you can call around to several drug stores and ask what their cash price is for your prescription. I would strongly advise calling Sam's Club and/or Costco, as they generally have the lowest prices. If you find a lower price, bring it to the attention of your Pharmacist. If they don't match the lower price, I'd look for a new Pharmacy.
Once all this extraneous stuff has been completed, then can your Pharmacy begin to fill your prescription. When completed, it is the Pharmacist's duty to offer you a consultation -- to discuss the medication, what it's for, whether it should be taken with food or not, and any possible side effects and so on. If you are taking any other medications, over the counter drugs, supplements, and/or vitamins, NOW is the time to have the Pharmacist check for possible drug interactions. These can be fatal. I strongly advise you NOT to wave off the Pharmacist's consultation. It could mean the difference between using the medication safely vs taking it incorrectly, leading to most side effects and possibly even death! Even if this is a drug you are familiar with, at least allow the Pharmacist to check for any drug interactions with your other medications. Also, always verify that you completely understand when to take the medication. Twice a day can mean several things: a) upon waking and at bedtime; b) between meals; c) a specified time, i.e., every 8 hours; or d) with meals; There are several ways to interpret twice a day, so ask the Pharmacist to clarify exactly when to take the medication, or if it makes any difference.
Finally, before you leave the Pharmacy counter, do two (2) things:
1) Count the number of pills in the bottle matches the number of pills prescribed on the bottle.
2) Verify that the pills inside the bottle are the correct medication.
Additionally, make certain that you receive all the bottles of medications prescribed and paid for. Once you get home, review all the literature from the Pharmacy about your medications, including all known side effects and what to do should you experience any of them.
Now, if you're they to pick-up a refilled prescription, well, the rules are a bit different. Most Doctors and insurance companies will only allow either 30 days or 90 days worth of medications, depending upon the specific drug. Which doesn't work out well for months with 31 days in them. Most insurance companies only allow you to request a refill no more than 25 days after your last prescription was filled. In some cases, this time is reduced to 72 hours before the 30th day after you last filled that prescription. For example, if I filled my prescription last month on the 15th, with the 25 day rule, I can begin to request refill on the 10th of the following month; with the 72 hour rule, I can begin to request on the 12th. Which appears to be sufficient time, except because last month was 31 days long, I'll completely run out on the 14th of the following month, so my 5 day grace period just became 4 days, and my 72 hours became 48 hours. Oh, and guess where the weekend falls? Bingo! So now, I've got no time and a very good chance of running out of my medications!
First, call in the refill the day before the 5 day grace or 72 hours. Next, contact your Doctor and explain that even though you are following the rules, you will run out if they don't approve a refill before the weekend. Then, keep call both the Pharmacy and the Doctor twice daily. You don't want to become a pest, just be persistent! If all else fails, ask if they will allow you enough pills to get you through until Monday. And finally, always make certain that the medication your Doctor calls into the Pharmacy to be refilled is the correct medication that you need filled!
This brings up a series of questions even I don't fully understand:
1. If I have a written prescription and the Pharmacy can call the Doctor, then why when I requesting a refill can they only send a fax to request an approval? For some strange Doctor/Pharmacist law, they can only communicate via fax with regards to refills. Who knew?
2. If the original prescription says to give me so many refills, then why are we doing any of this other stuff to begin with?
3. Why does the insurance company always get involved? Especially if they believe you want to get your prescription refilled one day early?
4. Why do Doctors post signs in their offices that state, "All refill requests will take a minimum of 72 hours to process." Do they mean 72 business hours or just 3 working days? I'm confused and I know the answer.
5. Why do I always have to remind everyone else, (the Pharmacy, the Doctor, and the insurance company) that a 30 day supply doesn't last as long during a 31 day month? Am I the only person who understands the math?
6. When it's down to the final few hours before I spend my weekend in pain, and the Doctor's office swears they sent a faxed approval to the Pharmacy hours ago, while at the very same time the Pharmacy swears they haven't received anything from the Doctor's office? How does passing the buck help? It doesn't. I don't care who did or didn't do what, I just want my refill to be approved and filled so I can come and pick it up!
7. Why do these rules exist? I can't go to visit my elderly parents for more than 3-1/2 weeks because I can't get more than 30 days supply of my medications. Not 31, 40, 45 , or 60, just 30 days exactly!
8. If you take more than one medication, this creates it's own ripple effect: drug A has to be filled on the 10th, drug B on the 12th, C on the 17th, D on the 23rd , and so on. That creates numerous phone calls each month, plus alot of wasted time with at least 3-5 separate trips to the Pharmacy, if all works out well. Which rarely happens. Usually I make one trip for each prescription. I once tried to ask my Doctor to write a partial prescription just to get all my medications to refill at the same time. You would have thought I was holding him at gunpoint!
The harsh reality is, there is no easy way to deal with getting your prescriptions. I've tried the Pharmacies with the automatic refills. It doesn't work any better than calling them in yourself, because, again, they fill based on the 30 day month, while 50% of our months during a calendar year are 31 days long. So, I either suffer through for a few days, or I keep banging my head against that stone wall. Either way, I still end up with one heck of a headache!
While we all use these medications occasionally or regularly, we all experience the same problems in getting them filled. First, no one can read them except for the Doctors and Pharmacists. Who's to say they're not just passing lurid jokes back and forth? It would seem they're worthless, anyway.
After that, finding a Pharmacy has become easier than finding a convenience store or gas station. There are several on every other corner, so that's not part of the problem. Those begin when you actually get up to the counter to request that your prescription be filled. Most Pharmacies are overwhelmed during particular hours: upon first opening, although this is usually only on Saturday's and Monday's, or following a holiday; next is between the hours of 10:30 am until 1:00 pm, due most in part to patients who've just seen their Doctor and received a new prescription or a newly written prescription order; then again, between 2:00 pm and 6:00 pm or later is extremely busy. Again, due to afternoon appointment patients, and those patients requesting refills that morning or the day before; The busiest days are Monday, Tuesday, Wednesday, some Thursdays, and always on Fridays. -- If you know or have a Pharmacy that is open on Saturdays, use that day, you'll save yourself a lot of time and frustrations.
Next, you'll need to present at pertinent insurance information, insurance I.D. card, plus your own personal identification, along with your date of birth, full address and telephone number. Now, don't relax just yet, the tough stuff is still to come. Two very important things, first. Different states have different rules regarding how long a prescription is accepted from the date on the prescription. So, if you aren't getting that prescription filled right away, be certain you know how long you can wait before you must fill the prescription or return to the Doctor for another one. Second, if you're concerned about the cost of your prescription, NOW is the time to ask the Pharmacist for an approximate pricing.
If for some unknown reason, your Doctor did not complete the prescription form correctly, well, just stop. Don't argue. It won't change anything. Take a deep breath and return immediately to your Doctor's office. I would even call ahead to alert them to the problem so they can write a correctly completed prescription by the time you arrive. Now, to be fair, the State and Government change the look and appearance of prescription pads regularly to decrease fraud. But, they also change the required information and where to put it on the form each time, also. So, take that few extra minutes while you're at the Doctor's office the first time, and read over every line and box of information required to make certain the Doctor didn't inadvertently miss a important requirement.
Once the prescription is deemed to have been completed properly, then you should expect a wait of at least 30 minutes, but more often 1 - 2 hours, for it to be filled. Consider using the Pharmacy at your local grocery or discount store that you frequent, that way you can do your shopping while you wait. Otherwise, if the wait is beyond 30 minutes, I would choose to run other errands and return at a later time.
Part of the delay is the Pharmacist generally has to contact the Doctor to verify the authenticity, the correct medication, dosage and frequency -- just to minimize fraud, again. They have found alot of patients change the number of pills, the number of refills, and sometimes the dosage or strength of the medications. Honesty is never just assumed, anymore. In fact, quite the opposite.
After that's verified, then they must verify your insurance coverage is valid and in effect, plus what medications are covered or not covered, and how much the insurance will pay toward each prescription medication. Some plans pay a flat rate for medications, while others have a tier-rate system. They pay so much for drugs from column A, a different amount for column B, different again for column C, and D, and so on. While others pay only for Generic medications, even when there is no Generic equivalent available. Some plans only discount a certain percentage off the cost of the medication, while others have an annual maximum they'll pay for all medications filled within the same calendar year. The manner that insurance companies pay towards prescription medications is as varied as the insurance companies, themselves. Even some plans within the same insurance company pay out benefits differently. Read you policy benefits or contact your insurance provider for full details as to how they calculate payment toward your prescription medications.
After all that, the Pharmacy may not have sufficient stock to fill every prescription right away. Most will offer to fill for less than the prescribed amount, temporarily, until they can restock the need medication. Of course, you'll need to return later to pick-up the remaining pills.
If you find a diligent Pharmacist, and most are, they usually try to shop around for the lowest price with their competitors, and will mostly match any lower price. If your Pharmacy doesn't offer this service, then you can call around to several drug stores and ask what their cash price is for your prescription. I would strongly advise calling Sam's Club and/or Costco, as they generally have the lowest prices. If you find a lower price, bring it to the attention of your Pharmacist. If they don't match the lower price, I'd look for a new Pharmacy.
Once all this extraneous stuff has been completed, then can your Pharmacy begin to fill your prescription. When completed, it is the Pharmacist's duty to offer you a consultation -- to discuss the medication, what it's for, whether it should be taken with food or not, and any possible side effects and so on. If you are taking any other medications, over the counter drugs, supplements, and/or vitamins, NOW is the time to have the Pharmacist check for possible drug interactions. These can be fatal. I strongly advise you NOT to wave off the Pharmacist's consultation. It could mean the difference between using the medication safely vs taking it incorrectly, leading to most side effects and possibly even death! Even if this is a drug you are familiar with, at least allow the Pharmacist to check for any drug interactions with your other medications. Also, always verify that you completely understand when to take the medication. Twice a day can mean several things: a) upon waking and at bedtime; b) between meals; c) a specified time, i.e., every 8 hours; or d) with meals; There are several ways to interpret twice a day, so ask the Pharmacist to clarify exactly when to take the medication, or if it makes any difference.
Finally, before you leave the Pharmacy counter, do two (2) things:
1) Count the number of pills in the bottle matches the number of pills prescribed on the bottle.
2) Verify that the pills inside the bottle are the correct medication.
Additionally, make certain that you receive all the bottles of medications prescribed and paid for. Once you get home, review all the literature from the Pharmacy about your medications, including all known side effects and what to do should you experience any of them.
Now, if you're they to pick-up a refilled prescription, well, the rules are a bit different. Most Doctors and insurance companies will only allow either 30 days or 90 days worth of medications, depending upon the specific drug. Which doesn't work out well for months with 31 days in them. Most insurance companies only allow you to request a refill no more than 25 days after your last prescription was filled. In some cases, this time is reduced to 72 hours before the 30th day after you last filled that prescription. For example, if I filled my prescription last month on the 15th, with the 25 day rule, I can begin to request refill on the 10th of the following month; with the 72 hour rule, I can begin to request on the 12th. Which appears to be sufficient time, except because last month was 31 days long, I'll completely run out on the 14th of the following month, so my 5 day grace period just became 4 days, and my 72 hours became 48 hours. Oh, and guess where the weekend falls? Bingo! So now, I've got no time and a very good chance of running out of my medications!
First, call in the refill the day before the 5 day grace or 72 hours. Next, contact your Doctor and explain that even though you are following the rules, you will run out if they don't approve a refill before the weekend. Then, keep call both the Pharmacy and the Doctor twice daily. You don't want to become a pest, just be persistent! If all else fails, ask if they will allow you enough pills to get you through until Monday. And finally, always make certain that the medication your Doctor calls into the Pharmacy to be refilled is the correct medication that you need filled!
This brings up a series of questions even I don't fully understand:
1. If I have a written prescription and the Pharmacy can call the Doctor, then why when I requesting a refill can they only send a fax to request an approval? For some strange Doctor/Pharmacist law, they can only communicate via fax with regards to refills. Who knew?
2. If the original prescription says to give me so many refills, then why are we doing any of this other stuff to begin with?
3. Why does the insurance company always get involved? Especially if they believe you want to get your prescription refilled one day early?
4. Why do Doctors post signs in their offices that state, "All refill requests will take a minimum of 72 hours to process." Do they mean 72 business hours or just 3 working days? I'm confused and I know the answer.
5. Why do I always have to remind everyone else, (the Pharmacy, the Doctor, and the insurance company) that a 30 day supply doesn't last as long during a 31 day month? Am I the only person who understands the math?
6. When it's down to the final few hours before I spend my weekend in pain, and the Doctor's office swears they sent a faxed approval to the Pharmacy hours ago, while at the very same time the Pharmacy swears they haven't received anything from the Doctor's office? How does passing the buck help? It doesn't. I don't care who did or didn't do what, I just want my refill to be approved and filled so I can come and pick it up!
7. Why do these rules exist? I can't go to visit my elderly parents for more than 3-1/2 weeks because I can't get more than 30 days supply of my medications. Not 31, 40, 45 , or 60, just 30 days exactly!
8. If you take more than one medication, this creates it's own ripple effect: drug A has to be filled on the 10th, drug B on the 12th, C on the 17th, D on the 23rd , and so on. That creates numerous phone calls each month, plus alot of wasted time with at least 3-5 separate trips to the Pharmacy, if all works out well. Which rarely happens. Usually I make one trip for each prescription. I once tried to ask my Doctor to write a partial prescription just to get all my medications to refill at the same time. You would have thought I was holding him at gunpoint!
The harsh reality is, there is no easy way to deal with getting your prescriptions. I've tried the Pharmacies with the automatic refills. It doesn't work any better than calling them in yourself, because, again, they fill based on the 30 day month, while 50% of our months during a calendar year are 31 days long. So, I either suffer through for a few days, or I keep banging my head against that stone wall. Either way, I still end up with one heck of a headache!
Thursday, April 29, 2010
Getting the initial appointment with your Primary Care Physician (PCP)
Scheduling that first appointment can be tough. The important thing is to be prepared. First off, Doctor's don't like doing new patient appointments. They're tedious and take up more time than a regular appointment. So, knowing that can help with the giant headache you'll have once you're done.
Second, come prepared.You'll usually be required to fill out roughly 10 or so pages of information. Family history, current medical conditions, current medications, and so on. Save yourself some time and the hassle. When scheduling the appointment, request all forms that need to be completed are either mailed, faxed, or picked-up by you ahead of time. That way you can take your time and complete all the forms without distractions from annoying kids in the waiting room, or without having to remember when you had that last physical, the exact dosage of your cholesterol medications, or the name and address of the last doctor you saw some six months ago. Then return them to the office staff as soon as possible for review. This way, once you've arrived for your appointment, usually 6-8 weeks later, they already have all the information and may possibly have requested copies of medical records from your previous Primary Care Physician, plus copies of recent lab results, x-rays, etc. Who knows, the new Doctor may have even found time to read through your paperwork and be somewhat familiar with you and your current health status.
Once you actually are in the exam room or office, you'll begin to feel as though you're experiencing "job interview, DE ja' vue." Relax, you are the one whose interviewing here. Don't forget, you pay for the services they provide, so let them impress you a little.
Do some homework ahead of time. Check out pricing for cash customers as a way to comparison shop. Ask for referrals. Let them know you are checking into other Primary's, and that you haven't made a final decision yet. After all, they're not the only Doctor in town -- probably not the only one in the same building.
Try to be specific about the kind of PCP you want. Make a list of questions and concerns regarding your
health care. Don't generalize. If you have diabetes and rheumatoid arthritis, then ask questions specific to care and maintenance for those conditions, plus any other family history health concerns you worry may arise. Use the Internet to help you understand your health conditions, risk factors, and family history. They all play a part in your overall health care plan. Find out what specific needs or concerns you should discuss with your PCP.
My health is the culmination of my life so far: the injuries, surgeries, illnesses, allergies, and family members health conditions, plus my current medical conditions. They all add together uniquely for me. Same for everyone else. There are a myriad of health issues and risk factors to cover with your PCP on this visit. Let the physical wait until another visit.
Last, but not least, ask what Specialists this PCP uses for conditions related to your medical care. For instance, if you have a chronic pain condition, what Pain Management Specialist do they usually refer to, does make a difference. Also, what laboratories and radiological groups they use, can be a factor in to consider. Although, most times this is controlled by either the insurance company or the Physician's group that the Doctor is affiliated with, so your choices may be limited, here.
It may become a choice between a better PCP and not the Specialist of your dreams, or the Specialist that you really want, but less choices when it comes to PCP's. Remember, Primary Care Physicians are just that, your primary contact for medical care. I find most Specialists are equally good, however, if not you can always request that they be added to your PCP's group later on. The important thing is to find someone who understands your medical needs and respects your input on how treatment is administered. find that combination and the majority of your battles are behind you.
Once you've survived all that, I've found most Doctor's are very similar. There are few differences in real care or how they administer the care with their patients. Some have better personalities, while others have kinder, gentler bedside manners, yet in the end, they all march to the same drum. The HMO's and PPO's and the Physician's Groups pretty much tell them how to act/react in any given situation. They primarily diagnose, then prescribe medications, with instructions to follow up in 6-8 weeks, unless symptoms worsen, then call for an immediate appointment or go to the nearest Emergency Room.
After all is said and done, you'll have to decide whether to stay with this PCP, or move on to another. If you've done all the prep work, the choice should be easy. But remember, you can change Doctor's if you feel the standard of care doesn't meet your expectations. Some insurance companies do have restrictions on when and how often you can change PCP's specifically, so read your policy benefits or contact your insurance company.
Get the most out of your appointment by being as prepared as possible. Even though you are paying the bill in the end, do strive to be respectful. We all, after everything, deserve the minimum amount of courtesy.
Second, come prepared.You'll usually be required to fill out roughly 10 or so pages of information. Family history, current medical conditions, current medications, and so on. Save yourself some time and the hassle. When scheduling the appointment, request all forms that need to be completed are either mailed, faxed, or picked-up by you ahead of time. That way you can take your time and complete all the forms without distractions from annoying kids in the waiting room, or without having to remember when you had that last physical, the exact dosage of your cholesterol medications, or the name and address of the last doctor you saw some six months ago. Then return them to the office staff as soon as possible for review. This way, once you've arrived for your appointment, usually 6-8 weeks later, they already have all the information and may possibly have requested copies of medical records from your previous Primary Care Physician, plus copies of recent lab results, x-rays, etc. Who knows, the new Doctor may have even found time to read through your paperwork and be somewhat familiar with you and your current health status.
Once you actually are in the exam room or office, you'll begin to feel as though you're experiencing "job interview, DE ja' vue." Relax, you are the one whose interviewing here. Don't forget, you pay for the services they provide, so let them impress you a little.
Do some homework ahead of time. Check out pricing for cash customers as a way to comparison shop. Ask for referrals. Let them know you are checking into other Primary's, and that you haven't made a final decision yet. After all, they're not the only Doctor in town -- probably not the only one in the same building.
Try to be specific about the kind of PCP you want. Make a list of questions and concerns regarding your
health care. Don't generalize. If you have diabetes and rheumatoid arthritis, then ask questions specific to care and maintenance for those conditions, plus any other family history health concerns you worry may arise. Use the Internet to help you understand your health conditions, risk factors, and family history. They all play a part in your overall health care plan. Find out what specific needs or concerns you should discuss with your PCP.
My health is the culmination of my life so far: the injuries, surgeries, illnesses, allergies, and family members health conditions, plus my current medical conditions. They all add together uniquely for me. Same for everyone else. There are a myriad of health issues and risk factors to cover with your PCP on this visit. Let the physical wait until another visit.
Last, but not least, ask what Specialists this PCP uses for conditions related to your medical care. For instance, if you have a chronic pain condition, what Pain Management Specialist do they usually refer to, does make a difference. Also, what laboratories and radiological groups they use, can be a factor in to consider. Although, most times this is controlled by either the insurance company or the Physician's group that the Doctor is affiliated with, so your choices may be limited, here.
It may become a choice between a better PCP and not the Specialist of your dreams, or the Specialist that you really want, but less choices when it comes to PCP's. Remember, Primary Care Physicians are just that, your primary contact for medical care. I find most Specialists are equally good, however, if not you can always request that they be added to your PCP's group later on. The important thing is to find someone who understands your medical needs and respects your input on how treatment is administered. find that combination and the majority of your battles are behind you.
Once you've survived all that, I've found most Doctor's are very similar. There are few differences in real care or how they administer the care with their patients. Some have better personalities, while others have kinder, gentler bedside manners, yet in the end, they all march to the same drum. The HMO's and PPO's and the Physician's Groups pretty much tell them how to act/react in any given situation. They primarily diagnose, then prescribe medications, with instructions to follow up in 6-8 weeks, unless symptoms worsen, then call for an immediate appointment or go to the nearest Emergency Room.
After all is said and done, you'll have to decide whether to stay with this PCP, or move on to another. If you've done all the prep work, the choice should be easy. But remember, you can change Doctor's if you feel the standard of care doesn't meet your expectations. Some insurance companies do have restrictions on when and how often you can change PCP's specifically, so read your policy benefits or contact your insurance company.
Get the most out of your appointment by being as prepared as possible. Even though you are paying the bill in the end, do strive to be respectful. We all, after everything, deserve the minimum amount of courtesy.
Monday, April 19, 2010
Why I began this quest.
My mission, while I didn't choose it, is to educate, assist, and gather together the masses to fix the problems in getting reasonable medical care. Notice I said reasonable. I'm not one of those people demanding free coverage of 100% of anything considered to be medical care, or it's equivalent opponents. I just want the things I was promised when I purchased my health care insurance policy. Those things inherently promised under the Hippocratic oath, by doctors. And, all the other health care providers, whom are so well paid, in high demand, yet somehow forget how to treat human beings; that is other than cattle being herded from one pasture to the next. Of course, we refer to them as waiting rooms even though we know better. And, waiting implies that at some point it will end, and some service will be given or performed. I have spent less time waiting for major auto repairs than waiting at my doctor's office, where I actually have a scheduled appointment time. Again, there is that translation issue. Appointment time usually means in health care terms: this is an approximate time for you to arrive, and we'll get to you within the next four (4) hour window, unless, of course, there is an emergency. Like the doctor wants to eat his lunch at some fancy restaurant on some prescription companies dime, or that he's tired and needs to rest before his afternoon golf game, or whatever else it is they do in their spare time. Now to be fair, I have met several doctors, usually P.A.'s (Physician's assistants) who work tirelessly 18 plus hours each day trying to fill the holes in the health care system. But they are too few and very far between, while being worked to their early death by bureaucracy.
So, while you're doing all this waiting, look around you and you'll realize how well things are going for our doctor friends. I've never seen such plush furnishings, granite floors and counters, wall-tiled granite bathrooms, all with accessories even Martha would be proud of. So, now we know, it's not really a money problem as they would have us believe. With their one of a kind cascading waterfall behind the reception desk, I don't think they're even trying to fool anyone anymore.
Then why bother? Why bother fighting against the tide for someone else's rights and problems? Truthfully. Someday soon these same problems and rights being denied and trampled upon will belong to you or someone very close to you, like a family member, a parent, grandparent, siblings, or just close friends. That's when the most unfortunate part begins. A sick, unwell, possibly dying person fighting against a well-oiled system, alone. Weak and defenseless, they are about to embark on the fastest learning curve ever achieved. How to fight the health care system. In plain English, the patient gets the shaft both physically and monetarily.
Don't think for one second those doctors and other health care providers are going to care what's going on with you or your problems. Payment is due, in full, at the time service is rendered. Pay now and fight it out with the bureaucrats, your insurance company, and whoever else later. They just don't care, other than getting paid on time, by you. Ultimately you are responsible for all bills, no matter whether they should be covered or not. They all stand squarely on: " It's not our problem (even if we do contribute to it). You are on your own."
Except now, I'm here. I've experienced a lot of woe and heartache and sleeplessness over the deviousness and underhanded standard tactics employed when someone actually is sick and needs their health insurance the most. Simple put, they don't want to pay. So send me your stories, your frustrations and all those horrors you've endured. Maybe together, and with others like us we can find a way to fight back against the system and create a grass roots campaign to change the way we are treated and without any voice in making any real change to how the system processes and denies claims.
So, while you're doing all this waiting, look around you and you'll realize how well things are going for our doctor friends. I've never seen such plush furnishings, granite floors and counters, wall-tiled granite bathrooms, all with accessories even Martha would be proud of. So, now we know, it's not really a money problem as they would have us believe. With their one of a kind cascading waterfall behind the reception desk, I don't think they're even trying to fool anyone anymore.
Then why bother? Why bother fighting against the tide for someone else's rights and problems? Truthfully. Someday soon these same problems and rights being denied and trampled upon will belong to you or someone very close to you, like a family member, a parent, grandparent, siblings, or just close friends. That's when the most unfortunate part begins. A sick, unwell, possibly dying person fighting against a well-oiled system, alone. Weak and defenseless, they are about to embark on the fastest learning curve ever achieved. How to fight the health care system. In plain English, the patient gets the shaft both physically and monetarily.
Don't think for one second those doctors and other health care providers are going to care what's going on with you or your problems. Payment is due, in full, at the time service is rendered. Pay now and fight it out with the bureaucrats, your insurance company, and whoever else later. They just don't care, other than getting paid on time, by you. Ultimately you are responsible for all bills, no matter whether they should be covered or not. They all stand squarely on: " It's not our problem (even if we do contribute to it). You are on your own."
Except now, I'm here. I've experienced a lot of woe and heartache and sleeplessness over the deviousness and underhanded standard tactics employed when someone actually is sick and needs their health insurance the most. Simple put, they don't want to pay. So send me your stories, your frustrations and all those horrors you've endured. Maybe together, and with others like us we can find a way to fight back against the system and create a grass roots campaign to change the way we are treated and without any voice in making any real change to how the system processes and denies claims.
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