"Men occasionally stumble over the truth, but most of them pick themselves up and hurry off as if nothing ever happened."Heath Ledger's death was such a tragedy, especially considering the cause of his death; accidental overdose of prescription medication. Its so infuriating! We're always talking about asymmetry of knowledge and medication compliance, yet considering the scope of funding in health care, there's very little procured to make the physician-patient interaction more valuable.
--Sir Winston Churchill
We get very little time with our physicians, an average of about 10 minutes to discuss our problems. Considering a physician sees approximately 20 patients or so a day, you, as a patient, have to be succinct and clear in your relay of information and hope the doctor is a good listener. Beyond that, there's little you can change at the point-of-care.
But think of all the things that happen before you even get to see the doctor.
- You call to make an appointment - insurance registration
- Fill out forms - reason for visit, current medications, medical history
- Sign some important looking papers - HIPAA, release of medical records
- Get your vitals taken - base health status
- Meet with the nurse - history of present illness (HPI), review of symptoms (ROS)
#1. Very little is more hazardous to your health than getting a huge bill from your doctor. Problem: Most likely the breakdown happened when the billing department forgot to call your insurance company and precertify you for services and procedures during your visit. Providing your insurance info is the first part of this whole process!
Solution: No matter how good your doctor's office is, check with the insurance company yourself! Make sure you know your copay and get your deductible information before you go in. After the visit, if you're prescribed a test or medication, check with the insurance company again to see where you should go. Sometimes the pharmacy or imaging center recommended by the doctor's office isn't covered under your insurance (or might not be the cheapest option!).
#2. This is probably the most important of all. Problem: You've written the same thing over and over again going to different doctors, but still you forget what that medication with the long name is called. Or you forget that you finished the course of your antibiotic treatment a few weeks ago. Or you decide that the headaches you've been having every so often are not important for your dentist to know. And did you fax your records from the previous 5 doctors you saw? Do you even remember the second one's name!? The list continues.
Solution: Get all your medical info in one place. Find a doctor that offers a personal health record (PHR) or web portal. Go online to HealthVault, RevolutionHealth, WebMD and fill in the blanks. These sites have put in a lot of work to make it easy for you. If you prefer paper, get a file folder and drop all your info in there. Take a CD, print out your record or take the file folder with you to the doctor's office so you don't forget anything!
#3. Complicated legal forms are a necessary evil. Problem: You don't really care about what you're reading so you sign and date at the bottom and hand them in. The front desk secretary files it away along with your ins. card and photo ID and when you come in the next time, for some reason you have to repeat this process.
Solution: Fill out your medical forms first and hand them to the secretary. Take the time to read what HIPAA is all about and fill out your PCP's name in the medical release form so he/she is notified of the current visit. If you can, check if the doctor's office has an electronic medical record (EMR). This avoids the practice losing papers (because they get scanned in electronically) and saves you time from filling out everything all over again. Also, request a copy of your medical records so you can enter them online or put them in your file folder. A doctor's office has to comply with your request within 30 days (10 if you're from NY)!!
#4. Don't worry about white coat syndrome. You're here to talk about what's wrong and get a medical opinion. On top of that, you came prepared! So relax and let the nice ladies fuss over you.
#5. This is where the nurse will go over everything you wrote down. Problem: There's a game of telephone being played here where the front desk talks to the MA who talks to the NP who talks to the doctor. To their credit, most of it is documented.
Solution: Your job is to be repetitive and stick to your story. Keep in mind the top 3 things you came in to discuss. Don't go on and on about how tired you felt after the Giants tailgate. Nurses usually ask you about pertinent things you might have overlooked like recent minor illnesses, allergies, or over-the-counter medications you're taking. Pay attention and be detailed about your answers.
By the time you get to see the doctor, both of you will have a clear idea of what your record represents and what you're coming in about. After restating the top 3 issues, the repetition can stop. Let the doctor ask the questions, be concise in your answers and ask for further explanation if you don't understand something. By the time you leave, you should have a general understanding of your treatment plan. Ask a nurse or MA for definitions and medical pamphlets after to make sure you have a full understanding . Remember, you're on the clock, so coming in organized prepares everyone for what's important; your health care!