Doctor, Doctor, Give Me The News!

Last time I started asking him a bunch of questions, he decided I needed a prostate exam right then and there.  Since that visit, I remain silent!

I've found that writing down my questions and concerns beforehand allows me to have productive conversations with my doctor. If I didn't do that, I'd likely forget to bring up things. I also take notes while at the doctor's so I can return to them and process what was said.

Medical mistakes are the 3rd leading cause of death in the U.S...AFTER heart disease & cancer. (U.S News, BMJ, MEDSCAPE, etc.)

Doctors are service-providers, not Gods.  Having several family members as medical professionals, I hold them to real-world standards.

One can use all of the tactics listed (& I have), but the modern managed-practice paradigm is profit-driven, still gender & age-biased, & 'support-staff' controlled... unskilled, high-turnover 'receptionists' with power to directly effect your well-being; appointments, messaging, records, referrals, prescriptions.  

You will be interacting/trusting THESE folks more than you'll EVER see the doctor (for your 8 minutes) to ensure appropriate, timely responses.  I have spent DAYS on the phone & in the 'patient portals' just addressing the mistakes made that-if hospitalized or under critical procedures-I wouldn't have had the energy or concentration to chase & most importantly, CORRECT.

I wrote a multiple incident(s) report, replete with dates, names, & degree of alarm to my last (6-year) doctor's management 'team' & my 'heavy-lifting' to correct or accept- as I left them....never expecting a reply.  I was correct.  The next doctor was worse, but I found out right away.

I will not settle for mediocrity or worse but most folks won't leave, just accept...and it is time, labor intensive & an exercise in futility regarding the most important relationship, especially as I age.

I don't want to die because I didn't try to protect myself NOW-BEFORE I'm ill or hurt.

I spend way too much time searching for simply 'O.K'...exceptional or merely 'good' seems a tragic, scary impossibility.

Americans spend more time researching an exceptional big-screen TV purchase than finding an exceptional doctor.

It's alot of soul-crushing work.

As a former social worker and current insurance advisor, I encourage you to advocate for yourself or bring a relative or trusted friend who can help you.

A. This starts with the plan you choose.

     Even if your 2 doctors are 'in-network,' if they're in different medical groups, you may           

     not be able to see your current primary care provider AND specialist.

     2 in-network pharmacies may have different prescription costs, as 1 is preferred, where

     the other is standard.

     If out-of-network care is covered, your financial responsibility could be significantly higher     

     when you use out-of-network providers.

B. Also, doctors don't always know what a medication costs, may not know Medicare solely covers lab tests as frequently as a medical specialty board, Health and Human Services, etc. may advise, and may benefit from being reminded of other appointments you have. This can lead to having -one- lab visit to address multiple doctor's lab orders, saving you time and money. 

C. When a medication is prescribed, ask if there's a comparable alternative that's less expensive (i.e. Why the newest brand name medication is necessary for you, instead of a generic.) On the other hand, ask why an older anti-nausea or psychotropic medication is being ordered versus a newer, yet affordable alternative.

D. Even if you receive a referral for a specialist, lab or x-ray services, call that provider's office to ensure your insurance is accepted, the referral has been received, and that Medicare will cover the service. Also, ask what documentation you need to bring (i.e. health plan card, referral, or lab/x-ray order, etc.)

E. Because some specialists see lots of severe cases, their first impression of your signs, symptoms, or concerns may be that 'its nothing to be concerned about.' Ask about potential outcomes, the impact of other conditions you have, and what to expect should these signs and symptoms not go away.

For example, for those with certain conditions or who are on certain medications, a rash or sporadic bleeding may not be 'routine or normal.'

There's a difference between occasional stomach upset and what may be gastro-esophogeal reflux, especially given your prior history and family history.

In summary, advocate for yourself or go with someone who may be better at it. For example, a spouse, adult child, trusted friend, etc. Note: even healthcare professionals need another set of ears when they're the patient. If something doesn't sound right, sufficient, or similar, speak up.