April 10, 2011

Finding the Right Health Care Provider:
In the past the doctor directed the care of a patient. Today medicine has changed so has the expectation of a patient, and the responsibility of the physician. It is important for everyone to have a Primary care provider, who can be an Internist, Family practitioner or in the older population a Geriatrician. The patient provider relationship now is more a partnership. Most physicians have what is known as a Provider-Patient Agreement. (see ours on our website)
Step # 1:
Make a list of what you believe is important
1. Should the provider be a man or woman?
2. Are they a part of my insurance(HMO/PPO Health maintanance organization/preferred provider organization)?
3. Are they a goup practice or a solo physician?

Step# 2:
1. Friends and family about their provider and why they like them?
2. Ask other subspecialists for their opinion and why they recommend someone?

Step #3
1. Make the call to the provider of your choice and speak with the staff.
It is important to like the staff as they can make or break your experience.
2. Ask if you would be able to visit the office?
3. Ask if you would be able to speak with the provider.

Step# 4

At your first encounter with the provider make a note of the following:
1. Are you able to understand the provider?
2. Did the provider listen to you?
3. Did the provider allow you to ask questions?

If all of the above is to your satisfaction the other factors that should influence your decision are
1. Is the doctor board certified?
2.Is the office located close to your home /office?
3. Does the doctor admit to the hospital of your choice?
4.What are the after hour policies?
5. How busy is the clinic and do they accomodate short notice appointments?
6. Would I be able to communicate with the doctor via phone or e-mail and does this cost me extra?

Getting Ready for an Appointment:

Make a list of important concerns and questions.
Remember as much as you would like to ask several questions during your visit, your doctor may have a limited time per patient.
There are several ways clinics try and address this:
Some have pre-appointment questionnares you can fill at home and send in prior to your appointment(ours is online)
Or you may be able to e-mail your questions ahead of time to the staff or doctor so they may prepare for this ahead of time.
You may make a list and ask only what absolutely bothers you.

The Lists:

Make a list of your medications
List of your subspecialists
List and contact information of your previous primary care provider
Try and get your records released before your visit so the doctor may familiarize themselves with your health.
If you have trouble hearing or seeing , prepare well bringing a family member who can take information down for you or bring in your glasses or hearing aids that will help optimize the visit.
You may take permission to bring in a tape recorder if need be
Make sure if you need an interpretor you do let the office know, bring one yourself or ask if they would be able to provide one.

At the Appointment:

1. Be honest :if you smoke, do not exercise, drink excessively, use illicit drugs or are addicted to pain medications make sure you let the provider know.
2. Stick to the most important issues troubling you and stay on the point.
3. There may be no time to warm up to your concerns, it would be good to voice your concern up front and not leave it for the end of the visit when the physician is wrapped up.

End of the visit:
Understand if any tests or consultations have been recommended.
Understant why the test is being done.
Understand why you are going to see a consultant
Understand what medications have been prescribed or changed and why
Understand what your role in your care is: Your diagnosis:is this something you can help or is this genetic, like diabetes :would it improve with diet and exercise? What are your options, is there any community services that can help?

Also remember to bring up sensitive matters up with your doctor. Talk about advance directives, end of life issues, social issues that affect your health, financial issues that affect your treatment. These are important to help design your treatment plan.

Internet Information:
As patients are getting to be well informed it is important to know a few important issues especially about the Internet:
1. Who is resposibile for the content?
2. Who is the author and what are their credentials?
3. Is the site a government site, or private site or a commercial site?
Be sure to discuss any information you think might be helpful.
Paying your doctor:
Health insurance is not an insurance to keep you healthy. It does not pay fully for your medical issues. It is there to help you pay for a good portion of your helath care. A few insurances do pay for a yearly preventive care visit. Most visits to the doctor have a co-pay or co insurance which is set amount for the visit or set percentage of the fees for the visit. Like any other service industry doctors also need to run the practice and do get affected if a good majority of their patients do not pay the out pf pocket expenses. It is almost 20 to 30% of the practice’s income is from patient’s out of pocket expenses. Understand your financial obligation.

Remember to optimize your health care, you need to have a good and honest relationship with your provider, understand yourself and your health goals and risks, participate in your own well being, follow up as recommended, and understand your insurance and your obligation.

Last of all :The “nightmare patient”:Don’t be one
One who makes an appointment:does not show up!
One who spends a lot of time at the appointment and does not follow through with recommendations.
One who repeatedly fails to take treatment:alternative:exercise/quitting smoking/fails to take medications but gets upset when he/she falls ill.
One who goes on the internet and insists on treatments he/she has read about :e.g. “I need an MRI of my back because it is hurting”
One who thinks his /her health is all the PCP’s responsibility.
Remember it is a partnership and an equal one. It works best when both parties are responsible, honest and understand their respective roles.

Also remember you are the consumer:

You do not have to put up with

A  PCP that is always in a hurry.

Is not a good listener

Does not like if you ask questions

Has staff that is rude

Does not follow through

Does not cordinate your care

Before you judge remember your doctor is human just like you, has a family like you do, has health issues like you do, has responsibilites besides his/her profession just like you do. Just like we as doctors remember patients tend not to understand everything they should, it requires consistent education and follow up. In summary make the relation with your PCP a Patient -Provider partnership that works towards the success of your good health.

Annual Survey

At the end of each annual visit please follow the questionnaire as it will help us better cater to your needs.

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