The Take-Charge Patient: How You Can Get the Best Medical Care
by Martine Ehrenclou
Being a take-charge patient is about being a proactive member of your health care team. The book includes advice on primary care and specialist physician visits, avoiding medication errors, surgeries and hospital stays, patient advocates, and some tips on dealing with insurance and billing.
The author recommends you prepare three documents.
- “Create a health summary before each medical encounter… It is a very brief document that lists your top three medical concerns, a brief description about how you have been feeling, your symptoms, any recent tests, procedures or surgeries you’ve had, any new medications you are taking and medications you’ve tried and stopped. It is also a good place to list any questions you have. Your health summary is your most current health profile. Keep it to about one-half page in length… The reason you are being asked to do this kind of preparation is so the doctor doesn’t have to waste time digging for information on you.”
- “Your medical journal is for keeping track of symptoms, listing questions for your doctor when you think of them, noting research you might have found and more. You can also use it for taking notes on what your doctor tells you during the office visit.”
- “Your medical ID card should contain the following information: your full name, your primary care physician’s name and contact information… your current medical conditions, medications and their dosages… allergies to medications, emergency contact names and phone numbers… This is something you will carry in your wallet.”
“Each time you see a doctor and any kind of test is done, ask for a copy of the medical record from that visit… This includes test results such as blood work, x-rays, MRIs, CT scans, etc.”
The author cautions that “your medical history follows you for your lifetime… Never let a medical error in your chart go unchallenged… By law you have the right to correct most errors you find in your medical records. These corrections are called amendments.”
“Communication is one of the major components of a good relationship with your doctor… Resist diagnosing yourself… Try not to interpret your symptoms—simply describe them… Speak up and ask questions… You must understand what your doctor is telling you about your medical condition, disease or treatment plan. If you don’t, you may not comply with her treatment and you will not get better. If you do not understand the medical jargon your doctor is using, ask her to explain.”
Another tip: If you are unable to get an appointment without delay, “ask to be put on a cancellation list.”
Medications. “According to the Institute of Medicine, medication errors injure 1.5 million people a year… You can do your part in preventing medication errors by using only one pharmacy. Each pharmacy keeps track of your medications in its computer and the computer is set up to alert the pharmacist if there is a drug interaction or possible medication allergy.”
Patient Advocacy. “Enlisting the help of a loved one to act as your advocate is part of getting the best medical care… An advocate can provide support for you while you see a doctor, be at your bedside if you are in the hospital, help record information offered by a medical professional, converse with you about that information, help you research and more.” If you have a serious illnesses or chronic medical condition, ask your insurance company to assign a case manager to “help coordinate services and navigate around obstacles for care.”
The Hospital. “Be alert of holidays and weekends and a night. Medical errors increase at these times. There are fewer nurses per patient and doctors can be away. Ask your advocate to be with you as much as possible…” Also ask your advocate to take notes during doctors’ rounds. “If you are having surgery in a teaching hospital, try to avoid scheduling in July, when new interns are starting out in the hospital. More medical errors occur at this time… If there is a more serious problem such as a medical error, contact the hospital’s ombudsman.”
Surgery. “If you have been told you need surgery, get a second opinion… You may find out that the first surgeon was correct, but you may also find out that there are alternatives to surgery. You also might find out more information about the surgery that will benefit you in your aftercare.”
Insurance and Billing. “Even if you see a doctor who does not take your insurance, you can submit your superbills (a superbill is the bill you receive for a visit with your doctor or other medical professional) and possibly get partial reimbursement… If your health insurance company claims that the cost of your care is above their customary cost, request to see the doctor’s notes. These notes may show that there are extenuating circumstances in your case that justify the additional cost.”
“Many doctors who don’t take health insurance offer a 20 percent discount if you pay their bill in the first thirty days.” Ask at the front office if the doctor offers this discount. HealthCareBlueBook.com provides information about average costs for medical care.
Urgent Care. “An estimated 17 percent of all patients who visit U.S. hospital emergency departments could be treated at urgent care centers or retail medical clinics instead, a move that would save $4.4 billion a year in health care costs… Lacerations, sprains, and minor infections are among the conditions that can be treated safely outside of hospitals, according to a RAND Corporation study published in the October 2010 issue of the journal Health Affairs.”
The book also includes a chapter on legal health documents, including Advance Directive, Living Will, Durable Power of Attorney for Health Care, and Do Not Resuscitate (DNR). “The time to prepare these documents is when you are healthy, not when you are sick or injured.”
Ehrenclou explains her personal experience as a take-charge patient. “During my sixteen months of chronic pain, I received ten misdiagnoses from eleven physicians… I know that if I had not become a take-charge patient, with all that entails, and kept pursuing answers, I would still be in chronic pain. My persistence and research led me to Dr. T., who diagnosed me correctly and cured me.”
Ehrenclou, Martine. The Take-Charge Patient: How You Can Get the Best medical Care. Santa Monica, California: Lemon Grove Press, 2012. Buy from Amazon.com