Talking to Your Doctor

We all want good medical care. But times have changed. Our healthcare system is complex and we are faced with numerous choices. We need help from our doctors in order to make informed decisions, which means we have to build a good relationship. The outcome should be a plan of care that is customized for you.

Getting good healthcare requires research. Your doctor can provide advice and is most likely your primary resource for health information, but ultimately the decisions are up to you, the patient. Once you have done the research, you can make informed decisions and design a plan of care that works best for you (http://patients.about.com).
            Here are a few basic steps for making informed decisions and achieving the best outcomes when talking to your doctor:
            1. Be sure to sign medical releases to access your health information and then put                                     together your own medical file.           
            2. Keep a current list of your prescribed medications, supplements, & over-the-                                    counter drugs
            3. Maintain your medical summary on one page.           
            4. Be informed about privacy laws, informed consent, electronic health record                                     systems, and various medical coding used for your diagnoses.
            5. Learn how to research and gather reliable health information and providers.
            6. Understand “Evidence-Based-Medicine” (EBM).
            7. Be an active participant in the conversation with your doctor.           
 
Sign releases to obtain your health information in order to develop your own medical file. Also sign releases, which gives your doctors permission to talk to your advocate or family members. Nothing is more frustrating than being told by the doctor: “Sorry, I cannot talk to you about your mother; she has not given me permission.”
 
Medical file: Keep your own records, and use this record as a reference for questions. Include test results, lab work, health proxy information & anything pertinent to your health status. Other reasons to keep your own records: medical practices may not have all your medical information available. Specialists, especially, may not know your pertinent medical history.
 
Medication/Drug list: Keep this list in your medical file, in your wallet, and with your health proxy information (which should be posted on your refrigerator if you live alone – accessible to an emergency response team). Having a list of medications saves time and prevents mistakes.
 
Single-page medical summary: This is a useful tool to bring to the doctor’s office. It saves time and gives you the opportunity to get to the “heart of the visit.” List your name, date-of-birth, address, phone numbers, emergency contacts, insurance information and primary physician. Include a brief history of your medical conditions, allergies, surgeries, and current problem (if applicable) or reason for your visit.
 
Patient Privacy and Protection: Most of us have heard all too often the term, HIPAA, which stands for Health Insurance Portability and Accountability Act. The basics of this 1996 act provide the consumer with a national standard for handling our medical information, access to our own records, notification of privacy practices, disclosure policies about your health information, and processes for filing complaints and penalties.  The HIPAA laws pertain to providers, health insurance companies and healthcare “clearing houses.” Oddly enough, some examples of organizations not covered under HIPAA (which means they DO have access to your medical information) are life insurance companies, agencies that deliver Social Security and welfare, auto insurance plans, law enforcement agencies, Workers Compensation, and more.
 
Professional services: It is helpful to talk with others who have the same condition, but typically we look to our doctors to get advice. If situations are complex, you might choose to utilize patient advocacy services (http://www.ahrq.gov/consumer/cc.htm).
 
Reliable health information: Doing research on your own is recommended, but can be complicated and confusing. Become familiar with credible sources such as Health on the Net Foundation (http://www.hon.ch/). It also means becoming familiar with understanding the meaning of Evidence-Based Medicine (EBM). Basically EBM means treatment options that have been researched and found to be beneficial to a population of people with a certain medical condition (http://patients.about.com/od/researchtreatmentoptions/a/evidencebased.htm). The benefits of the treatment should outweigh the risks and side effects.
 
Communicating with doctors: Utilize your time wisely. As mentioned above, bring a one-page summary. After your physician has reviewed this, have a list of questions available. Keep the questions simple and write down the answers. Bring an advocate (family, friend, professional) with you if necessary.
 
Plan of Care
Once you have carried out all or some of the steps above, start your plan with a list of your treatment options if you have a medical condition or preventative measures if you are making wellness choices. Discuss the plan with your doctor.
            Example for a medical condition: You have researched and gone through the above-noted steps in order to come up with a list of all the treatments for dealing with frequent headaches. After ruling out any underlying condition for the headaches, you may choose medication, acupuncture, chiropractic work, relaxation techniques, etc. After narrowing your list of treatment options, discuss these with your doctor, who may have feedback about which option is more effective or feasible for your condition.            
            Example for Prevention: You decide on a vigorous exercise plan to prevent cardiac complications since you have a family history that puts you at risk for heart problems. After researching exercise approaches and the various programs available, discuss your plan with your physician to make sure it is safe and effective.
            In conclusion, it is important to be an informed patient. “When you don't fully understand or can't act on information about your health care, you are more likely to be in poorer health” (http://www.ahrq.gov/consumer/cc/cc090710.htm). Take the steps to make informed decisions and work with your physician in order to develop an effective plan of care; the outcome is worth the time and effort.