Wednesday, August 13, 2008

Health Care and Doctor Visits

People are not going to the doctor as much these days. About 22% of Americans have reduced the number of times they see their doctor because they want to save money in these tough economic times, according to a survey released this month by the country's state insurance regulators (National Association of Insurance Commissioners) according to the San Francisco Chronicle. Eleven percent of those surveyed also said they had cut back the number of prescription drugs they take or the dosage of those medications to make the prescription last longer. Some physicians noted an increase in such behaviors by their patients and were concerned about potential health consequences.

Men are the usual culprit most of the time according to a survey released on WebMD in 2007, which was conducted by Harris Interactive for the American Academy of Family Physicians. The report indicated that many U.S. men only go to their doctor when they're extremely sick, skipping preventive care. While most men -- 85% -- said they seek medical treatment when they're sick, almost all -- 92% -- said they waited at least a few days to see if they felt better before seeking care. In the survey, most men indicated that they have health insurance, have a doctor, and feel comfortable talking to their doctor. Nearly 80% said they felt they were in excellent, very good, or good health. However, feeling fine doesn't always mean you're in tip-top shape. For instance, someone who dodges doctor visits might not know whether their cholesterol or blood pressure is too high. Those problems don't have obvious symptoms. Men may be more likely to see their doctor if their wife or partner encourages them to do so, according to the survey--nearly 80% said their spouse/significant other influences their decision to go to the doctor. When men do go to the doctor, most say they always or usually follow their doctor's advice.

According to, Today, doctor visits have become more complex. Doctors are making more diagnoses per visit and managing multiple medications. And the patient may spend only 15 minutes actually seeing the doctor. That's why many patients are challenging the traditional model of "follow doctor's orders." With Web and other drug advertising, people are likely to ask more questions or voice strong opinions about their care. And research shows that patients who are active and involved with their own health care decisions tend to get better results. To get the most out of your visit, approach it as if you were planning for a business meeting. Organize your thoughts, establish an agenda, and by all means, write things down. Do you have symptoms? Jot down notes about when they started, what happens when they occur and what makes them better or worse. Are you on a medication? Write down questions about how long you're supposed to take it, the likely side effects, the costs, and if there is any food, drink or activities you should avoid while taking the medication. also gives very helpful tips about visiting your health care provider. Physicians offer these other recommendations to make your visit to the doctor's office an effective and beneficial one:
1.) Choose a doctor you like. After all, this relationship is an intimate one, and hopefully long-standing. You should feel comfortable asking questions and discussing your health care with your doctor. If he or she speaks in jargon, don't be shy about asking for a simpler explanation. And remember, there's no such thing as a dumb question.
2.) Make an appointment early in the day if you can. A doctor can be knocked off schedule by emergencies or longer-than-expected hospital rounds, or just trying to see too many patients in one day. The earlier your appointment, the less likely you'll be affected by schedule changes. If the doctor is running late, you should be given an update or estimate of his or her arrival. If you're not told, ask.
3.) Involve the office staff. Many people express frustration at having to wait to talk to their doctors about simple health care questions. If this happens, try asking a nurse or another member of the physician's patient-care team to answer any routine questions.
4.) Mention all medications you are taking. This includes all the medications prescribed by other doctors, over-the-counter pills and supplements you take - and even those medications you are supposed to take, but don't. Make a list, or better yet, eliminate any doubt by bringing all your pill bottles.
5.) Tell the doctor about what you used to do, but can no longer do. Sometimes patients come to accept a certain level of disability, particularly if it's the result of a condition that has come on slowly. For example, if you used to run but your knee bothers you, or if you used to garden or knit, but your hands and fingers ache, these are things you should tell your doctor. If you don't share these problems with your doctor, you may miss out on treatments.
6.) Tell the doctor about your concerns - or fears. Make a list, in order of importance, of medical concerns or worries you may have. If you smoke, if you're depressed or under stress, or if you're having incontinence problems, these may be difficult subjects to talk about, but your doctor can help.
7.) Mention if a family member has recently been diagnosed with a serious disease or condition. Family history is crucial information for a doctor. Many patients provide this information when they make an initial visit, but it's also important to keep this information current.
8.) If you travel outside of the country, be sure to let your doctor know, particularly if you're going to formerly remote places in Africa and Asia. This information can become key if you come down with vague "flu-like" symptoms.
9.) Bring along a family member or friend. If you think you may have a hard time remembering or understanding the doctor's recommendations, it's OK to have someone accompany you to the office. Because of patient confidentiality, however, it may not be appropriate for your companion to ask for confidential information on a follow-up phone call, unless you have given the doctor permission to provide such information.
10.) Before you leave, make sure you know what you're supposed to do next. When are you due back? Are you supposed to call, or will someone from the office call with your lab results? What routine screenings are coming up next? How should you prepare for them? Don't leave the doctor's office unclear about what happens next. Otherwise, you'll be making follow-up calls to the office.

Remember, your relationship with your doctor is a partnership. Effective communication will help you and your doctor make the best decisions for your health. It's common to feel confused, and overwhelmed. These feelings and your health condition can make it especially difficult to keep track of and prepare for appointments, medications, and tests. When you go to your doctor you want to accomplish two main goals:
( 1 ) Assist your doctor in determining your medical needs and most appropriate treatment plan;
( 2 ) Ensure that your receive timely access to medical care and the related services you need.

Americans made over 1.1 billion visits to physician offices and hospital outpatient and emergency departments in the last year, which works out to an average of four visits per person per year, according to statistics released by the U.S. Centers for Disease Control and Prevention. With all this activity in the health care marketplace, patients and physicians need to communicate effectively at the time of service and with all follow up visits and correspondence. Time is too precious to waste on ineffective medical solutions, expense, and confusion. The vast majority of medical practitioners are extremely interested in the health and well being of their patients, and effective results benefit both the medical community and the public. Be prepared to work with your doctor when you have your next visit. Don't be afraid to ask questions and seek other options. Trust your doctor and listen to the prognosis. But don't forget, he works for you. The medical industry wants to heal the sick; but overall, it's your health. Make sure you find a physician that fits you for mutual benefit.

Until next time. Let me know what you think.

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