The Healthcare Consumer

 

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Ask a Question that you would like to have answered here.

 

 

Q. If one of your patients asked you what they could do to contribute to reforming Healthcare in America; What would you tell them? 

A. "SPEAK UP. I think one of the things we, as physicians, fail to understand from our patients is that they don’t always understand what we are asking them to do. The patient should force...or at least encourage us to make sure they understand what we’re telling them. They may/may not read or comprehend our instructions. But; it’s important that they understand.  It's okay to say, "I don't understand", or, "I don't know what that means".  I say it every day! 

We, physicians, don’t ask patients often enough what is important for them to be able to do and factor that into our decision-making and recommendations. We could do a better job with encouraging patients to share with us what they are missing out on or what makes them happy. Sometimes we are too focused on what we think is the "right" thing to do as opposed to what is "right" for a particular patient.  We care but we don’t always ask enough questions to fully understand. 

Give us feedback!  When patients fill out a patient satisfaction survey; The comments section is the most important part. The survey is long. They should complete the sections that they care about. Hospitals receive payment from the ratings but organizations change behaviors based upon the comments. The patient’s comments are really helpful. 

Bring a family member or a trusted friend with you to your doctors’ appointments. We provide a lot of information. The family member can take notes. It’s just so much information; you won’t remember it all." – Dr. Craig, CA

 

Q. If you know you are not going to comply with something being asked by your doctor, should you say so? - Mrs Crawford, MD

 

A. Of course you should say so. Then you can work on alternatives.  Persons have seemed to have forgotten that the physician works for them. Third party payers, hospitals, "health systems", pharmacies, government have all seemed to have convinced persons that they pay for their own health care but are "lucky guests".  Empower yourself and demand that your concerns be addressed and have your care fashioned within the constraints of science and law to meet your needs. Your health. Your money.  Your life. Your body.  Your physician. Your hospital.  

- Wesley B. Vanderlan,

MD, FACS Assistant Professor of Surgery

Uniformed Services University

Assistant Clinical Professor of Surgery

Louisiana State University, New Orleans

Q. What frustrates you about America’s Healthcare?


A. “Having opiates pushed at you when there are other non-addictive alternatives available to make people comfortable when dealing with pain. Also, the non-addictive alternatives being priced by big pharma at more than 10 times the actual cost.” ~Rosalyn, WA


Response: Thankfully, America’s healthcare system officials are waking up to that fact that opioid addiction has run rampant and out of control for too long. In years past, blame for the skyrocketing painkiller prescriptions was laid at the door of emergency room staff, so state legislatures and hospitals around the United States focused their energy on tightening emergency room prescribing guidelines.


Turns out, they weren’t the biggest problem: a study published in Annals of Emergency Medicine found that a significant majority of prescribed opioids came from office-based doctors—those who prescribe in an outpatient setting—rather than emergency departments.


As a result, Centers for Disease Control and Prevention officials have recognized that office-based doctors overprescribe. So they issued guidelines for better prescribing practices. Doctor-based opioid prescriptions have been on the decline since 2010, yet prescription rates are still high compared to past decades.


So your doctor writes an Rx for something else, but the co-pay (or full cost) is a budget-killer.


Doctors do have access to insurance drug coverage information, but many don’t keep track for each of their patients. Explain your concern and ask about a substitute drug, perhaps a generic version of the one prescribed. If there are no alternatives to the drug, you can try patient-assistance programs.


There are also many non-opioid pain medications available over-the-counter or by prescription. Ibuprofen, acetaminophen, aspirin, and steroids are sometimes all some patients need.


A physician anesthesiologist can also work with you to develop a safe and effective pain management plan. Some people find relief with non-drug therapies that can be used alone or in combination with medications, such as:


  • Physical therapy which includes whirlpools, ultrasound and deep-muscle massages.

  • Acupuncture where very thin needles are inserted at different places in your skin to interrupt pain signals.

  • Surgery for when other treatments aren’t effective; used to correct abnormalities in your body that may be responsible for your pain.

  • Injections or nerve blocks may help if you have muscle spasm or nerve pain.


No two cases are the same among the millions of Americans who suffer chronic pain. Everyone has unique needs. Taking a prescription opioid may not be the best option. Through close examination of your needs, speak with your doctor to weigh many options—and work together.


Q. What frustrates you about America’s Healthcare?


A. “I struggle with the industry’s inability to solve some of its key human resources issues that have been plaguing it for years. One area is the inability to solve critical staffing shortages. Healthcare is sick on a number of levels, but has not been able to strategically able to address how to maintain a sufficient poll of qualified candidates. Let’s not even talk about how to engage and retain staff. Quality people correlate with quality services.” ~Marianne, FL


Response: It’s true—America is in a critical period for human resources in the health field. Qualified health personnel—especially nurses—is scarce and being touted as one of the biggest obstacles to healthcare system effectiveness.


Let look at supply-side issues first: improving recruitment, retention and return, and keeping in touch with staff. Research indicates that nurses are attracted to work and remain in work because of the opportunities offered for them to develop professionally, to gain autonomy, and to participate in decision-making while being rewarded fairly.


But things are already getting better. According to a report from Hospital Review, hospitals across the US are already responding to the shortage:


A few things to know:


1. Hospital officials are offering incentives to recruit and keep nurses such as retention and signing bonuses, higher pay and student loan repayment, no-cost housing and career mentoring.


2. Hospital officials are investing more in "travel" nurses who work for a temporary period, and foreign nurses. One West Virginia medical center doubled the amount it spends on travel nurses so that the financially struggling hospital can continue operations.


3. Competition. Rural hospitals are forced to offer higher pay and more benefits to stay competitive with metropolitan hospitals. Hospitals must compete with clinics and insurance companies for staff.


Hospital officials’ recruitment and retainment efforts come at a good time during this shortage. The Bureau of Labor Statistics projects the number of employed registered nurses nationwide will grow 16 percent by 2024, more than double the average growth rate of 7 percent for all occupations.



Q. What frustrates you about America’s Healthcare?


A. “That I can’t make my own decisions about what my body needs. For example—I have had horrible periods since I was young. Lose too much blood. Have had miscarriages. Still can’t get a hysterectomy. The government says ‘no’ even if I pay for it myself. I was allowed to get my tubes tied, but that’s it. And that’s one of the most frustrating things to deal with.”  ~Rachael, State Unknown


Response: Understandably, not being able to make quality-of-life health decisions without government approval is frustrating.


Let’s look at a few things, beginning with who makes decisions about your treatment.


Your doctors will provide information and advice to you about treatment. You can say “Yes” to treatments you want. You can say “No” to any you don’t want —even if the treatment might keep you alive longer.


After listening to you and giving an examination, your doctor must tell you about your medical condition and about which treatments and pain management alternatives are an option. Often, more than one treatment might help—and people have different ideas about which is best. Your doctor can tell you which treatments are available, but your doctor can’t choose for you. You make that choice, depending on what is important to you.


What about when government officials say “no”? This is when it may help to think of your doctor as a partner, rather than your boss who answers to the government.


You may be able to proceed without the government’s okay, if you are ready and willing to push through.


According to Survivorship A to Z, the first step is to check around to find out if you can obtain the surgery for free or for low cost. For example:


The doctor who gave you the diagnosis may know of specialists willing to take people without insurance. The doctor may even know of specialists who work for free.


  • Hospitals which receive funds from the government must provide a certain amount of free or low cost services. This is known as Hill-Burton. The finance department in a hospital can tell you if Hill-Burton treatments are available. The earlier in the year you ask, the more likely it will be available.

  • A hospital may have money available to pay for procedures for those who fit their specific criteria. A hospital's finance department can tell you about what, if anything, is available.

  • Preferably the free surgeon has an anesthesiologist who is also willing to do pro-bono work. Anesthesiologists are responsible to keep you asleep and check vital signs during an operation.

  • If you cannot get free surgery, consider negotiating with a surgeon for the amount of fee and the period of time over which the money must be paid.


Begin with doing your homework. In your geographic area, find out a fair price for the service you need. Keep in mind that prices vary by place, and also by who is paying.


For example, there may be a different charge for people who are insured by different insurance companies, and for people who are covered by government programs such as Medicare or Medicaid, and for people who are not insured.


For many years, common medical practice was that doctors made decisions for their patients. This paternalistic view is being replaced to one where patients and doctors share the decision-making responsibility. Doctor-patient relationships are very different now than they were just a few decades ago.


However, conflicts still abound while the medical community and those it serves struggle to define their respective roles.