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You've got to be a savvy consumer to make sure your needs are met.
Going
to the Doctor
Getting
the most out of health care services requires you to be an active
and vocal consumer. If you feel intimidated, uncomfortable, or forget
to ask questions when you visit a provider, you are not alone.
Visiting
a provider can be highly stressful. Being prepared and having faith
in your life experience and common sense will help you avoid feeling
intimidated by places and providers who may appear cold and distant.
Expect
that providers will not know everything they need to about your
condition or disability. The information explosion in health
care makes it difficult to keep current. Providers cannot be experts
on everything. Plus, the fact that your condition or disability
often represents a small percentage of a provider's practice means
it is important that you educate yourself and then your providers.
Be
informed about the health conditions that are of most concern to
you. This helps you participate as a partner in your health
care. It will also improve the quality of your decision-making.
Anticipate
that some health care providers may not be free of the common negative
stereotypes of disability. Unfortunately, people working in
medical settings may reinforce these stereotypes because they are
exposed to only people with disabilities who are indeed sick. Medical
students report that little is taught about disability during their
four years in medical school.
Consider
taking an advocate or friend who can listen, take notes and help
ask questions. This is especially important if you tend to forget
your questions, freeze, or become less effective as a self-advocate
when dealing with health issues. If you take an advocate or friend:
- Choose a
support person who has the skill to think objectively, is able
to listen and remember accurately, and who can offer you emotional
support.
- Ask her or
him to be there for you and assist you but not take over.
During
an appointment, take notes on important information. At the end
of a visit, always check your understanding by briefly repeating
what you heard the provider say. Consider taking a tape recorder
if you don't want to worry about taking notes.
Ask
open-ended questions. Avoid leading questions. Leading questions
can force providers to give the answer you want even if it's not
true.
| Leading
question: |
|
"I'm
going to be OK, aren't I?" |
| Open-ended
questions: |
|
"What
are the chances of my recovery?" |
|
"What
is the outlook?" |
|
"What
are the implications of the treatment?" |
Never
be afraid to say, "I'm having trouble understanding. Could you describe
the problem in plain terms?" Don't pretend you understand if
you don't.
Sometimes
what you hear may surprise, shock, or upset you. Don't hesitate
to ask for more time to make a decision that could affect your life.
Ask if delaying your decision will affect the outcome of your treatment.
Speaking up is the most powerful tool you have for protecting yourself,
and protecting how you want to live your life.
People
often hesitate to get a second opinion. It's your health; get
one if you think you need one, particularly if:
- You feel
uncomfortable with your provider or the treatment recommendations.
- You feel
what you are being told doesn't make sense or isn't right for
you.
- You are concerned
about a procedure (especially a surgical one).
Your provider
isn't sure or doesn't seem to know what the appropriate course of
action should be.
- You are dealing
with a life-threatening condition or risk of increased disability.
When
the second opinion differs from the first, you may feel justifiably
confused and decide you want a third opinion. Get one or use
a trusted provider to review the differing recommendations.
When
you visit any specialist, make sure the physician goes over all
your options and answers all your questions to your satisfaction.
Since it may be difficult for you to sort these issues out alone,
having a primary care provider can be beneficial.
If
your care is not coordinated through a primary care provider, it
may be more difficult to sort out recommendations that are given
to you by specialists about complex medical problems.
An
additional consideration is that the advice and opinions people
with disabilities get for everyday conditions are often not put
through a disability filter. For example, at times the provider
may attribute a symptom to your disability when the two are unrelated.
Conversely, a symptom that may in fact be an early warning sign
for another condition could be a typical characteristic of your
disability.
Selecting
a provider
You
can increase your chances for quality care by establishing a long-term
relationship. In fact, research confirms that people who are
more active in their relationships with their physician have more
positive results. As providers get to know you, they're able to
see you as an individual rather than a textbook or theoretical case.
Talk
to your friends, especially those who have disabilities similar
to your own, to see if they are familiar with any of the physicians
that participate in your health plan. Call the offices of different
practitioners about the types of patients they see. This will help
you pick a primary care provider that will have at least some familiarity
with disability-related issues.
Providers
practicing in rehabilitation settings tend to have a stronger knowledge
base related to health needs of people with disabilities and
often know providers who offer primary health care for people with
disabilities. Primary care providers can coordinate the referrals
to sub-specialists who may be able to address your more complex
problems.
Experienced
primary care providers are usually familiar with specialists from
many different disciplines and they have knowledge regarding
the competence and expertise of such physicians. This awareness
comes from having referred patients to these specialists on previous
occasions and from having evaluated the quality of their consultations.
The
experience and familiarity of the primary care provider with various
experts will help to lessen concerns you might have about biased
or inappropriate recommendations. Recommendations are usually sent
to the primary care provider for review. If the recommendations
do not seem appropriate to you and your primary care provider, get
further advice and consultation.
Being
a savvy health consumer does take time and planning. Follow some
of these visit strategies and remember - you have the right and
responsibility to ask: Why? Why not? What? How? When?
[By
June Isaacson Kailes, Disability Policy Consultant, excerpted from
her book, Be a Savvy Health Care Consumer: Your Life May Depend
On It.To learn more about her other publications or to order this
book, visit www.jik.com/.
]
See also ...
Educate
Your Doctor
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