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Be your own health advocate

I can remember a stay in the hospital years ago. The doctors were trying to figure out what was wrong with me. Lots of tests were performed. In an effort to keep up, I asked the doctor if I could read through his notes in my record. He had no problem with that. So, one afternoon I pulled on my sticky-bottom hospital socks and padded out to the hall and grabbed my medical record file (at that time they were stored on the wall outside the patient’s room). When the nurse came into my room a bit later she scolded me and informed me that the information inside my record was none of my business and meant for the doctors and nurses only. Right or wrong, good or bad, years ago that is how it worked.

Even in my weakened state I was both mortified for going against the rules and outraged that my information was considered not my business. When the doctor next came in to talk with me I again asked if it was OK to read my file. Perhaps I had misunderstood. Not a problem, he said. I then asked if he would make a note of it for the nurses. I never ran into that particular problem again. It was a simple communication error. But for me it illustrated how little most patients were involved in their own healthcare.

Back in the day of the family doctor, we had one-stop medical care. We had one source for information regarding our health. Whatever was determined by this one person was how it would be from then on. If the doctor had a patient with more complex issues than he could manage, a referral to a specialist would be written. As the patient traveled to a larger city to see a doctor with more experience, the communication would stay between the doctors. The patient update would be from their family doctor. The family doctor would be the keeper of all the parts of medical care.

The world’s population has grown more than sevenfold over the past century. Globally, there are nearly 1,900 patients per physician. In the United States it is a lighter load, averaging 300 patients per doctor. No longer can one person adequately handle the medical care of a community. Health care is sophisticated from top to bottom. We know more. We want more.

But where does that leave the patient? Getting care when feeling sick has always been the responsibility of the individual. Nothing’s changed there. We call and make an appointment. We still begin with our family doctor. They are the generalists. They know the basics of the whole body. As the illness is defined and specific body parts identified as “not well,” the family doctor will refer the patient to a specialist. The specialist knows a lot about a specific part of the body. Straightforward.

It makes sense written out. But the process takes time and requires some management. That is where patient advocacy comes into play. The role of a patient advocate is to help the patient navigate through what has become a complex health care system. But we don’t necessarily need to hire an advocate. We can often be our own advocate.

Here are a few tips to help you get the most out of your health care:

(1) Ask questions. If you are unclear about something, ask. Let your doctor know. Don’t be embarrassed to need a word or two spelled out. This is a new language for you.

(2) Bring another pair of trusted ears with you. Have someone with you who can hear what the doctor says so you can compare notes after the appointment. Both sets of ears probably won’t hear the same things. As you talk it through after the appointment, you can fill in each other’s gaps. If you can’t have someone in the room, call them during the appointment so they can listen. Or ask the doctor if you can record the appointment to review later.

(3) Understand how your health insurance works. Don’t be surprised when you get the bill from your provider. Compare the bill to your insurance company’s explanation of benefits. A deductible is different from a copay is different from a premium.

(4) Maintain your own records. Get a notebook for notes and a calendar to keep your schedule. Don’t allow your need for an appointment to get lost in someone else’s shuffle.

(5) Review your medical bills for errors. Mistakes are made. Numbers get transposed and charges could be entered incorrectly. Know what you are paying for every time.

(6) Prepare for each appointment. Don’t rely on yourself to remember what to ask when you are in the exam room. As questions come up between appointments, write them in your notebook. Then carry your notebook into the appointment so your doctor can address your questions and concerns.

Your health and well-being is your goal and the doctor’s goal. You both want the same thing. You are both on the same team. Work together with respect and honesty. Do it for yourself.

Lesslee Dort is a board-certified patient advocate who firmly believes knowledge is power when it comes to being in control of one’s health. Reach her at lesslee@friendstogethermi.org. Read her here the third Thursday of each month.

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