9 Tips for Navigating the Healthcare System

Twenty years working with and around healthcare professionals, as well as being an occasional patient, has taught me a few things about our current healthcare system (in the U.S., anyway). Along the way I have a gathered a handful of suggestions that I give to friends and family (when asked), and that I use myself when interacting with what I feel to be the primary elements of healthcare.

DNA

Courtesy of Pixabay.

*This article is NOT intended to give medical advice. The intent of this article is to offer ideas about how to navigate the healthcare system. Readers use the ideas in this article at their own risk. (I really do think they are good tips, though!)

Your Doctor

  1. Be candid. Your doctor needs to have all of the information in order to access your situation accurately. Missing bits of information can delay diagnosis as well as treatment. No need to be embarrassed, physicians are trained to deal with what might seem to be the most personal physical issues. If you’re worried about privacy, take heart. In the United States, HIPAA laws help keep your information safe from others, and also available to you.
  2. Write stuff down. This is important before and after the appointment. Writing down details prior to your appointment about frequency, duration, and type of symptoms can help give your clinician a clearer picture of the situation, and you can avoid the chance of blanking on important details while in the office (spoken from experience). If your doctor isn’t already in the habit of giving patients a printout after the appointment, detailing the visit, writing your insights down right away will help you remember important points and instructions that you may have been given.
  3. On occasion, don’t be afraid of getting a second opinion. As much as we hate to admit it, sometimes medicine is more an art than a science. This means that not every treatment will work in the same fashion for every patient. Getting a fresh perspective from another trained professional and trying a new modality to solve a problem can occasionally be the difference between successful treatment and failure.
pharmacy

Courtesy of Pixabay.

Your Pharmacist

  1. Pay attention. Most pharmacists have trained at least six to eight years, and many hold doctorate degrees in pharmacy. You may only spend five minutes at the counter when picking up your prescription, however, a lot of critical information can be conveyed in those five minutes (side effects/possible interactions/what to do if you miss a dose). Paying close attention and asking questions at the counter ensures that you get the most out of your prescriptions.
  2. Read the label and call back if you need to. It might sound odd, nevertheless, sometimes instructions change depending on various factors, not limited to: what size/strength the pharmacy has in stock, if the pharmacist noted an issue with the prescription and called your doctor to verify the order. At any rate, always read the label and confirm the instructions with the pharmacist before you leave. If you have questions, or feel as though you might have missed some information from your visit to your pharmacy, feel free to call back. In my experience, the best pharmacists are more than happy to share their knowledge!
  3. Plan ahead. To make your visit to the pharmacy quicker and easier, make sure you have your prescription insurance card (sometimes a separate card from your medical insurance card) with you, and that you know your drug allergies and the names of other medicines that you take (over-the-counter medications, as well). When ordering refills, note that many physician’s offices request 24 to 72 hours to reply to a refill request. Try to order at least three (business) days before you will run out of medication so that the physician has adequate time to call back the pharmacy for your request.

Your Insurance

  1. Avoid Surprises. When your physician recommends a new procedure or treatment, it may be helpful to call your insurance company ahead of time. This allows you to confirm whether or not the procedure/treatment is covered (and at what cost to you). If it’s not covered, it may be worth asking your doctor for an alternative modality.
  2. Understand your policy. Not nearly as simple as most of us would like, knowing things like what your deductible is, how much your copays are, and what kinds of services are covered can help you avoid unexpected bills, and also help you determine if your policy serves your needs.
  3. When traveling… When you are on your way out-of-town, a quick review of what your “in” and “out” of network hospitals are, might be a good idea. Nobody plans on getting ill over vacation, but (again, speaking from experience) it happens. Knowing what facilities your insurance will cover at your destination can help lower your stress levels (at least a little). If you are heading out of your home country, you may want to find out if you have overseas coverage.

Wishing everyone a happy and healthy year! I hope at least a few of these tips are helpful to some of you. Stay cozy!

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