Do Your Homework

In today’s convoluted health care system it is difficult to know for sure that you are getting the best medical attention or referrals that you deserve and your medical condition requires. Don’t you hate it when you call a doctor’s office to schedule an appointment and the first words uttered out of the receptionist mouth is: “What kind of insurance do you have?” It’s very sad to think that the level of medical care you receive is somehow attached to the logo stamped on your insurance card. But that’s reality with increasing overhead costs and declining reimbursements.

Then with this so-call health care deform, governmental regulatory agencies continue to enact new mandates that are transforming the way hospitals and doctors offices operate and do business. For example, the electronic health/medical record (EHR/EMR) mandate. Hospitals and health care providers are struggling to prove meaningful use for these systems and trying to implement an electronic version of the old-fashioned manila medical chart by some fast approaching deadlines. The heat is on to implement sooner verses later in order to capture the maximum monetary incentives offered by The Centers for Medicare and Medicaid Services (CMS) by the end of 2011. If health care institutions and doctors offices do not get on the bandwagon and implement their electronic record systems by the end of 2014, their pocketbooks will feel the vanishing effects of reimbursements.

OK, that background is probably more information that you need to know or even care about. However, these mandate diversions can impact you and your health care and the result can be rather frightening. And I would like to share with you some tips on what you can do to ensure you or your medical condition does not get overlooked during this paper to computer transition.

It’s easy to trust those professionals who have earned the high honor medical degrees and are identified by their long white lab coats. But just because the person wearing the long white lab coat has two initials after their name does not mean that they are always right. Just because they recommend and refer you to Dr. I’mThe Specialist for your pain in the butt (PITB), does not mean that Dr. I’mThe is the best physician to treat your PITB.

Physicians are busy just like the rest of us and many times they refer patients to the same specialist over and over again just out of pure habit, or based on insurance and hospital networks that they are affiliated with. It’s easy to think that they have our best interest in mind; but that is not always the case. Sometimes the office is more focused on what kind of insurance card you hold and making sure you complete the demographic and medical history paperwork (for the umpteenth time) so that they have documentation to bill the highest level of service. I know, I know, it all comes down to dollars and cents.

Once you have been referred to a specialist for further evaluation it’s time for you to do your homework. It’s ok to have your primary care office call and schedule that appointment with Dr. I’mThe Specialist just to secure an appointment slot assuming all of your research points to Dr. I’mThe is the best for your PITB.

Assuming your PITB is not life threatening, call all your friends, neighbors, and relatives to get the inside scoop on this particular specialists reputation and expertise in the community. Ask for other names for specialists in the same field of expertise from these same people. Then google, google, google and read everything you can about the names of those specialists. I even go as far as checking this New York State education website to ensure that the physician has a valid medical license and no fishy outstanding malpractice claims. And I encourage all of you to do the same in the state that you live in. It is up to you to make the informed choice about who is going to treat you – not your doctor.

Once you have narrowed down the top specialists, call their office and ask questions to test the waters. I would go out as far out on a limb and state that the personality of the person answering the phone is a direct correlation to the personality of the physician. Rude receptionist = rude doctor, knowledgeable receptionist=knowledgeable physician. Start with general questions about the hours of the office, directions, office locations, how many years has the doctor been in practice, average wait times, emergency appointments, etc. . You should receive educated responses to all of these questions. If you don’t- RED FLAG! You need to feel comfortable with the intelligence of the office staff in addition to the doctor that will be treating you.

If your primary care doctor gets offended because you chose another doctor to evaluate and treat your PITB, then perhaps it is time to say bye-bye and find a new gatekeeper.

Please don’t rely solely on the white coat when being referred out to a specialist. It’s up to you to do the research to select the best doctor when it comes to your health.

Do you agree, disagree, remain neutral on this healthcare discussion? I would love to read what you have to say in the comments below.

On a side note: I have decided not to continue with the Weed out Wednesdays posts. I had a vibe that it was getting a little boring. I will still bring you organizational tips and ideas that you may like in the future.

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