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Active “Patient”

Healthcare is expensive, time consuming, and stressful. Therefore, it’s imperative that you, as consumer, customer, and patient, get the most from your healthcare experience — become an “active” participant. Benjamin Franklin once said, “if you fail to plan, you are planning to fail.” There are several things you can do to “plan” for your next medical visit.

Before your appointment, think about what you want from the visit. Do you want to talk about a health problem, get or change a medication, get a medical test, or discuss treatment options or a surgery? Write your “plan” down on paper and bring it with you. As an example, have you ever noticed the difference in a visit to the grocery store with a list and without? This is no different – get what you want and need without forgetting what’s important. Further, the healthcare insurance and payment options are more complex now than ever. Contact your insurance carrier in advance to ensure you’re clear on your financial responsibilities (deductible and co-pays). When you arrive at your appointment, the clinic will probably ask for your co-pay and any remaining balance. However, they won’t have the amount you owe at the conclusion of today’s services since the clinic has to submit the details of the services to your insurance and the insurance company will let the clinic (and you) know the amount of patient responsibility (see the explanation of benefits statement from your insurance company).

During your appointment, ask questions to ensure you fully understand what your provider tells you. And if possible, share your “plan” with someone else and take them with you to the appointment. They can help you to ask and understand all the answers. Example questions include, what is my diagnosis, treatment options, benefits of each option, treatment side effects, will I need a test, what’s the test for, what will the medicine do, how do I take it, medication side effects, why do I need surgery, are there other non-surgical options, how often do you perform this surgery, and should I change my daily routine/behaviors? In addition, there are two primary types of patient categories in an outpatient clinic: new and established. According to the American Medical Association, “a new patient is one who has not received any professional services from the physician or another physician of the exact same specialty and subspecialty in the same group practices, within the past three years, and an established patient has received professional services…within the past three years.” These patient types should be transparent to you, the patient, but could result in some additional time and paperwork when you’re at the clinic.

After your appointment, there are times when you should re-engage your provider. For instance, if you experience side effects, if your symptoms get worse, if you receive any new prescriptions or start taking any over-the-counter medications or supplements, if you don’t receive the results of a test, and to ask about any results you don’t understand. It’s always okay to re-engage your provider if you have questions, but don’t be surprised if your provider defaults to another appointment (depending on the questions). There are two primary reasons for another appointment. First, most providers feel any services they offer will be of a much higher quality when face-to-face, particularly if the provider needs to examine you or run additional tests. And second, an unfortunate reality of today’s environment is the litigious umbrella overshadowing healthcare (providers may feel at greater risk for a malpractice claim depending on the questions asked). If you leave your appointment and feel your provider wasn’t listening, there are a few simple options: (1) ask to speak with the practice administrator, (2) ask for a customer comment form and include your contact info, or (3) seek another provider. The world of healthcare is slowly evolving into a true service industry. Therefore, many physicians and administrators have realized you, the patient, are the most important part of the healthcare process (you are the customer) and your feedback is absolutely wanted and needed – if we don’t know it’s broken, we can’t fix it.

Becoming active in your healthcare will ensure you get the most from your appointment. Furthermore, the time and money spent on your care will be more worthwhile and less stressful when questions aren’t left unanswered and you understand everything your provider tells you. In addition, active involvement will help you make better decisions, improve the quality of care received, avoid medical harm, and you’ll feel much better about the “value” of your healthcare.