How to be your own health care advocate

Going to a new doctor’s office for treatment of some painful problem is scary. Will you receive some terrifying diagnosis? Will you even understand what your physician is talking about, or will the language used be filled with big words and impossible to understand. Will the doctor be arrogant, and difficult to relate to? Perhaps you will be prescribed some potentially-dangerous drug. Many serious and intimidating challenges present themselves in our health care system.

There was a time, not that long ago, when you didn’t question a doctors decision about the diagnosis or treatment. His word was law (there were far fewer females entering medicine then). Their experience, and all that education, provided them with unquestioned supremacy. Patients were far less informed, and materials on medical topics were hard to come by. Obviously, this is no longer the case, with internet research providing all manner of data and information. Unfortunately, just because it can be found somewhere on the world wide web, does not make it accurate or correct.

But health care providers are under greater stress than ever before. The demands on medical professionals have increased tremendously in the past twenty years, without a commensurate expansion of time and resources. Government oversight, along with the pressures of working for a private, for-profit corporation, have changed health care in ways unimaginable just a short time ago. The documentation required by the insurance companies is extensive and consumes a large portion of a physician’s time, sometimes making patient care less of a priority. The result: the time with your physician is shorter and the visit more condensed than ever.

A significant concern for many when it comes to medical care is the cost. How much do you know about your health insurance? What services are covered by your insurance plan and, if it is, what percentage? How big is your deductible? Many people do not know these essential items. Added to this quandary, many insurances obfuscate the issue, making it difficult to know any specific answers. Many private insurers, be they Medicare plans or not, deny coverage whenever possible. The representative may say some particular treatment is part of your plan, but will the doctors office jump through all the hoops required to allow for payment?

There has been a movement in recent years to empower patients, to make them part of the medical decision-making process. People need to realize they should have some control over what happens to their bodies. The way to do that is by being your own health advocate, a concept being touted to such a degree there are now professionals who do this for people as a paid service. Hiring someone like this is not generally feasible (although bringing a family member can help fill that role).

One of the biggest problems is the tendency for many people to be passive bystanders when we see a physician for medical care. There is also a tendency to feel anonymous, that you are a diagnosis as opposed to an individual. This may be difficult for many, but there are steps you can take, specific ways to be involved in the process of your medical care and become an effective health advocate for yourself.

Perhaps the most critically important is to become educated about your illness. Take the opportunity to find out more about what is wrong with you and the diagnosis proffered. Being knowledgeable regarding your condition is not the same as challenging your health care provider, but you have the right to ask for what you need, be it the type of care you receive or information you are provided.

As mentioned previously, it is helpful to have another pair of ears by bringing a friend or family member to act as a support system. Also recommended is keeping a journal of your health condition and any changes or progress you are making. In addition, letting your health care team know that you want to be involved in the process of deciding about treatment options. Ask for more detailed information when needed.

Understand how your health insurance works, and what is covered (although this is a very difficult task in our current system). And when you are in your doctor’s office, don’t be afraid to ask questions. You will probably not have much time with your provider so have them written down prior to your appointment. When talking to your health care providers, it is essential that you be honest. Don’t tell them what you think they want to hear. This benefits no one. Some new symptom or sensation may provide key information to making a more accurate, specific diagnosis.

Being an effective health advocate is aided by keeping accurate records. This is easier than ever because of those electronic health records (especially since you have the right to get a copy of your doctor’s records). And don’t wait for your physician to suggest obtaining a second opinion. Even if you are comfortable with the initial diagnosis, getting the input of another provider, especially concerning any surgery that isn’t an emergency, is often a good idea. At the very least, this can reduce your stress and increase confidence. Similarly, if some therapy (or medication) is recommended, and it has the potential to cause significant harm, you may feel better about consenting to it if another physician has affirmed it is appropriate.

You may like your doctor and feel that he cares, but this doesn’t rule out being your own advocate, and asking for what you need to feel confident about the course your care is taking. Patient advocacy is concerned with treating the person as a whole, not focusing on the disease. This is your right in the world of modern health care.

We are only beginning to understand how our emotional, mental and spiritual make-up affects our health. Health care providers need to take these factors seriously. The progress made in achieving a cure may be largely dependent on how you feel, emotionally, about your well-being and your physical state. As a general statement, the better you feel about your health care, and your part in it, likely the better you will do. Patients who want a voice in their health care must often assume this role for themselves. Take part in your health care, be a willing participant and your own health advocate.

Editor’s note: Dr. Conway McLean is a physician practicing foot and ankle medicine in the Upper Peninsula, with a move of his Marquette office to the downtown area. McLean has lectured internationally on wound care and surgery, being double board certified in surgery, and also in wound care. He has a sub-specialty in foot-ankle orthotics. Dr. McLean welcomes questions or comments atdrcmclean@outlook.com.


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