Medical Matters


So, you are going to see the doctor. Have you prepared? In this day and age, going to see your doctor isn’t like it was for we old guys and gals who were around in the 50s, 60s and 70s. Back then you could just show up on his doorstep (his because a woman doctor was an almost unheard of commodity then, whereas today all but one of the physicians and specialists I see are female) and you’d get seen. Back then it also cost $3 for an office visit and for $7 — at least in the Highlands area of Louisville where I grew up — Dr. Elliott Podoll or Dr. Lennie Rosenblatt would come with his little black bag to the house and treat you in your own bed!

Times have certainly changed and with them there’s a lot more paperwork, restrictions and that rather odious (to many of us) thing called HIPAA.

That’s the well-meaning law which guarantees privacy but does so to such an extreme degree not even our lovers, best friends, rabbi, priest or sister-in-law can find out we are even in the hospital or at the doctor’s much lass what the prognosis is. I could go on and on about how much I personally hate HIPAA and how I always write in a bunch of names I especially want to know how I am doing, followed by “and anyone who cares to ask!” 

But HIPAA aside, doctors have changed a lot since the old days and if you are caught off-guard you might find that $45 office visit or $50 or $20 co-pay if you have insurance is money wasted. That’s largely because so many physicians’ practices are not owned by the friendly doctor who sees you (as was always the case before) hut by some hospital or mega-corporation off in some far-flung city. 

 At HQ you aren’t a patient but a client and you are known by an account number or by whether you pay the bill or not. Care has changed and for the patients, and often the doctors who don’t usually like working for some big brother, either not for the best.
The bean counters determine just how long your doctor gets to see you, as well as how many patients he or she must see to have an “efficient day.” This, of course, doesn’t take into account that seeing someone with sniffles and a sore throat will take less time whereas someone with HIV/AIDS or a major concern will need a lot more. 
It also doesn’t take into account any pleasantries like “How was your vacation?” or any “extras” you might want to ask about (like that mole which changed color and worries you but is not the prime reason you made an appointment).

So what can we, as patients, do? First remember that a doctor today is just like a store or restaurant. If you go to Macy’s and want a blue dress shirt but they have nothing to fit, you try Nordstrom’s or Sears Roebuck or J.C. Penney. 
If you want a crab dinner and the first place you go doesn’t sell those, you go to a different restaurant. The same thing applies here: If the doctor you see sells his or her practice or just is not a good fit for your needs, then shop for another one. It’s business. And unlike settling for roast beef when you want crab or white when you want a blue shirt, this is your health and life we’re talking about. 

When searching for a new doctor, be sure you include asking while considering a physician if they take your insurance, what their office policy about time with patients is, how to get refills on your prescriptions and anything else you need to know — including no-brainers like days and hours they are open. 
If you need to, make a list before you go for your get-acquainted appointment and make sure you get the answers you want. Keep shopping if the responses aren’t to your liking. 


Also explore with the doctor who owns his or her practice and what the policy is on appointments. Recently, our physician sold her practice and joined a major Indianapolis medical group so the next visit we asked, “Is there a change in time allocated per patient or other policies we should know about?” and she assured us that had been negotiated in the sale so all patients were going to continue to receive care regardless of time. We’ve found her to be a lady of her word and continue to use her practice. 
But there are also other things we should all do before we see a doctor: One is to make a list in a few words of what you want to discuss. If you have that mole besides the sore throat be sure to note that you need to discuss it so when you do get your time with the doc you won’t leave having forgotten. 
Also ask the doc to clarify things you don’t understand. There is a differenece between taking a pill every eight hours or three times a day. There’s also a difference between “a fever” and “a fever over 101 degrees.” 


If you don’t understand what’s being said or need clarity, stop the doc and ask! You are the customer.. er, ah, the patient. Also, if you can, take someone with you. My partners always go with me and often they hear things I have missed. It’s never a bad idea to be certain what the doctor wants you to do and how to do it. A ban on partners in the office would be a deal-breaker were a physician to impose one, though thankfully none ever has. 

Finally, be certain you know what’s next. Should the pills work in five days or should you call back in two? Should you get that blood test now or later? When you get it, will the office call you with results or will you need to call them? And if so, when? Will you need to make another appointment? 

And if you need further treatment — be it pills, a procedure, referal to a specialist or something as easy as a knee brace — know about anything you do not understand. Leave the office informed about what’s happening and what needs to take place as well as when to follow up. 

Remember, many practices only allow seven to 10 minutes per patient so if you plan to make good use of your time then you will need to be prepared before the secretary calls “Next!” and you get your audience with the doctor. You’ll feel better for being prepared! — and that I can guarantee!

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