Do As You’re Told! Listen to your doctor!

You’ve broken an arm, or you’re running a fever, or you’ve developed a rash. A visit to your doctor results in an order for a drug, a bandage or cast, surgery, or another treatment plan to help you heal or become healthy again.

Or maybe you have a chronic condition or disease, and you’re consistently under a doctor’s care. At each visit, your doctor reviews your treatment plan and may make adjustments. The goal is to help you manage your condition to improve or maintain your health.

In either case, your doctor did her job. She developed a treatment plan. That’s what you expected, and that’s what you, and your insurance company, paid them to do.

So what’s your job? Your job is to heal, or at least to keep yourself from getting sicker. Your job is to follow the treatment plan provided by your doctor. In a nutshell, your job is to listen to your doctor.

Sounds simple, right?

Remarkably, studies tell us that 50 to 75 percent of patients don’t follow their doctors’ treatment plan. Either they don’t fill a prescription, or they don’t change a dressing, or they forget to take their pills, or they fail to follow instructions in some other way. Even more surprisingly, the people with the chronic problems such as hypertension, have the highest non-compliance rates. Children, too, are often victims of caregivers who fail to follow a doctor’s instructions.

Do you do what your doctor tells you? Are you a compliant patient? Or are you among the majority who don’t follow the plan prescribed by their doctors?

Your doctor spent many years in medical school, and has experience to guide her treatment decisions. She doesn’t make recommendations to improve her own health; she makes them to improve yours. By not complying with her plan, you may be putting yourself at a disadvantage.

Yes, there are times when a treatment isn’t helpful or it may be incorrect, and it may make sense to question it. If you think that’s the case, then contact your doctor first, and discuss the situation with her before you make any changes yourself. It will give her an opportunity to make adjustments if necessary, and it’s a great way to work in partnership with your doctor.

But being a sharp patient means knowing that following your doctor’s orders usually means a better chance at healing or regaining your health. Do yourself a favor by following her advice.

If you need help understanding your doctors advice or treatment plan ReAssured Advocacy can help. Call us today at 303-756-8436.

Reprinted with permission from Trisha Torrey, Every Patient’s Advocate: www.EveryPatientsAdvocate.com

Choose the Best Hospital for You

When it comes to choosing a hospital, most patients default to their doctors or surgeons’ preferences instead of intentionally making their own choice.

That can be foolhardy.

Hospitals are dangerous places. From infections that can’t be cured or beaten, to surgery mistakes, to drug errors and more, patients are at risk. Some are so problematic that Medicare refuses to pay for any treatment that becomes necessary due to, what it calls, these “never events.” Yet patients continue to get sicker and die during hospital stays, not from the reason they were admitted; rather, from some problem that developed during their stay.

Why shouldn’t we rely on our doctors or surgeons to choose the best hospital for us? Because each has agreements, called admitting privileges, with only one or two hospitals. They didn’t sign those contracts with patient safety in mind, and they don’t have the option of treating us in another hospital that may be safer.

One way we can protect ourselves is by doing some homework. Easily accessible resources can provide background on everything from a hospital’s safety record, to its focus on communications, even how well it keeps patients comfortable when they are in pain.

Perhaps you anticipate heart surgery, or may need a knee or hip replaced, or know you might be sick enough to need hospitalization soon. If so, determine which hospitals are safest first, then find names of doctors who have admitting privileges. Of course, you’ll still want to research the track records of those doctors as part of your due diligence, as well as your health plan allowing you to use the doctor and hospital you choose.

Even if you don’t expect to be hospitalized, it’s smart to know what your local hospitals’ strengths and weaknesses are. You never know when some event will trigger a trip to an emergency room. Unfortunately, emergencies often result in hospital admissions. So check out the possibilities right away.

Fancy TV commercials, glossy ads, and prestigious-sounding awards don’t provide us with the information we need about patient safety and experiences. The best resource for objective information that will help you choose a hospital is called Hospital Compare. Maintained by the US Department of Health and Human Services, it can be found at: http://www.hospitalcompare.hhs.gov/. If you don’t use the Internet yourself, ask a friend or loved one to help, or go to your local library for assistance.

Checking up on hospitals before you actually need one will give you a head start on staying safe.

If you need help finding a hospital or doctor ReAssured Advocacy can help. Call us today at 303-756-8436.

Reprinted with permission from Trisha Torrey, Every Patient’s Advocate: www.EveryPatientsAdvocate.com

Behold the Second Opinion

So you’ve been given the bad news. Those strange symptoms and test results have resulted in a name – a diagnosis – and it’s something you’re going to have to deal with.

The odds are in your favor that your diagnosis is correct. After all, the 500,000 medical errors or misdiagnoses made each year are only a small percentage of the total number of medical decisions. But how can you be sure?

It’s your responsibility to figure it out. Often that will require a second opinion. Surprisingly, fewer than one-third of patients who are dealt a difficult diagnosis ever seek a second opinion. But it’s very important you do so!

When you visit your second doctor, make sure he has all the same evidence to review as your first doctor. Provide copies of your previous records and any test results available.

A second opinion will result in one of three outcomes. Both doctors may agree on your diagnosis and treatment recommendations. Or, the second doctor may agree with the diagnosis, but provide you with a different treatment option. Or it could be that there will be disagreement on the diagnosis, in which case there will probably be disagreement on the treatment options, too.

Suppose the doctors differ? Now what?

Let’s start with some “don’ts.”

Don’t assume that the doctor who gives you better news is the correct one. Just because you like the answers better doesn’t mean she is right.
Don’t assume the second doctor is correct. If the second doctor’s opinion is always the correct one, why did you go to a first?
Don’t assume that the “nicer” doctor is right either. A doctor with better bedside manner isn’t necessarily a better practitioner.

Here is what you should do in a case of differing medical opinions.

If the doctors’ opinions are very different, you’ll want to consider getting a third opinion. The third opinion will likely be similar to either doctor #1 or doctor #2, and that will help you make your treatment decisions, too.
If the doctors are only shades apart in their opinions and recommendations, ask them to discuss your situation with each other. Ask the doctor you prefer to work with to report back to you.

Finally, let your intuition help. Don’t discount its ability to help you judge which doctor can be more helpful to you, or which one has made a better assessment of your health. It’s your body. Let your intuitive mind work in your favor, too.

If you need help finding a doctor for a second opinion ReAssured Advocacy can help. Call us today at 303-756-8436

Reprinted with permission from Trisha Torrey, Every Patient’s Advocate: www.EveryPatientsAdvocate.com

Need Surgery? Take Responsibility to Avoid an Infection

You need surgery – perhaps a new hip, tumor removal, a face lift, or repair of an ACL.

Used to be you would show up at the hospital hours before your surgery, where you would be prepped, anesthetized, the surgery would take place, then you’d begin your recovery. Nurses attended your every need.

While the overall process hasn’t changed much in recent years, the details and outcomes have. Unfortunately, some of those changes are deadly.

The most dangerous change is the increase in hospital infections. You’ll recognize some of their names like MRSA (“mer-suh”, also called staph) and C.Diff. These infections kill at least 100,000 of the 1.7 million Americans who are infected in hospitals each year, many of them surgery patients.

You may recently have heard about another, newer infection called CRKP (Carbapenem-resistant Klebsiella pneumonia.) CRKP is killing up to 44 percent of hospital patients who have contracted it in 36 states, including New York.

I hope this alarms you – it should! Enough to take some responsibility for preventing these infections for yourself or a loved one who may need surgery.

Here’s how:

Begin by choosing hospitals and surgeons with the lowest infection rates. The US Department of Health and Human Services offers a website that can give you some of that information at Hospital Compare.

Prepare ahead by asking your surgeon about prescriptions for pre-surgery antibiotics, or special germ-killing soaps to use during pre-surgery showers.

Pack to prevent infections, too. Take bleach-based antiseptic wipes and sprays to clean hospital room surfaces where germs reside, like the bedside table, the hospital bed rails, the telephone, TV remote, bathroom surfaces and doorknob. A germ-filtering mask might stop germs that travel through the air, like those that cause pneumonia or upper-respiratory diseases.

Most deadly infections are spread by touching. So the most important step is insisting that everyone wash their hands before touching you, and before touching something that will then touch you, like a stethoscope (which should also be sanitized.) Hospital providers know full well they should wash their hands, but they aren’t always diligent about it. Don’t be afraid to remind them, or even nag them about it.

Then be sure an advocate sits by your bedside for those times you are sleeping or drugged and can’t stay on top of your own infection control.

It’s more important than ever that patients and their advocates work to prevent hospital infections.

……………………..

Learn more about preventing hospital acquired infections.

Learn more about hospital infections like MRSA, C.Diff. and CRKP.

If you need help with an aging parent or family member needing surgery or struggling with a complex medical condition ReAssured Advocacy can help. Call us today at 303-756-8436.

Reprinted with permission from Trisha Torrey, Every Patient’s Advocate: www.EveryPatientsAdvocate.com

Be a Smart Health Insurance Consumer

‘Tis the season for holiday cheer, shopping frenzy – and making health insurance choices for 2014.

Maybe you’re like my friend Jim who looks at the cost of coverage and chooses the plan that extracts the minimum from his paycheck.

Or maybe you consult your crystal ball, and actually crunch some numbers.

Regardless of where you get your health insurance the problem is, without looking behind the scenes at the actual coverage a company offers, you might not be getting the best protection for your health or your bank account. Being a sharp patient means being a smart consumer, too.

Here are some questions to ask about each plan option to make the best choice for you.

First, does the health insurance plan let you see your own doctors? Or will you have to change doctors? If necessary, determine how important your choice of doctors is, weighed against the cost of the plan you are considering.

Next, make a list of what you need to have covered. Include possible doctor visits, tests such as your annual mammogram, and treatments you know you’ll need. List the drugs you take, and whether they are generic or branded. Then add to your list other aspects you might not have previously considered, such as dental or vision coverage, health club memberships, or alternative therapies.

Does the potential insurer actually cover what you need? In particular, look at the drugs you take to determine whether the company insists on generics, or lists high co-pays for your name brand drugs. Then check coverage for tests you need. Sometimes they are covered only if you are over a certain age. Do you plan to have a baby and need maternity coverage? Some companies even cover alternative therapies or health club dues.

Can’t find a plan that meets your needs? Then be a good consumer, and let health insurance providers know. Some tell me they are eager to hear from us. Others are not interested – and that should be of concern to you as you make your choice.

It’s important to keep your employer’s human resources office in the loop, too. In many cases, they have a large influence on the coverage options provided to you.

Whether you are covered by your employer or using the Health Insurance Exchange, knowing the realities of insurance plans and costs will keep you and your wallet as healthy as possible.

If you are dealing with a serious illness and need help with insurance denials or billing errors ReAssured Advocacy can help. Call us today at 303-756-8436.

Reprinted with permission from Trisha Torrey, Every Patient’s Advocate: www.EveryPatientsAdvocate.com

Mom’s Gift Is a Gift You Can Give Your Loved Ones, Too

When Mom developed memory problems more than a decade ago, we knew, as caregivers, we were in for difficult years ahead.

Mom transitioned through her Alzheimer’s Disease as many do. Changes in her demeanor, strange behaviors, advancing loss of memory and capabilities. Our experience with her decline was no more or less heartbreaking than anyone else’s. Friends and acquaintances who have suffered Alzheimer’s or dementia with their loved ones would nod their heads, or provide a hug, knowing and understanding. It’s like a fraternity that no one wants to join.

Mom died two weeks ago. We grieve our loss, of course. But we are also relieved, and make no excuses for our relief. Her hell-on-earth has come to an end.

I don’t share this with you today to be maudlin. In fact, just the opposite. I share this with you so you can appreciate one of the best gifts Mom ever gave us, which became more important than we could have imagined during her final days and hours.

The gift? Twenty years ago, Mom signed a Do Not Resuscitate order. A DNR is an “advance directive.” That is, a document that states that if she ever suffered a life-ending event, no extraordinary effort should be made to keep her alive. Mom loved us so much that she provided us with peace-of-mind for her final days and hours.

Two weeks before Mom died, she suffered a heart attack. Her DNR left no questions about what to do. True to her wishes, she was kept comfortable until she passed away very peacefully.

You can give this same gift to your loved ones. It’s actually fairly simple. No matter whether you do or don’t want to be kept alive, your state provides legal documents for you to use to designate your end-of-life wishes. The paperwork requires only two other signatures. No attorney is necessary. And if you change your mind later, you simply sign new paperwork to reflect your change of heart.

Once the paperwork is signed, be sure you tell your loved ones and caregiver about your wishes, and tell them where to find your signed documents.

Holidays mean family gatherings. There’s no better time to designate and share your end-of-life wishes. Find the forms and background information you need at http://bit.ly/advdirectives. It’s a gift that will cost you some thought and some time, and will last even beyond your lifetime. This is especially important if you are the caregiver.

If you are a caregiver for an aging parent in town or long distance and are overwhelmed with navigating the complex healthcare system, ReAssured Advocacy can help. Call us today at 303-756-8436.

Reprinted with permission from Trisha Torrey, Every Patient’s Advocate: www.EveryPatientsAdvocate.com

Have you heard about ICE? In case of Emergency.

If a glass of water or a soft drink comes to mind, then you’re on the wrong track.

This ICE refers to In Case of Emergency. More than cooling your liquid refreshment, it may save your life.

The ICE initiative was begun in Great Britain by a paramedic who was frustrated by his inability to find emergency contact information for too many of the victims he needed to treat and transport to a hospital. He suggested people begin programming emergency contact information into their cell phones so paramedics and EMTs could easily find it. The idea spread quickly across Europe, especially after the London and Madrid train bombings. Paramedics, EMTs, emergency room personnel and the public embraced the idea.

ICE then crossed the Atlantic to the US. Today it’s being promoted across the country by Mark Balduzzi, a former law enforcement officer who wants those of us in the United States and Canada to embrace it, too. Most emergency personnel know to look for ICE on a cell phone. Now it’s time to educate the public to do the programming.

That’s where you come in. Here’s how it works:

Just as you add any of your other contacts to your cell phone, set up a new contact and name it ICE. On the same line, input the name of your contact and if you have room, that person’s relation to you, e.g. ICE – Jane Smith – wife.

Then fill in the rest of the contact information such as home phone, work phone, cell phone – whatever it takes to find that person should you be unable to respond in an emergency. If you want to have more than one contact person, call him ICE-2. Be ready In Case of Emergency.

ReAssured Advocacy is ready to help a loved one with no family members in town navigate the health care system or in case of emergency. Call us at 303-756-8436.

Reprinted with permission from Trisha Torrey, Every Patient’s Advocate: www.EveryPatientsAdvocate.com

Catch a (medical) code!

You fall and gash your hand. You need stitches, which your doctor describes as 12002.

Your continuing heartburn problems result in a diagnosis of GERD. But your doctor’s paperwork says you suffer from 530.81.

No matter what we patients call our medical challenges, our providers and payers use a different language — medical codes — to manage our care. These codes describe how we are diagnosed and what our diagnosis is, control the services and treatments we get, and, of course, determine how it all gets paid for.

To get the best care possible, we patients need to understand medical coding systems, and why they are important to us.

Current Procedural Terminology, CPT codes were developed by the American Medical Association to help physicians and their insurers speak the same language about reimbursement. 12002 is the code for stitching a wound up to 3+ inches wide, for which a doctor in Central New York will be paid $143.13. A larger gash would require a different code and more reimbursement. A doctor in another location might get paid more or less for that same code. Medicare uses mostly the same system, but calls them HCPCS (Healthcare Common Procedure Coding System) codes.

ICD (International Classification of Diseases) are diagnosis codes developed by the World Health Organization, and are used across the globe to signify the same disease or condition. For example, 250.0 means diabetes in Syracuse, Zurich, Tokyo and elsewhere. ICD codes may also be found on death certificates, and are used to trace contagion routes of infectious diseases.

In the United States, insurers use ICD codes to determine whether they will reimburse providers for tests or treatments. For example, if your paperwork reflects 530.81 for your heartburn, your insurance won’t pay for a CT scan of your leg or a prescription for a skin rash.

We patients find CPT and ICD codes on the paperwork, receipts and bills we receive from our doctors and payers. Tracking these medical codes grows increasingly important since mistakes can affect our care and wallets. Miscoded records may mean we are refused necessary treatments. Upcoding, the attempt by a provider to be reimbursed for higher-end services, or even services never provided, can reflect a simple mistake, or evidence of fraud.

Find more information about coding systems used by providers and payers, plus tools for matching specific medical codes to their diagnosis, test, service or treatment, at http://bit.ly/medcodes .

If you need help understanding your bills, medical codes or correcting billing errors, ReAssured Advocacy can help. Call us at 303-756-8436.

Reprinted with permission from Trisha Torrey, Every Patient’s Advocate: www.EveryPatientsAdvocate.com

Three Questions to Ask Your Doctor

Last week I attended a conference focused on patient literacy, empowerment, and education. Among the conference attendees were doctors, researchers, educators, and advocates.

The overriding theme was that most doctors aren’t doing enough to help us patients understand our medical conditions, nor are they helping us make the right decisions for ourselves. The results are patients who, due to lack of understanding, just don’t heal or get well the way they could or should. In extreme cases, this may lead to errors which lead to permanent harm or death – simply due to poor communication.

We’re not talking about bedside manner here. We’re talking about risk – the risk of patients who haven’t been to medical school and need to be taught to understand their problems and treatments. As your friendly patient advocate, I was pleased to see medical professionals beginning to understand that sometimes teaching is as much their role as diagnosing and treating.

Suggestions for communications were plentiful. From developing educational materials, to making sure interpreters are available for people with poor English skills, the overriding theme was improving communication with patients, no matter what language they speak, or how well they read. It was at once eye-opening, informative, and downright scary.

One important discussion was the fact that many patients feel intimidated by doctors and freeze when it comes time to ask questions. One speaker suggested that it’s impossible to ask an intelligent question of a fully-clothed doctor when we are sitting naked on an examination table, covered only with a thin sheet! We’ve all been there.

A simple tool was discussed that is worth sharing with you. It’s called “Ask Me 3” and it’s a series of three questions you should always use when you visit your doctor for a medical problem. The three questions to ask your doctor:

Question one is simply, “what is my main problem?” It gets to the heart of your diagnosis and helps you understand what you’ve got.

Question two is: “What do I need to do about it?” Your doctor’s response will outline your treatment options and prepare you to learn more about them.

Question three is: “Why do I need to do that?” This will help break down each treatment option into its benefits and components and will help you make the treatment decision that works best for you.

These three questions to ask your doctor are worth writing down and taking with you to your appointment. In the meantime, if you’d like to learn more about Ask Me 3, check out their website: http://www.npsf.org/askme3/.

If you or a loved one need help navigating the complex healthcare system, ReAssured Advocacy can help. Call us at 303-756-8436.

Reprinted with permission from Trisha Torrey, Every Patient’s Advocate: www.EveryPatientsAdvocate.com

Can You Risk Not Getting a Second Opinion?

My friend Rachael has a large lump behind her knee. Her orthopedist diagnosed it as a benign tumor, but told her they need to keep an eye on it. She should return in three months, then six months, then nine months and so forth. They will image it each time to see if it has grown. If it does grow, they will need to make some different decisions.

Rachael casually mentioned her diagnosis to me.

“You WILL get a second opinion, won’t you?” I responded.

Rachael said she really hadn’t thought about a second opinion. She explained that she had seen THE orthopedist in town, she trusted him, and she was confident he was right.

I was flabbergasted. I asked her how she could know he was right? After all, he had given her two possible diagnoses for her tumor, and there are differences in treatment. It’s also possible it could be malignant. Waiting months, only to learn the tumor has grown or is malignant, would be horrible!

Rachael is like the majority of patients. She thinks that since she trusts her doctor, then her doctor must be right.

In the perfect world it would work just that way.

Unfortunately, just because a doctor seems trustworthy doesn’t always mean that doctor is right. We don’t live in a perfect world. We live in a world where even the best doctors make diagnostic mistakes. In our world, doctors are hurried and sometimes miss evidence. In this same world, they are reimbursed by insurance for all those images, but not for taking the time to talk to us.

In our world we must get a second opinion because we risk too much if we don’t.

A second opinion yields three possible outcomes. Two doctors might agree on the diagnosis, but differ on their treatment recommendations. That gives us more information for decision-making. Or they may differ on both the diagnosis and the treatment recommendations. That suggests the need for a third opinion. Or they may agree on both the diagnosis and the best treatment, which provides us with confidence that we’re on the right track.

Getting a second opinion is always a winning proposition. Not getting one is a risk that isn’t worth the potential cost of life or limb.

Is it time for you to get a second opinion, too?

If you need help getting a second opinion for yourself or an aging parent ReAssured Advocacy can help. Call us at 303-756-8436.

Reprinted with permission from Trisha Torrey, Every Patient’s Advocate: www.EveryPatientsAdvocate.com