Five Steps to Better Healthcare

Do you know how to get the best healthcare to meet your family’s needs? As the healthcare system gets more complicated, appointments with your doctor get shorter, and costs continue to rise, getting individualized, evidence-based care is a challenge. Personal healthcare advocacy skills are techniques to get information and take action so you can make standardized care a better fit for your and your family. They include understanding some basics about how the modern healthcare system works, knowing what actions you can take to increase your chances of getting the care that’s best for you, knowing what questions to ask and how to make informed decisions, and knowing your rights as a patient. With some personal advocacy skills under your belt, you can learn get the most out your healthcare. Here are five things you can do that can help you get better care.

1. Understand the business of healthcare
Healthcare in America is a business. There is a strong incentive for profit. You need to understand how doctors and facilities make money and get paid, or you may end up paying for tests and procedures that aren’t medically necessary. You need to be an informed consumer, like you’d be if you were buying any other big-ticket consumer item.

2. Get clear on your values, needs, and desires
You are the expert on you. Your input is important, so you need to be clear on how much control you want over decision-making, what your care philosophy is, what your medical, physical, emotional, and practical needs are, and what you want and expect while being a patient. Even great doctors need your input. They can’t know everything about you, so it’s up to you to convey your thoughts and opinions throughout the care process. Communicating your values, needs, and desires is the key to getting individualized care.

3. Meet your community
Connect with people who can guide you to great doctors and facilities. Ask around, get referrals, and interview providers. Tour facilities. Learn about all the different types of care that might be available in your community. Connect with others who have similar health issues, and use their knowledge to expand your own. There’s no need to reinvent the wheel, when there is so much crowdsourced knowledge so close at hand. Create systems of support so you’re not going through your health needs alone. Supportive communities can literally be life savers.

4. Build a strong team
Find providers who match your philosophy of care, so you’ll be more likely to have a good working relationship. Work with providers who go the extra mile to spend the time you need to understand your health situation and make sure you’re actually being cared for. If you keep getting a nagging feeling that it’s not a good fit between you and your provider, switch. Your health is too important to leave in the hands of someone who is hard to work with, or you don’t trust.

5. Have effective conversations with your care providers
Do research on your condition, so you understand the basics and can talk about it quickly and efficiently with your doctor. Ask BRAIN questions (watch this video to know what those question are), and speak up for yourself. You won’t get the things you need if you don’t ask for them, and doctors and other caregivers can’t read your mind. You need to speak up about your values, needs, desires, thoughts, and opinions to get care that focuses on you.

Do these five things, and you’ll be better prepared, better informed, and ready to take actions to get care that works for you and your family.

Michal Klau-Stevens is a professional speaker and healthcare consumer advocate. She is a maternity consultant, pregnancy coach, and expert on consumer healthcare care issues, Past President of BirthNetwork National, a Lamaze Certified Childbirth Educator, and mother.  Her website is TheBirthLady.INFO. Find her on LinkedIn and on Facebook at The Birth Lady page!

When Should You Go to the Emergency Room?

The way we access healthcare has changed quite a bit in the last two decades, and there are new options available for getting medical help when you get injured in an accident or if you become ill. I attended a talk recently by Dr. Michael Gutman, Medical Director of New England Urgent Care, and he shared important information about when to go to the emergency room and when you can seek out alternative urgent care options.

With the growing shortage of primary care physicians, and the available doctors getting busier every day, there’s a good chance that at some point your doctor’s office may tell you to go to the emergency room if they can’t see you right away. Or, you you might have symptoms that are more than what your doctor treats in the office. But, emergency rooms are meant to handle to the most serious health problems. Going there when you are experiencing a problem that is less acute can keep the most critical emergency patients from getting the quick care they need, and can cost you extra time, money, and hassle. 

Walk-in health clinics are popping up all over in communities around the country. Some of them offer a good alternative to going to an emergency room, except for certain very serious or life-threatening cases.

So, when should you go to the emergency room?

Dr. Gutman says you should call 911 when -

• You think you are about to die*
• Your breathing is so impaired you can’t talk in sentences
• You are having chest pain that you think is a heart attack
• You or your spouse think you are having a stroke
• You have altered mental status
• You used to be able to walk yesterday and today you can’t
• You are injured and you can’t walk as a result

*This is not meant as a joke. Dr. Gutman is an experienced emergency physician with military experience in Iraq. He says that people with anxiety can have this feeling and it doesn’t mean death is imminent, but when an injured or ill person expresses they feel they are going to die, it is not a good sign. Get that person to an emergency room right away.

If the symptoms you are experiencing are not mentioned above, you are a good candidate for a walk-in urgent care clinic. An urgent care clinic differs from other walk-in clinics because it can handle more complicated emergency health issues. Where some clinics offer immunizations, strep tests, checking for ear infections, or treatment for cough, cold, flu, or minor injuries, urgent care clinics can do more. They can take x-rays to check for broken bones and do stitches on small lacerations, and may offer other services too. For example, New England Urgent Care does IV fluids, x-rays, and stitches on larger lacerations, because all their caregivers have at least two years of emergency room experience. They have lab facilities and rapid analysis through St. Francis Hospital, if necessary. They also have on-site pharmacies, and they can expedite your admission to the hospital if transfer to a hospital is deemed necessary.

Some of the benefits of going to a clinic rather than an ER are that the copays are usually the same as a doctor’s visit instead of an emergency room visit, the charges are much less, and there’s usually a short wait time before you are seen by a doctor, nurse, or physician’s assistant.

When my husband slipped and fell on the ice last year, he went to New England Urgent Care. He was taken in for x-rays within 20 minutes of our arrival. X-rays confirmed he had broken two ribs. The physician’s assistant gave him clear, written instructions for care. He left with a filled prescription for pain medication and instructions for follow-up. He was home resting in just about an hour and a half. And, we didn’t have a heart attack when we saw the bill. It was a great alternative to a hospital emergency room.

Check to see if there are any walk-in urgent care clinics in your community. Find out what services they offer, and if they would be a good alternative to the emergency room of your local hospital. It’s a good idea to check clinics out in advance, before you have an emergency such as an injury or illness. When that happens, you might not have the luxury of time to do the research.

Be prepared, and know which urgent care clinic or emergency facility is right for you.

New England Urgent Care has clinics in West Hartford, Simsbury, Bristol, and Enfield, Connecticut. Their website is UrgentCareNewEngland.com.

Michal Klau-Stevens is a professional speaker and healthcare consumer advocate. She is a maternity consultant, pregnancy coach, and expert on consumer healthcare care issues, Past President of BirthNetwork National, a Lamaze Certified Childbirth Educator, and mother.  Her website is TheBirthLady.INFO. Find her on LinkedIn and on Facebook at The Birth Lady page!

Human Interaction Eases Data Overload

There is so much information available now, it’s amazing that our heads don’t explode on a daily basis. For almost anything you want to learn about you can find sources of information in multiple formats, including books, magazines, research studies, and videos. Most of it is available at your fingertips through the Internet. There is more information available now than at any other time in history, and the democratic distribution of it through technology is turning the notion of expertise on its head, as lay people have access to the same information as the specialists. But as amazing as technology is at leveling the playing field and providing vast amounts of information to any anyone who seeks it, technology cannot fully take the place of face-to-face interaction. To rely solely on data and to miss out on human interaction is a mistake that can blow your mind.

Doing research online is a one-way conversation. You can quickly fall down a rabbit hole by clicking link after link. You may be gathering lots of information, but it can be a challenge to figure out what pieces of data are important for your needs, and which are distractions. Any question you ask Google will return dozens, if not hundreds, of hits. Most of them will not be relevant for you, yet you’ll have to figure out which are meaningful on your own. This type of research is important when you need to learn about a health-related issue, but at some point you’ll have to pull away from the online information trove and speak about your needs to a real person. Not moving forward to the face-to-face interaction phase can be an avoidance technique that can keep you from getting the help you need. In the case of a serious illness, like cancer, this can be costly indeed.  

If you want to get really scared by learning about worst-case scenarios, go look up a health problem on the Internet. Have you ever done a search, clicked on a link that sounded promising, and were horrified by what popped up? There is no way to prescreen what will appear on your computer monitor when you click that link. Sometimes the information is helpful, but sometimes it will inspire fear that can immobilize you from taking action. Having someone to talk to about what you’re finding in your research can give much needed perspective. Whether you are participating in a class, a support group, or meeting one-on-one with someone who can help you navigate your healthcare needs, discussing what you are learning with other people can be a helpful, and necessary, reality check.

It’s easy to get caught up in believing you need to know everything you can in order to make a good healthcare decision. The insurance industry and healthcare industry both push for patients to be informed consumers of healthcare, but how much information is enough? The fact is, you won’t be able to know as much as your doctor knows about certain things unless you go to medical school, too. That’s why we rely on doctors, after all. You need to know enough to have a knowledgeable conversation about the options available to you, and the risks and benefits of the various options. Once you have that basis of knowledge, you need to seek out the people who can help you implement a plan of action. That means interviewing doctors and having conversations with people in the real world.

It all comes down to relationships. Healthcare is better when it’s provided by people you know, like, and trust. That trust comes from person-to-person interaction. The same way that internet searches link you from one piece of information to another, each person you meet connects you to others to find the support you need. At the same time the volume of information available has grown, the number of people who have expertise in sorting through that information has grown too. You don’t have to figure it out alone. Once you have some basic knowledge under your belt, your time can be used more effectively by talking with people who can guide you to your next step.

Keep your head about you by balancing online research with real-world interactions. Get out from behind your computer and talk to people! 

Michal Klau-Stevens is a professional speaker and healthcare consumer advocate. She is a pregnancy coach and expert on consumer healthcare care issues, Past President of BirthNetwork National, a Lamaze Certified Childbirth Educator, and mother.  Her website is TheBirthLady.INFO. Find her on LinkedIn and on Facebook at The Birth Lady page!

The Changing Relationship Between Doctors and Patients

The Changing Relationship Between Doctors and Patients

By Michal Klau-Stevens

“What does the doctor say?”

That’s the question we often ask when a loved one has a health concern. We place great trust in doctors, because of their training and expertise. Yet, the doctor-patient relationship has changed over the past few decades in ways that have a direct effect on your care. Here are some things about the doctor-patient relationship that are different from how they were, even twenty years ago.

It used to be that you had a family doctor or internist who saw your care through from beginning to end. Today, there are many large medical practices, and while you may see “your” doctor for much of your care, it’s also likely that you will see other doctors in the practice, or get referred to a specialist. Medical care has become more compartmentalized, and specialists focus on certain body systems or illnesses. You may need to coordinate your own care while managing orders from several different doctors who may not see the overall health picture. If you need surgical or hospital-based care, you must be prepared to work with care providers who are strangers to you, and who don’t know your individual needs.

Also, the average medical appointment today is 7 to 15 minutes in length, where previously appointments were over 30 minutes. The teaching, conversation, and relationship building that used to happen in the exam room do not happen with the same depth as they used to. The interactions between doctors and patients today leave little time for developing a true relationship in which your physical, mental, and emotional needs are understood as deeply as they were in the past. The discussion time, and therefore the opportunity to develop personal connection, simply doesn’t exist today.

Another aspect of the doctor-patient relationship that is different from previous generations is the access to “special” information. It used to be that doctors’ training taught them information that was not available to patients, which made them authorities whose word was not to be questioned. Today, patients have access to vast amounts of medical information through the Internet, and can access far more data than was ever possible in the past. While most patients don’t achieve the level of medical learning that doctors have, they are able to engage in conversation about their care on a much higher level now than before. This patient access to specialized medical information changes the relationship from one of authority to one of partnership.

In addition to Western, or allopathic, medical information, patients also have access to information about a wide variety of natural, herbal, Eastern, and alternative healing modalities. Most doctors who are trained in the United States are not trained in these other types of care. Many doctors are skeptical about them because they differ so greatly from their “traditional” medical training and some modalities have little peer-reviewed scientific research to support their claims, even though they have been used in other parts of the world for hundreds of years. Patients who wish to use alternative therapies may find their doctor does not support their use, and conflicts will arise.

Medical schools don’t offer a lot of training for doctors on how to manage their relationships with their patients, and the landscape is changing faster than school programs can catch up with anyway. Patients vary in their knowledge levels, and the quality of information they are learning ranges from top-notch science to quackery, depending on its source. Since this shift is still happening, with some patients taking an active role in their care, and others still relying on doctors to take the lead, it’s not always clear to doctors or patients how to manage the changing relationship expectations.

Put together, these changes to the doctor-patient relationship have deeply affected levels of trust on both sides. When patients feel they can’t trust their doctors because they haven’t developed strong relationships with them, they may not feel secure in following their advice, which can cause serious problems. When doctors feel they haven’t developed a strong relationship with their patients, they can’t care for them as well and may be more likely to practice defensive medicine.

What does all this mean for you as a patient today?

This means the demands on you to advocate for your needs are stronger, because you may not be able to rely on a relationship with a trusted caregiver to guide your care. You must be more outspoken about what you need and want throughout your care, and you must develop skills to help you communicate effectively with unfamiliar caregivers.

In order to do that, you must be proactive in learning about your health needs or illnesses from trustworthy outside sources. You can’t assume your doctor will tell you everything you need to know because there is not enough time in typical medical appointments to give you all the information you will need to make truly informed choices.

Be prepared for your appointments by doing research in advance, and having a list of questions prepared with the most important questions at the top of your list.

Finally, you must seek out doctors and medical practices that match your care philosophy and approach to medical care from the outset. Each practice has its own work and medical care culture, and it’s up to you to explore all the options available to find which will be the best fit.

As frustrating as it can be to both patients and their doctors, the days of “just do as your doctor says” and “letting them take care of you in the hospital” are over. The changing doctor-patient relationship makes getting good individualized healthcare different now than it used to be. The times, they are a’changin’.

Michal Klau-Stevens is a professional speaker and healthcare consumer advocate. She is a maternity consultant, pregnancy coach, and expert on consumer healthcare care issues, Past President of BirthNetwork National, a Lamaze Certified Childbirth Educator, and mother.  Her website is TheBirthLady.INFO. Find her on LinkedIn and on Facebook at The Birth Lady page!