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Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.

Overview

A well qualified, experienced doctor and a good relationship with that doctor can be critical to your health care.

Outcomes tend to be better when people act more as active health care consumers than as "patients."

As you read through the following summary, keep in mind that links to information about each subject are below.

With respect to doctors, it is advisable to:

  • Take the time to choose the best doctor for your situation and your individual concerns
  • Decide the kind of relationship you want with each doctor, including who will be the decision maker (the doctor, you with the doctor's input, or a trusted family member or friend.)
  • Decide who will be the decision maker (you or the doctor)
  • Prepare for each appointment. For example:
    • Keep track of symptoms you experience between meetings. (We provide a symptoms diary to help)
    • Write down your questions and prioritize them before the meeting. (We provide a Prioritizer to help keep track. A push of a button reorders your questions so you can ask the ones that are most important to you first.)
    • Schedule tests you take periodically before the meeting so the two of you can review the results at the meeting. (Your doctor's office or nurse can arrange the test for you.)
    • If important subjects will be discussed, consider taking someone to act as a patient advocate with you.
  • Learn how to maximize your time together and what to do afterward.
  • Keep in mind there is advice about handling bumps in the relationship, and, if needed, about how to change doctors.

To maximize your relationship with a doctor:

  • When you call for an appointment, state the purpose so that appropriate time can be scheduled.
  • Communicate well when you're together (for example, by using medical terms to help make the discussion more precise and less time consuming).
  • Be firm, but polite, in getting what you need. It has been reported that doctors tend to spend more time with patients they like and less time with people who act pushy and obnoxious.
  • Keep your doctors up to date. (For a simple system for keeping your doctor(s) to date, click here.)

When it comes to important medical decisions, trust your doctor's expert opinion, but consider verifying on your own. If medical tests are recommended, become an informed consumer before agreeing. 

Learn how to work the medical system so you can get what you need from each of your doctors. For example, if you have more than one specialist, be sure one acts as a health care coordinator. If there isn't such a person, appoint one.

Dr. Jerome Groopman suggests that if there have been the same symptoms for a long time and recommended treatments have not solved the problem, ask your doctor the question: " What else could it be?" The question can can help your doctor look at the situation from a different angle or perhaps put together the pieces of information in a new way.

Try to develop a relationship with the doctor and the office staff, particularly with doctors you see over and over. You may need to call upon their individual services should you have a problem. Having a friend on the doctor's staff can be an immense help when you need to see the doctor in a hurry and there are no appointments available or you need something done in a hurry.

If you have a major decision to make, things aren't clear or you just feel as if you need one, you can ask for a second opinion. The request should is so common the first doctor should not be offended. Second opinions are usually covered by health insurance.

If bumps or problems arise in the relationship, try to work them out. If you can't, change doctors.

Keep in mind that, if needed, there are doctors who make house calls.

Experience indicates that our information helps patients work most effectively with a doctor. After reading an article, click on the back button on your browswer to return to this overview.

NOTE:

  • If you have health insurance, check with your insurer to find out if telemedicine is covered. With telemedicine you connect with your doctor over the telephone or the internet.
  • Because of the federal Americans With Disabilities Act (ADA), doctors cannot discriminate against you because of your health condition. For information, click here.

How To Locate A Doctor

You can locate a doctor a variety of ways including:

  • Referral from another doctor.
  • Your insurance company's listing.
  • Referral from family, friends or co-workers.
  • Via the internet. Following is a list of the leading websites for locating a doctor (in alphabetical order).  When you find a doctor of interest to you who is board certified, note the date when the doctor was last certified. If the date was more than 10 years ago, the doctor has not been tested about current developments. S/he may still be current, but not tested which confirms being to date.
    • American Board of Medical Specialties "Certified Doc": www.abms.org  offsite linkAllows you to search for a doctor by a specialty. 
    • American Medical Association "Physician Select": www.ama-assn.org/aps/amahg.htm offsite link. Provides information on every licensed physician (more than 650,000) in the United States and its possessions. The site also contains "Group Select" which provides information on more than 19,000 group practices.
    • Choice Trust by ChoicePoint: www.ChoiceTrust.com  offsite linkProvides a credential history report for doctors, including disciplinary actions from all 50 states for a fee. You can also search the doctor's non-professional background on this site.
    • Health Grades "Physician Report Cards": www.healthgrades.com  offsite linkAll doctors listed have been in practice for at least two years, are board-certified in their specialty, and have had no Medicare or state medical board sanctions within the past three years. (If you are interested in a doctor who doesn't receive a top consumer rating, ask him or her why she or he is rated in a certain way.)
    • Health Pages: www.thehealthpages.com  offsite linkLists over 500,000 doctors. You can narrow your search by board certification, gender and years in practice. The site also includes comments from patients. If doctors supply the information, the site also includes e-mail addresses, health professionals on staff, office hours, languages spoken, whether the doctor is accepting new patients, and fees.
    • Web MD "Find A Doctor": www.webmd.com  offsite linkProvides information on more than 500,000 doctors. This site also contains provider directories (health insurance affiliation) for more than 300 managed health care plans.

Oncologists: http://www.plwc.org/portal/site/PLWC/menuitem.724de8b96edd64acfd748f68ee37a01d/?vgnextoid=56e6ea97a56d9010VgnVCM100000f2730ad1RCRD offsite link Members of American Society of Clinical Oncologists can be located through this site.

To find a doctor who makes house calls: See the website of the American Academy of Home Care Physicians, www.aahcp.org offsite link. It lists doctors by zip code and state served.

To find a doctor who provides medical advice over the internet or telephone: To find websites such as www.Teladoc.com offsite link, type "telemedicine" in your favorite search engine.

To Learn More

If Paying For A Doctor's Services Is A Problem, There Are Alternatives

If paying for a doctor's services is an issue because  your insurance carrier refuses to pay or because you are uninsured, there are options. Even if a doctor's office has a general rule that charges are to be paid for at the time of treatment, there are always exceptions.

You may choose to discuss the issue with your doctor and/or his or her office and ask for a financial arrangement. As a general matter, it doesn't hurt to also ask for a discounted fee.

If you are referred to a specialist, it is usually better to discuss the financial issue with the finance person or office manager at the time of your visit. It may be more difficult for the office to deny you a meeting if they are dealing with you face to face instead of on the telephone.

Consider reading our article about being "Uninsured" and how to get the health care you need.

The bottom line is to secure the treatment that you need now, and worry about paying for it later.

For more information, see "To Learn More".

Who's In Charge?

Historically, doctors made medical decisions for patients.

Today, an empowered consumer has a choice among the following options:

  • To be the decision maker, with input and advice from a doctor or other medical professional.
  • To let the doctor or other medical professional be the decision maker.
  • To let a trusted family member or friend be the decision maker.

There is no right or wrong. The key is what works best for you.

It may help to know that evidence indicates the more empowered a patient, the better the medical outcome.




How To Keep Your Doctor When You Change Health Plans

It is understandable if you want to keep your doctor when you change health plans. Your doctor know you and your health history - possibly even starting before your diagnosis.

Following a few alternatives to consider to change plans and still see your doctor. As you consider them, keep in mind that there may be deadlines you have to meet.

  • Ask your doctor if he or she would consider contracting with your new insurance plan. If he or she is agreeable, then contact the customer service plan if you purchased the plan directly. If not, contact the person through whom the plan was purchased. He or she will have more influence with the company to get it to agree with your request. 
  • Check your state law. It may provide that your new plan must arrange for continuous care if you request it. If there is no such broad requirement, the law may at least require that you be allowed to continue to see a doctor for a limited time if you have a serious or life-threatening illness. These laws generally allow you to continue to see your current doctor for a fixed period, such as 90 days. It may also provide the right terminates earlier if your doctor certifies that you can be safely transferred to a new doctor.
    • To find out about the law in your state, The Actors' Fund of America's Health Information Resource Center at www.ahirc.org offsite link. Or call your state insurance department. Contact information is available through the National Association of Insurance Commissioners at www.naic.org offsite link. Or look in your local Yellow Paqes.
    • Check with your doctor to let him or her know that you will need a letter describing the medical necessity of continuing your care with your doctor.
  • If you are losing your group insurance:
    • Check to see if you can continue your group coverage (and thus continue to see your doctor) under COBRA. On the downside, you will have to pay the premiums during a COBRA continuation of your policy.
    • If you do not have a right to COBRA continuation of your health insurance, you may be able to convert your employer-sponsored gorup plan to an individual plan.

If you cannot continue with your doctor, show him or her the choice of doctors to whom you will be limited. Perhaps he or she has a recommendation.

To Learn More

Protection Against Discrimination By Doctors And Other Health Care Workers

The ADA (Americans With Disabilities Act) provides doctors, and other health care cannot discriminate against a person because of a health condition. This means that doctors and other health care providers cannot do the following:

  • Refuse to treat you
  • Treat you differently than other patients.
  • Provide a different or separate service or benefit than provided to other patients.
  • Use eligibility criteria that screen out or tend to screen out people with disabilities (unless the criteria are necessary).

A health care provider is not required to treat a person who is seeking or requires treatment or services outside the provider's area of expertise.

A doctor or other health care provider may lose his or her license to practice for refusing to treat people with a particular health condition.

In addition, doctors and other health care providers must provide reasonable accommodations if needed for people with disabilities.

If a health care provider discriminates against you because of your health condition:

  • You may go to court to enforce the law. You don't need to file an administrative claim first for this type of discrimination (unlike other sections such as employment discrimination). However, you can't receive an award for money damages.
  • The U.S. Attorney General and the Department of Justice are empowered to bring a civil suit. (You may also have a right to sue under the Federal Rehabilitation Act, state or local laws). To learn how to enforce the ADA, click here