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How To Work The Health Care System And Get The Medical Care You Need


No one cares as much about your health as you do. it is up to you to manage your own medical care.

If you participate in your health care, you will feel more in control of the situation, save valuable time, decrease stress. You will also help prevent errors.

The following steps are simple and easy to do. They may seem like a lot when you see them all in one place, but they are not.

Keep your own copy of your medical records.

  • It is your job to manage your own health care unless you hire a professional to do it for you. Looked at in one place, it can seem like a lot of work. In reality, it is easy to do. This is especially so when you consider the small amount of effort to the control it provides.  
    • As a manager, you do not have to do everything yourself. You can enlist family and friends to help.
  • It is important to keep your own medical record.  Advantages to keeping your own medical record include the following:
    • Save you time and stress.
      • You won't be delayed seeing a doctor until he or she gets a copy of your record or latest test results. 
      • You will be able to remind yourself what each doctor found and when, what was discussed, and what was decided.
      • Mistakes can be prevented. 
    • You will be a more informed consumer.
    • Things will be a lot easier on your memory banks.
    • You will help prevent life altering errors – and possibly save your life.
    • You will have a fail safe if something happens to your doctor or his/her office.
  • Where To Keep Your Record
    • You can store your record online at such sites as Microsoft's Health Vault. offsite link or you can keep your record on your own. 
    • Non-profit organizations such as American Cancer Society offsite link and Lance Armstrong Foundation offsite link offer binders in which you can store your records, and take them with you easily. Or you can set up your own system with simple folders.
  •  How To Start
    • Create a list of your medicines, including dosages
      • Carry the list to you each time you see a doctor. 
      • Also carry a copy with you at all times (such as in a wallet or purse) in case of emergencies. 
    • Create a medical journal, either in a folder or a notebook. 
      • Include a sheet for contact information for each of your doctors and facilities including name, phone number, fax number, e-mail address, and street address. If possible, get your doctor's mobile phone number - or at least a number to call for emergencies.
      • To learn what a medical journal should contain, click here.
    • Get a copy of your medical records to date relating to your current condition. Also get the records about any other ongoing health conditions, conditions which could recur, surgeries and major health situations.  
    • Check the records to make sure they are accurate. It is easy to see whether the pages relate to you or someone else entirely or you see key words that relate to the condition in question. You don’t need to understand all the medical jargon .
    • If you have questions, ask the doctor or nurse in his or her office.
  • To Keep Your Record To Date
    • Before each appointment, test or scan, let the doctor or other appropriate person know you want a copy for yourself of the results -- including the results of all tests and/or film such as from X-Ray, MRI, CT or PET Scans.
    • During each visit, remind all doctors and other experts to send notes about your appointment to your primary care doctor.
    • After each appointment or medical encounter:
      • If you keep your records on line, your doctor or his staff can enter the appropriate notes and test results into your file.
      • If you are comfortable with the idea, create your own summary of what happened during each appointment. If not, ask the doctor’s staff to prepare a summary and to e mail or fax it to you. Give them a deadline which works for you both, such as one or two days. Make a note in your calendar to follow up if you don’t receive the copy.
      • Be sure the summary includes test results, and any changes in prescriptions. Also get copies of any scans or films.
      • Send the summary by fax or email to each of your doctors with a cover note asking them to review the information and to contact you immediately if they have a comment. Scanners and fax machines are very inexpensive these days and well worth the investment. The more doctors you see, the more important this step is.
    • If a drug or a dosage is changed, also be sure to change it on your list of medications, including the copy you always carry with you.
    • If you go into the hospital, ask for:
      • A summary of what happened
      • A copy of the entire file
    •  File everything in one place.
        • Office supply stores can guide you through storage systems.
        • If money is an issue, cardboard boxes can work just as well.
    • It may sound silly, but make sure your records and films aren’t accessible by children or pets.

Create a relationship with your doctor's staff

  • Your doctor's staff can be your ally in receiving the best care from your doctor. You're already aware, for example, that your doctor's nurses and staff can make your life easier, such as getting you an appointment when you want it. In fact, it's amazing how helpful they can be in squeezing you in to a doctor's harried schedule if they like you. Or go the extra mile to get you the earliest possible appointment with another specialist.
  • Staff can also make your relationship with your doctor more difficult, whether intentionally or not.
  • Following are a few tips to consider. You won't always make a friend, but you have nothing to lose by trying.
  • Get and use the person's name - and how to pronounce it.
    • People at the other end of a phone often react negatively when they are asked their name. To reduce the chances of a problem, consider saying something like:"My name is Cathy Merritt. Would you mind telling me your name please?"
    • If you don't understand the name, or how to pronounce it, ask the person to spell it for you or to pronounce it again. If the name if the least bit unusual, it couldn't hurt to let the person know if you find the name interesting.
  • Speak in a friendly manner.
    • Be friendly and expect friendliness in return. You'll usually get it.
    • Being friendly doesn't mean you shouldn't be assertive. In fact, be as assertive as necessary to get what you want. After all, you are the customer
  • Engage the person. Open yourself.
    • If you open yourself, the odds are she or he will do the same. Let him or her know facts that probably apply to them as well such as "I'm a mother, or a dad"
    • Empathize with the person at the first opportunity: such as, "Gee, I bet you have a hard job." or "You must be VERY busy. Thank you for being so patient with me."
  • Ask for help.
    • It usually works to ask for help to get what you need, and in the shortest amount of time possible.  "Can you help me?" or "I need your help."It helps to add a reason for why you need what you need and when you need it. 
  • Sympathize with the pressure the person is under.
    • People in most doctors' offices are under pressure to get more done in less time. Work loads can be unbearable. In addition to a normally packed schedule, there are unforeseen emergencies to deal with. It helps if you let the person know you understand the pressure and appreciate the time and consideration they are showing you.
  • Use anger sparingly.
    • Don't be obnoxious or treat the person as an adversary.
    • There are times when controlled anger works, but use anger sparingly. Once anger is out of the bag, you can't take it back.
    • If, in reviewing your problem, you feel yourself getting upset all over again, make sure the person knows your anger isn't directed at him or her personally. "Please don't think I'm angry at you personally, Carla. I know you're trying to help me. It just gets me so frustrated sometimes."
  • Stay with your friend.
    • Let the person know that whenever you have questions, you will call him or her. The odds are the person will be more responsible in her dealings with you.
    • Get the person's direct phone number or extension.
    • When you do make the repeat call, ask for your friend. If he or she's not available, find out when the person will be and call back.
  • Find out the best means of communication. If it's not the phone, still call ocassionally to keep the relationship alive.
    • It may be faster and easier to fax or email the person. If so, use the system he or she suggests. However, make periodic calls to your friend when you need something to help keep the relationship alive. As you know, relationships need attention.
  • Show that you care
    • Always say "thank you."
    • Perhaps bring small gifts for the office such as cookies. Holiday cards or small gifts are also a good idea.
    • It wouldn't hurt to hand write a thank you note once in a while.

Report unexpected changes in your health. Stuff happens in between appointments. You may be reluctant to call your doctor because of reasons such as "she's so busy" or "I'm going to see the doctor in a few weeks." Forget those reasons. Instead:

  • Keep track of symptoms the doctor told you about.
    • If you are experiencing a symptom that your doctor described as normal, you probably don't need to call.
    • If the symptom is more severe than described, or if you have a question even about symptoms the doctor told you about, contact the doctor right away and describe what's happening.
    • We provide a chart to help you keep track of your symtoms. Click here.
  • Always report unexpected symptoms.
    • Contact the doctor right away and describe the symptoms. Let the doctor guide you about whether you need an appointment.
    • If after speaking with the doctor you think what is happening is serious enough to be seen, call for an appointment.
  • It is preferable to contact the doctor by email or fax instead of calling. It makes it easier for the doctor. He or she can get back to you as soon as it is convenient, with full attention to your situation. If telephone is your preferred method, use it. If you have to leave a message for the doctor, leave details about your symptoms so you don't have to sit by the phone. The doctor can leave the answer on your voice mail. (If you don't have voice mail, a very inexpensive answering machine will do the job.)
  • Bottom Line: If there's any question at all, listen to your inner voice and call for an appointment as soon as you can get one. Use all your persuasion to get the appointment as soon as possible. If one isn't available, call every day until there's an opening. Or just show up at the doctor's office about a half hour before normal opening time. Unless you do that all the time, they'll work you in if it's at all possible.

Learn how to communicate with your doctor between appointments. (for instance, via e mail.)

  • When you need to speak with a doctor that day:
    • When you call, never minimize your symptoms.
    • State the worst fear(s) you may have.
    • If the person on the other end of the phone doesn't seem to understand how severe your situation is, state the facts again trying to use different words. 
    • If you haven't already made friends with the person with whom you're speaking, now is the time! Their involvement in getting the message through usually helps.
    • If you get a call back from someone other than the doctor, and don't get a satisfactory answer, ask to speak with the doctor.
    • Make sure the doctor can get through to you during the doctor's call back time by staying off the line. If you are on the phone during that time, instantly check "call waiting".
    • If you have difficulty being assertive for yourself, pretend you are calling for a child you love that you think has symptoms that should be talked about with the doctor right away. If you're not up to it, or if you can't describe your symptoms, ask a frirend or family member to make the call for you.
  • If your doctor doesn't call you back within 24 hours without a good reason -- that can be considered to be a good reason to change doctors.  
    • Before changing doctors, read through our information about how to ovwercome bumps in the relationship with your doctor by clicking here.
    • If all else fails, to learn how to change doctors, click here.

Learn time tested tips for making an appointment when you need one. One advantage is that they help get an appointment sooner. 

  • In general
    • Keep in mind that you get better results from being courteous and friendly than from being obnoxious. Honey does get the bees.
    • Let the person who sets the appointments know the reason you want the appointment so appropriate time can be scheduled.
    • People cannot read your mind or see any symptoms when you are on the phone. Say what needs to be said. For example, if something is urgent, say so. "I'm coughing a little more than usual" doesn't convey: "I can't breathe and have to sit up at night." Many of us are used to down playing our symptoms when asked how we're doing by friends and family. This is a mistake when talking with your medical care givers. They need to know what's actually happening.
    • It would not hurt to say something that makes you an individual rather than an anonymous caller. For instance, say something such as "I'm very anxious about my condition and can't sleep until I know what I'm dealing with."
    • If you have special needs, let the person know. For example, if you can't afford the time to wait for the doctor, ask for an appointment for first thing in the morning or just after the doctor's lunch break. He or she is likely to be running on time at those moments.
  • If you cannot get an appointment soon enough to suit your needs:
    • Ask to be called if there are any cancellations.
    • Keep reminding the person you speak with about the importance of the earliest possible appointment.
    • Follow-up every few days in case an opening does occur and the person who sets appointments forgets to call you or gets too busy to even think about it.
  • If you are calling a specialist:
    • Ask the appropriate person in the office of the doctor who suggested you see the specialist to make the appointment for you. Stress the importance of the earliest possible appointment.
    • If you can't get an appointment with a specialist in a timely fashion, ask the specialist's office you're calling for a referral to a specialist in the same field who is more readily available. It may get you an appointment faster since doctors don't like to lose patients. If it doesn't get you an earlier appointment, you'll at least get a referral to another doctor who can see you sooner. (Of course, check out the doctor to whom you've been referred.)
  • Anytime you can't make it to an appointment: Call and cancel with as much notice as possible. Most doctors have cancellation policies, and you may be charged for a visit if you don't cancel early enough -- particularly if you are a repeat offender.

Learn the tips for seeing your doctor without an appointment.

  • If the need arises overnight, one way to see the doctor is to go to the office before office hours and ask to be worked in to the schedule. Another is to call the office as soon as it opens. People frequently cancel by leaving the doctor a message. Even if there are no appointments, staff can try to work you in.
  • If the need arises during the day, call the doctor's office and let the receptionist know you have to see the doctor right away -- when can you come over? If you feel the problem is really serious, let the receptionist know you're on your way over. If the situation seems severe enough, go to an emergency room or call 911.
  • If you have an insurance plan that requires approval before you see a doctor: get on the phone immediately to the health care company. Maybe you can get clearance before the doctor's office opens.
  • For the future, ask for permission to see the doctor "multiple times" which means you don't have to get approval for each appointment.
  • Don't settle for seeing a nurse practitioner if you can avoid it. Given your health history, the doctor is likely to have the best idea of what is going on
  • For related information, see: Entering A Hospital Through The Emergency Room. How To Maximize Your Time In An Emergency Room, How to Obtain Acute Care Without Health Insurance

If you email a doctor, keep it short and to the point.

  • Email works well if you have a question about whether your current symptoms or questions require a visit.
    • In the subject line, give the doctor an idea of the content. For example, say "Symptom question."
    • Be brief.
    • Don't include multiple issues. If there are many issues, schedule a meeting.
    • Include your name and some other identifying information such as your address.
    • If you can, set your computer to notify you when the email has been read so you don't wonder whether the doctor saw it.
    • Keep in mind that currently doctors are not paid for time they spend reading emails so don't expect the doctor to take a lot of time preparing a response.
    • If you don't hear back in a reasonable amount of time, call the doctor's office.
    • If you can, print and save your emails in your medical file.
  • If you have more than one doctor, and aren't sure the issue relates to just one of them, send the e-mail to all your doctors.
  • Before you use your workplace computer to email sensitive information, keep in mind that your employer can look at emails sent or received on your office computer.

If your doctor usually keeps you waiting:

  • Learn how to minimize wait time
  • According to the health care consultants Press Ganey, in 2015 the average wait time to see a doctor was 23 minutes. Of course, since this is only an average, some wait times are much longer.
  • Alternatives for minimizing wait time include the following. Use whatever techinque or techniques work best for you. NOTE: If you expect the doctor to be on time, be sure you are on time for the appointment as well. (With some doctors, if you are late for an appointment, you will only be seen after all the other patients who showed up on time).
    • Look for a doctor who is usually on time.
      • There are doctors who understand the value of your time as well as their own and do their best to keep to a strict time schedule. Of course, given the nature of a medical practice, there may be emergencies that throw off a doctor's schedule, but the norm is the key here.
      • Keep in mind that doctors who work on time have to do their best to limit the amount of time spent with you to the alloted amount of time that will keep the doctor on schedule. It is particularly important if you see this type of doctor that you maximize your time together. To learn how to maximize your time with a doctor, see How To Maximize Your Time With A Doctor.
      • Doctors who do not take insurance ("concierge practice") usually see a patient at the appointed time.
    • Be the first appointment of the day or right after lunch.
      • The person with the first appointment of the day is usually seen right on time. There is the additional benefit that the doctor is likely to be fresher and more alert as well.
      • If that time slot isn't available, ask if the doctor takes a lunch break. If so, ask to be the first appointment in the afternoon.
    • Call before you go to the doctor's office
      • Call to find out if the doctor is on time or how delayed she is. Emphasize the importance of your time today -- in a friendly manner of course.
      • Time your departure to be on time for your appointment.
    • When you make the appointment, ask if the doctor schedules patients in batches.
      • Some doctors' offices book patients in groups. Patients are then seen in the order in which they arrive. To avoid a wait:
        • Ask if you can have a scheduled appointment instead.
        • Arrive 10 - 15 minutes before the scheduled group appointment so you are among the first to be seen.
    • If you are kept waiting, speak up and let the doctor know that this is a problem for you. 
      • Hopefully he or she will apologize and offer a good excuse for the delay. Ask the doctor how to avoid ot at least minimize wait time in the future.
      • You can also ask for a discount from the bill because of the wait. The doctor may say "no", but at least he or she will get the idea that being on time is important to you.


  • If you can't change the wait time for a doctor, and time is  important to you, consider changing doctors. While we do not recommend a change in doctors lightly, a change should be considered when there is a problem with a doctor that cannot be worked out. Click for information about smoothing bumps in the road with a doctor, and about switching doctors,
  • In case you are kept waiting,  see What To Do In A Waiting Room for ideas about what to do while in the doctor's waiting room. The tips are also useful in case you are kept waiting in the doctor's exam room. 
  • If you have more than one doctor, 
    • Be sure that each one is kept up-to-date, even if you have to do it yourself.
    • It is important that each of your doctors be kept to date. If there is no coordination, you may receive medically inappropraite treatment, duplicate tests and incompatible medications. 
    • It is preferable that one of your doctors act as a health care coordinator. Usually that job goes to your Primary Care doctor, but it could just as easily be the primary specialist for your health condition. If a doctor doesn't take on the role as coordinator, appoint one.
    • If your doctors do not share electronic health records, we suggest a simple system for keeping your doctors to date. Click here.

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