Sunday, September 27, 2009

Be Your Own Healthcare Advocate

We all know the controversy going on in this country regarding healthcare---and I don't want to talk about that. In fact, if you talk to me about it in person, I will probably just mildly agree with whatever you say about it.

I'd like to take it to a more micro-level. What do you do when you need to use your healthcare provider? Do you advocate for yourself, or do you just blindly trust whomever you have chosen to see? Speaking from experience, I think there are parts of the healthcare system that are just horribly pathetic. I don't want to pinpoint small town doctors or hospitals as always being "bad," so please don't take it that way. If you live in a small town, you have just as many questions to ask as the big city people---maybe with a slightly different focus depending on what is available and what you need.

I recently went to the doctor, for the first real time that I actually needed something. I didn't see a doctor, but a nurse practitioner. This was at the Medical Associates of the Finger Lakes, Penn Yan branch (because although I live in Rochester, I'm lazy and after I called 20 places who were not accepting new patients, I gave up and went back to the place in PY I have never really liked). It's not because it's in PY that I don't like it, but because it's dingy and gray looking and the nurse practitioner tells me the exact same bad information every time I see her. (Did you know that women in their 40s+ are most likely to get HPV because they don't use protection? Also, you can cure any skin breakouts by eating broccoli. Neither one is true).
This most recent trip in, I had a specific question, was looking for a specific referral, and had by all intents and purposes researched enough that I knew exactly what I needed. The NP not only did not listen to me, but she came up with her own idea of what she thought was going on (asked me 10 questions out of a book, to which I answered No to all but one), and then concluded that she was right (!?). Then she referred me to the most inappropriate specialist for this particular issue, to which I will not go and waste insurance money or co-pays on. It made me think about all the people out there who are just taking this crap service because they don't know any better (and that is not an insult, it's just a case of trusting the so-called experts).

What do you need to do to advocate for yourself?

1. Research your symptoms before you go. Google it. Easy. Print out what you think it might be and understand why, and also what the options are for treatment.

2. Get a second opinion. If you go to the doctor, and anything serious happens (i.e. diagnosis or referral) or you don't feel like the doctor is on the right track, go find another doctor and get another opinion.

3. Go to a doctor who has good reviews. This is not always easy, but try and find other people who have gone there and listen to their stories and make your decision based on that and what your needs are.

4. Ask questions. I don't know how many people come to me and say their nurse takes their blood pressure and doesn't even tell them what it is. YOU NEED TO KNOW YOUR NUMBERS. In fact, you should keep track on paper. What if normally you have low BP (100/50), and one day you get it checked and it's 120/80 (textbook perfect), so they say---great BP! But for you, this is high. You just missed an opportunity to catch something before it's a bigger problem. A good question to ask your healthcare provider, "What would you do if you were in this situation?" Don't assume they are telling you everything, or that you shouldn't ask something--if they don't know they'll look it up. And if they don't look it up, you should find a new doctor.

5. Take into account what you're looking for. If you have a hangnail it's not such a huge issue. If you have a chronic disease, are pregnant, have something unidentified that could be serious, or are just being extra cautious---make a big deal about it.

Why is this so important to me? First, because I screwed up. I didn't follow this advice, and I wasted an afternoon driving to PY to talk to a nurse who was rude and a NP who was completely incompetent and irresponsible for my health outcome. It was pathetic, and I wasted money on it.

Like I said before, I am not putting down small town doctors or hospitals, but take into account what your needs are when you choose where to go. This NP I went to has always served the purpose before because I never actually needed anything from her.

When my sister was pregnant, she chose to go to FF Thompson in Canandaigua because it was probably better than Geneva (just a guess that's what she was thinking). Whether it was technically those doctors' and nurses' "fault" or not, I would bet my life on the fact that she wouldn't have died that night if she had her baby in Rochester. I'm guessing she didn't follow my rules above, because otherwise, in spite of childbirth being commonplace, she'd have weighed the seriousness of having a baby and wouldn't have minded driving the extra half hour to ensure everyone came out of it alive. But you know what? I can't ask. On top of that, I won't ask the three people I know who have had babies in the exact same place with the same doctor since then, what they are thinking. Only because it's none of my business, and maybe they just see Jen dying there as a fluke. And they are right, it's not common. But it happened. And that makes it possible---I bet Jen didn't think it would happen to her either, and she never thought there'd be an emergency that FF Thompson wasn't equiped to handle, whether they should have been equipped or not. They didn't handle it. She didn't consider that option---if she had?

Associated with #5 above, ask yourself: Are the risks associated with your healthcare choice low? If not, make a new choice. If so, could you reasonably make them lower with another choice? This my friends, would have saved my sister's life. Her choice was reasonable, but she could have made it better if she had even known to think about it.

I'm just asking you, because you're reading this, to think about those things when you make your healthcare decisions. Be your own advocate because no one will ask the questions for you, or decide what's most important when choosing care. You get to decide, and most of us don't decide actively---going with the flow is not always the best choice. Don't make assumptions. Don't take chances with your life and health.

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