How to understand how physicians make their decisions when caring for you

A visit to a doctor for a routine check up or when you are feeling ill can sometimes be stressful. In addition to making a physical assessment a doctor needs to know if you have health care insurance or the financial resources to pay for your care.

Your doctor will address your care and prioritize your needs. Acute situations are handled promptly as well as needed diagnostic evaluations.

Along with the advancement in treatment options and the use of advanced technology is the ever increasing cost of health care. This has impacted the needed considerations a doctor must make when he or she delivers care.

A doctor has the inherant challenge to provide the best of the state of the art care with cost containment in mind. It is often one of the most frustrating realities in the practice of medicine.

When your doctor prescribes medication for your health problem he often has favorites because of their known efficacy and that they have been well tolerated by the majority of the patients he cares for. In addition to costly drugs their are also those that are generic, less expensive and are most often the choice that the doctor will make.

Doctors have supported medical advances in the treatment of diseases that once were life threatening and have had a high rate of mortality. This is what we have come to expect as consumers of health care in the U.S.A

This guide may provide you with some information that may assist you in becoming a proactive partner with your doctor in the pursuit of your optimum health care and maintenence.


Step 1

Anticipate a methodical sequence in care

Diagnostic testing is often done by ruling out the most serious illness or problem first. A test that is ordered may say » R/O colon cancer or R/O heart disease etc.

Life threatenening or critical health problems are addressed first. Results of testing that is negative is reviewed by your doctor and their results can be passed on to you by his nurse. A doctor will speak to you with findings that need follow up or more intervention.

In some hospital settings your primary care doctor will turn over your care to a doctor who is hospital based . You will then follow up with your primary care doctor after you are discharged from the hospital.

Step 2

Identify key personel in your doctors office

Understanding the rhythm in the doctors office is essential to your understanding of his time and its needed management. Speak to the appropriate staff rather than expecting a conversation with your doctor. A nurse, receptionist or billing personel can handle many problems.

Relationships are important in health care. Trust is imperative between you and your doctor. Learn early in your relationship who his partner is in your health care. It may be his office nurse or a nurse practicioner that he works closely with. This would be the person you would ask for when any problems arise. This person may be able to act on his behalf or will speak to him about you.

Step 3

Ask for written educational material on your illness , diagnostic testing and self care. Including any available information on your medications.

Most doctors offices can provide you with some written infomation on the self care needed for your health problem. This may include information on your medication. If not, ask for the information at your pharmacy when your prescription is filled. Read it carefully.

You can always ask to have a second opinion when determining best options for care of your health problem.

Step 4

If miscommunication or conflict arises regarding your care. Discuss openly with your doctor or his staff and expect clarification with positive resolution.

Medicine is an art and not a science. Ongoing communication is essential to maintain working relationships. You as a patient have every right to have your questions answered and your choices respected . You can also change doctors if need be. Your doctor in turn expects that you will be honest regarding your symptomatic complaints and compliant regarding his recommendations on self care.

Things Needed
• Patience with the process
• Proactive role in your care.
• Educational information on your illness, its management, and any medication.
• Compliant behavior related to following your doctors recommendations.

Tips & Warnings
• For any acute distress, sudden mental confusion, chest pain, severe shortness of breath, or active bleeding go directly to your hospital emergency room.
• Most decisions made by your doctor are on a case to case basis. Most medications for treatments of a major illness are covered in part through a patients insurance company.
• Chronic illness and the maintenance of care often warrants frequent visits or outpatient care.
• Often doctors will use pharmaceutical samples given to him to assist those who may have financial hardship
• Some medication costs can be further contained by the physician ordering scored tablets in larger dose. For a 10 mg dose one tablet of 20 mg will give two doses.
• There are some health problems that do not warrant medication and you may benefit from a change lifestyle or diet.
• If you are unable to afford your medication.Your doctor may contact the pharmaceutical company on your behalf for assistance.


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