Proactive Patients

Member-Only

MedSteps Checklist

Name the condition and/or its alternate names

Q’s in search of general practitioner

  1. Do you have another doctor you send your patients when you aren’t available?
  2. Who is on call with what system during off hours?
  3. Which local hospital do you comply with if any, and which hospital do you suggest for my needs?
  4. When do you rely on another doctor or specialist?
  5. How many people have you successfully taken off painful medications?

Q’s before surgery

  1. Always clarify the problems that you need to treat.
  2. Know the time pressure for this procedure.
  3. Is the surgeon a “high volume” surgeon.
  4. What are the alternatives?
  5. How many complications are there? How many have you seen?
  6. How often does the actual surgeon visit after surgery?

Q’s before taking psychological medications

  1. What are the side-effects of this medication? (don’t be satisfied with 3 or 4)
  2. What are the long term effects (nowadays psychological tests are only following patients for 6-8 weeks)?
  3. Remind the doctor about any strong history of the past when symptoms began (like relative’s death, rape etc.). These occurrences generally alter all testing.

Q’s for Cancer

After being clear that you have a cancer diagnosis, answers to these questions will give you confidence.

  1. Does the therapy you are suggesting work?
  2. If it does work, what should I expect as side effects? Can this treatment give other cancers?
  3. How are you managing side effects?
  4. Will I have life changes?
  5. How are you or the hospital gaining from these treatments?
  6. I would like to talk to five of your patients with the same diagnosis and identical demographics (age, sex).

SurgiSteps

A series of steps preparing for a calming surgery

You have been down the path of diagnosis, and been advised for surgery. Now you have to face the emotional rollercoaster, and (often) time pressure, to deal with some of the most important decisions in your life. The most important part of your decision is to enhance confidence in yourself that post surgery will not become a “Monday morning quarterback” experience, regardless of the outcome.

  1. Choosing a surgeon- Knowing your surgeon has seen this before and operated many times (or at least seen once and taught once, in extreme circumstance)
  2. Methods of surgery- There are usually more than one, and you or the doctor chose one based on: method result and the patients compatibility to the particular rehab
  3. Understanding the time frame- Priorities help to a focused confidence
  4. You can visualize the surgery chosen- You have enough step by step information to know the surgery as if it is happening in front of you
  5. All the doctors including the surgeon have been presented- You know each doctor’s purpose
  6. You have met all operating parties- You’ve personally met whom are touching you and deciding on your behalf
  7. Anesthesia- Understanding the feelings and slow recovery give emotions less panic. Being aware of the minute complications of manipulated airway, or unseen reactions should always be a reality not ignored
  8. Understanding complications involved any time- You had a dialogue about: anesthesia, blood loss, and drop in blood pressure, wound healing, or leaking of membranes that have chemicals.
  9. Being ready for “no turning back”- You know all the “who what where when and whys” there is no reason not to proceed
  10. Regardless of the time constraints you had time to make a calculated decision- Even in a time pressure it could only takes minutes to have a good feeling that you considered your choices
  11. When the decisions aren’t made by the actual patient, expose them of the future- The stable emotions of the actual patient give the best road to recovery
  12. Prayer- The beginning and end

 

Recovery- Although recovery might seem as part of the options for surgery (unless that particular patient won’t rehab properly to certain surgeries regardless of the surgery results) it is a section that is dealt with post operation. Here are some of the reasons:

  1. Most people can only handle so much. Dealing in detail with rehab and using that as your guiding light, is like taking antibiotics before you get sick. The potency of the information is effective once one is past surgery.
  2. The results or mid-surgery changes, may affect the path of recovery
  3. Our “inner-reaction” smarts aren’t engaged until they are absolutely necessary. It is a useful tool that we rely on for a comfortable decision.

Unrealistic Expectations of Patients

Make your appointment worth it. Understand your limits.

  • Don’t discuss several major problems, all in one standard consultation
  • You won’t get a prescription without at least one in-person consultation
  • Physician or their office won’t be available 24 hrs a day for any problems
  • Most physicians will not always know the exact diagnosis at first consultation and start treatment immediately, expect some patience.

Qs for the Doc

What is the trick to asking questions?

Reactive patients ask because:

1) Need for information- Not quite informed so we ask a question hoping the doctor doesn’t think we are stupid. Really, the doctor didn’t tell us enough information

2) Need to be noticed- Got the basic idea, but need to show the doctor we are in the know and want as much info as possible

3) Hopelessness- Nerves took over so what the heck, ask

4) We can’t get out what is on our mind- So we just ask questions hoping the doctor picks up the non-verbal points to give the proper explanation

Our alternative

Proactive patients ask:

With the purpose of making a likeminded team.

Good questions are a way to develop a new “patient doctor” team. The questions are just used as a way to lead the conversation. Conversation then develops into a give and take, viewed like an interlocking zipper that continues to connect as you pull. The new team needs to pull together to zip up. The good questions are now part of therapy, like a closure to all procedures. Once there is chemistry, with questioning and proper responses, there is willingness towards one another to work together.

Tip: Asking good questions to make a team doesn’t mean you have chosen a doctor, it just gives you the best chance to have a feel which direction you will be led in.

MedSteps

A series of steps guiding toward the best medical care

  1. Diagnosis – Ask any carpenter: Measure twice cut once
    • The three most common types of blunders (2013 John Hopkins investigation): failure to diagnose (54%) delay in diagnosis (20%) wrong diagnosis (10%).
    • The lens of the diagnostician is just as critical as a surgeon. Surgeons can be traced based on their handiwork and their immediate success. However, only complete success can be an undoubted test for the diagnostician, any failure can be blamed on surgeries or medication.
    • Trusting your gut and reasoning is the only coarse to dead set clarity, so what makes us sure?
    • The following questions can be raised before you carry on towards a second opinion.
      1. I understand that the doctor is convinced of a disease but how confident could I be that he sure about the diagnosis… is there another diagnosis?
      2. Are there more tests that could confirm the diagnosis and/or was the original test or imaging unclear?
      3. Have all my medical records been reevaluated as a full picture before zeroing in on the specific symptoms?
  2. Second Opinions- Our competitive world has some small advantages, use it.
    1. A good physician or general internist will always promote second opinions, they may even give options as to whom to see.
    2. Second opinions could be researched for diagnostics or for procedure and future progress. Each step has its own focus. (This will bring you closer to the “No Mistake Zone”)
    3. Be in the know of the different methodologies. Communicating with a doctor on the other side of the fence always comes in handy.
  3. The Internet- Using devices to become medically inclined without a medical background
    1. The internet is a good way to be taught the basics. There are support groups about most acute conditions. It will not only give a primitive landscape but can give you the opportunity to contact people across the country. Additionally, using the key word “diet …” or treatment guidelines…” lead you to evidence based techniques.
    2. NIH- National Institute of Health this exceptional website incorporates most research of disease procedure and prevention. It lists the primary doctors whom partook in the research and for how many people (there are more things to list too long for this work).
    3. Avoid pictures (images) and stick to facts and statistics.
    4. There are many places to post curiosity questions without pestering a doctor.
  4. Final Plan- Making a decision that makes you feel as if you were in the “No Mistake Zone”
    1. Know precisely the name of the condition, and the gambit it covers.
    2. Being clear as to which procedure is urgent and which you have time to consider.
    3. Meet face to face with all doctors involved.
    4. Those doctors were clear to you of the risks and benefits of your options.
    5. When you visualize the process, your gut tells you this is the correct choice.
  5. Prayer- Human actions are only half the process

A–allow for truth B-find the best C–clarify with tools you know well D-be determined E– speak to the One who executes results

Congratulations proceed with confidence

Insurance Insider

  1. When something is denyed from your insurance take immediate action, noting to the insurance that you are taking immediate action.
  2. Check with your doctor for an often occurring coding error.
  3. Start maintaining files of bills and correspondence.
  4. File an official appeal.
  5. Never take “no” for an answer ask for state insurance council or state representative or senator, for assistance.