Friday, December 10, 2010

Medical Minutiae

Mollie writes:

When Millie and I started this blog, we did it to celebrate homemaking.  Most of it centers around our children since we are each dedicated moms.  But homemaking also includes other issues, including marriage, partners, money management and a bazillion of other details.

One of the issues where I consider myself a diva is the issue of health care.  After sweating my way through a chronic disease (multiple sclerosis) for 20 years, I've become something of an expert on the ways  of the sickly.  There is a lot to say, so occasionally I'll sort out individual topics and deal with them one by one.

One thing we don't hear a lot about is patient responsibility.  It's our job to be sure we are providing our medical providers with our latest insurance information and the pursuant information for the paper work that will accompany it.  We need to sign those medical information release forms so that a claim submitted for payment can be adjudicated quickly and reimbursement made to the provider as soon as possible.  It's just a matter of common sense.  If you have a co-pay, make it at the time of care, since those nurses, doctors, secretaries, bookkeepers, phlebotomists, etc. aren't working for free.  Remember, even a doctor has overhead.  By the time she pays her staff and rent and malpractice insurance and medical school debt, she still deserves some money to manage her household.

It is also our responsibility to be honest with our providers.  Somethings slip our minds or we make mistakes filling out forms.  If you make a mistake or forget something, just own up to it.  Just yesterday I blew it and listed a perfectly safe drug as one that caused my liver enzymes to soar.  In a nutshell, instead of listing zanoflex as the drug that shut down my liver, I listed another drug that I've been taking safely for years.  But we get battle weary, and we make mistakes.

A solution to this problem is to do what I'm doing now; that is, write a small medical biography about yourself (and your kids, etc) and take it to the doctors' office.  List the names of your drugs, both prescription AND over the counter.  List your surgeries, pregnancies, family medical history, etc.  Do this at home, when you are clear headed.  Print it, and take it with you.  You can let the doctor keep the copy attached to the forms you've also completed.  It lets these folks know that you are an involved, careful patient.

Also, there's something to be said about spelling all the medical conditions and prescriptions properly.  It lets them know that you may not be a medical professional, but you speak the language, even if it is a second language.

Along with your history, bring a printout of your questions.  I always ask whether a new drug is excreted by my liver or my kidneys.  I'm just over protective of both and like keeping up to date on this.  But I'm sure you have your own personal issues you want addressed, your own questions answered.  Going in with a printout also lets the provider that you mean business.  It also means that you'll waste less of their time.

Show up on time.  I hate it when a physician makes me wait - and usually it's because she was taking care of the patient in the next room who was having seizures that lasted longer than the 15 minutes the visit originally was for.  Time is not magic in the doctors' office.  Treat it with respect.  Print out the directions to the clinic, etc.

Leave the kids at home, unless they are the patient.  It's hard enough to give a patient the "bad news" without scaring the kids in the exam room spitless.  They don't need to hear bad news in this fashion, if at all.  They also don't need to wait in the waiting room for you to come out all teary eyed.  And the office staff has to draw blood, make appointments, settle billing questions, etc. so they really aren't reliable babysitters.

I had the doctors' appointment from hell yesterday, it began at 4:40 am when I rose to catch the ferry to drive to Seattle 'til I got home that evening to pick up my dog from daycare.  It was to determine if I'm eligible for a new drug for MS that will replace my 3x weekly self injections of interferon.  I'm hoping that all goes well, and I can switch therapies:  but before this decision is made, I had to see a neurologist, a pulmonary technician, an ophthalmologist, a dermatologist  and have lab tests run.  By the end of the day, my eyes were crossed and my fatigue level exceeded.

And I still had to shoulder my share of the responsibility.  It's a jungle out there, but we are up to it!

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