How To Get More Cost-Effective Care From Your Doctor

I think it's possible to stay healthier for less money. One of the most important steps to take in getting there is to effectively partner with a primary care provider.
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Cultivating a more efficient, cost-effective relationship with your doctor may not be something that has been at the top of your mind. You may figure: If I am sick, injured or even dying, I need my doctors to tell me what to do and take complete control of my health outcomes. The cost is something simply out of my control. But, fingers crossed, my insurance will cover it, or at least part of it. What isn't covered will hopefully not be too expensive.

Risky move.

This may be true for some people and may have been more likely in years past. These days, if you go this route, you are likely shouldering more and more of the financial burden. Health care is taking an increasingly large bite out of our wallets: Health spending reached $2.5 trillion in 2009. By 2019, health spending is expected to climb to $4.5 trillion a year.

A question that we should be asking ourselves is who is going to be paying for this ever-increasing health care bill? Another: Are there going to be enough health care providers to care for everyone, and give them all the time needed?

These issues provide an opportunity to see our health care in a whole new light; a wake-up call that could actually make us healthier.

I think it's possible to stay healthier for less money, and with less use of the health care system. One of the most important steps to take in getting there is to effectively partner with a primary care provider. An enormous amount of money gets wasted by doctors and patients who don't understand and trust each other. Doctors may order unnecessary tests just to cover themselves from lawsuits. And patients may get treatments they really don't want because they don't ask why the doctor is ordering it. Even more gets wasted when patients hand over total responsibility for their care to a doctor who's probably overwhelmed.

If you don't already have a primary care provider, you need to find one. And don't settle for just any provider -- choose one who will welcome you as an equal partner in your health.

Once you've found him or her, invest time in developing a good relationship. Discuss that you want a new type of interaction -- one in which you're going to both play a role in medical decisions that affect you. Discuss that you're interested in saving money and using carefully chosen and focused medical treatments, with a clear understanding of why and to what end.

Having a good relationship means both sides do their part. For the patient, that means you arrive at appointments ready to talk about your symptoms, and you leave appointments with an understanding of what you need to do to address your problems. You may need to be proactive in following up on test results and being available if your doctor needs to speak to you.

I recently read an article directed at physicians that offered tips at improving communication. A tip I really liked was: Ask your new patient three things about them. Knowing that a patient describes herself as a mother, horseback rider and cook helps the doctor understand more about who she is and what qualities in her life and health are important to her.

Making it personal is a good thing.

Finally, don't be afraid to remind your doctor of something you feel he or she may not have remembered. Know that they are likely seeing many patients each day and it can be difficult to remember details on everyone. Find something that makes you memorable for them.

I was recently asked what a person should do when it seems like the doctor isn't really listening or is distracted. My answer: Acknowledge the elephant in the room. Sure, you may feel awkward about "calling them out," but this is your health, your time. Doing this in a gentle and polite manner is my recommended approach: "Doc, I may be off-base here but it seems like you may be a little distracted. I know we only have a little bit of time, and you are super busy, but I want to make sure we are getting the most out of the visit together." I know I would appreciate this.

The Rx:

-Come to your health care appointments prepared: Know why you are coming and what your history is. Write down your current medications and your questions. Remember there may not be time in one visit to cover everything.
-Consider sharing this list with your doctor at the start of the visit so that he or she can help you prioritize.
-It is your time; claim it.
-Make sure you and your doctor are on the same page.
-If you are dissatisfied with your provider and you don't feel the relationship can become solid, seek a new one.

For more tips on getting better health with less use of the health care system, check out The New Prescription: How to Get the Best Health Care in a Broken System.

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