Dear Senator Obama and Senator McCain,
As part of your spending cuts, put a scalpel to insurance premiums. Cut and cap. It is preposterous to think that someone on a limited income (like seniors, retirees, disabled folks), or those whose salaries have flat lined can continue to afford increases of 25% or more per year. With the average annual cost of living increase of 3 to 5% it is simply unaffordable. For many this can be as much as 10%or more of their income.
For the past three years many insurance premiums have risen as much as total of 25% per year for the past few years! Meanwhile your insurance rates in Congress were recently reported as an 8% increase last year to a hefty 12% this year. Give us the same. After all you do work for us. You and your colleagues keep saying we should have the same health insurance opportunities as Congress. Act on it and stop the private insurance sector from hemorrhaging us to code blue.
Start by putting a cap on insurance premiums. Make this retroactive for the unfair cost increases over the past five years. Let the insurance companies apply this instead of a tax credit to our insurance.
It is time that patients instead of shareholders and company executives reap the benefits of decent health care. Shift the focus on preventive care to preserve your health and save your life as opposed to waiting until you get sick and die.
Do the right thing and the best thing for your country. Keep insurance premiums affordable. Keep your country's health from failing. Invest in prevention, health maintenance, wellness, and health preservation. Make the insurance companies accountable for this, too. Disease management is good, but if it is prevented or detected early it's even better.
Information technology such as electronic medical records are great, too. Be realistic. We are behind here and trying to catch up. Take care of patients first and do this as you go. Most doctors' office are still trying to figure out how they are going to afford it.
Consolidate some of the government health agencies that overlap. As I waded through the Health and Human Services department, I drowned in an alphabet soup of agencies that do similar things. It looks like a lot of money being spent for those most in need; however, the disparities in health care continue in despair.
Keep our country's vital signs stable. Resuscitate. Perform CPR STAT. Open the airway, breathe in fresh air, and circulate the proper health care to all Americans. It is our birth right. It is our privilege. Make it our asset.
Best regards,
Dr. Richardson
P.S. On a personal note - my insurance company increased my premium another 25% this year from $700 to $882. Pre-existing conditions have prevented me from getting affordable continuous coverage elsewhere, or from getting into less expensive plans in the company. My years of employment with this company have amounted to nil.
martes, 7 de octubre de 2008
lunes, 6 de octubre de 2008
Patient Grievance
You arrive at your doctor's office for an appointment. You arrive at the scheduled time. You make your co-payment. You wait for 45 minutes before you are taken into the exam room. The doctor enters in a frenzied panic about 15 minutes later. He tells you that you must reschedule because there is not enough time for him to see you. After persistent banter back and forth, your "official" doctor visit begins.
Once the visit starts, there are multiple interruptions from the staff. The doctor does not have the results of your tests. He fumbles persistently through the chart ignoring your presence. You look over your list and move on to the second item while test results are being located. Another interruption puts these results in your doctor's hands. Since you have not heard about these tests done a month ago, you assume all is okay. You assume wrong again.
As the doctor comes to his senses and recoups his professional demeanor, you continue with your list of items to discuss. After 30 minutes you have it all together - copies of test results, prescriptions, and a plan for follow-up on all that is necessary. You are asked to schedule your next appointment in one month at the doctor's convenience. There is no one at the front desk to give you an appointment.
Doctor visits like this are far too common to ignore. In this instance, the patient had an abnormal test that would have been ignored for a longer time. The unprofessional encounter amplified the patient's stress and blood pressure. It may have been easier for the doctor for the patient to reschedule, but would it have been the right thing to do, and the best thing to do?
Doctors would you?
1) keep arguing with the patient until blood pressure reaches 160/120
2) blame the patient for waiting one hour to be seen
3) see the patient
4) see the 2 drug reps and make the patient reschedule
5) apologize for unprofessional rudeness.
Patients would you?
1) reschedule appointment
2) let the doctor know you were on time - deal with it
3) continue talking with doctor instead of wasting time
4) stand up for your rights
5) file patient grievance with insurance company, state medical board.
Filing a patient grievance/complaint is a smart thing to do. A grievance is a request for an investigation of a complaint about a possible risk to the health, safety, or well-being of a patient; or a situation where the patient is unnecessarily at high risk. Check with with your health insurance provider to find out the details for reporting unacceptable medical services that may threaten your life. In addition, it may save other lives as well since about 15% of JCAHO sentinel events reported are from responsible patients who speak up.
by J. L. Richardson, M.D., family physician, patient advocate (specializing in grievenace process and medical record review), patient, and author of Patient Handbook to Medical Care: Your Personal Health Guide, and upcoming Patient Handbook to Surgery: Surviving Your Operation.
Once the visit starts, there are multiple interruptions from the staff. The doctor does not have the results of your tests. He fumbles persistently through the chart ignoring your presence. You look over your list and move on to the second item while test results are being located. Another interruption puts these results in your doctor's hands. Since you have not heard about these tests done a month ago, you assume all is okay. You assume wrong again.
As the doctor comes to his senses and recoups his professional demeanor, you continue with your list of items to discuss. After 30 minutes you have it all together - copies of test results, prescriptions, and a plan for follow-up on all that is necessary. You are asked to schedule your next appointment in one month at the doctor's convenience. There is no one at the front desk to give you an appointment.
Doctor visits like this are far too common to ignore. In this instance, the patient had an abnormal test that would have been ignored for a longer time. The unprofessional encounter amplified the patient's stress and blood pressure. It may have been easier for the doctor for the patient to reschedule, but would it have been the right thing to do, and the best thing to do?
Doctors would you?
1) keep arguing with the patient until blood pressure reaches 160/120
2) blame the patient for waiting one hour to be seen
3) see the patient
4) see the 2 drug reps and make the patient reschedule
5) apologize for unprofessional rudeness.
Patients would you?
1) reschedule appointment
2) let the doctor know you were on time - deal with it
3) continue talking with doctor instead of wasting time
4) stand up for your rights
5) file patient grievance with insurance company, state medical board.
Filing a patient grievance/complaint is a smart thing to do. A grievance is a request for an investigation of a complaint about a possible risk to the health, safety, or well-being of a patient; or a situation where the patient is unnecessarily at high risk. Check with with your health insurance provider to find out the details for reporting unacceptable medical services that may threaten your life. In addition, it may save other lives as well since about 15% of JCAHO sentinel events reported are from responsible patients who speak up.
by J. L. Richardson, M.D., family physician, patient advocate (specializing in grievenace process and medical record review), patient, and author of Patient Handbook to Medical Care: Your Personal Health Guide, and upcoming Patient Handbook to Surgery: Surviving Your Operation.
martes, 16 de septiembre de 2008
Second Opinion, Third Opinion
Dr. Oz has spoken again. On today's "Oprah" he made it crystal clear that second opinions, even third, are "patriotic" and show you care about your doctor. He said physicians should not be offended if a patient gets another opinion. Instead physicians should embrace the opportunity and respect their patients. He further stated that that this is an opportunity for doctors to learn.
Most doctors do get a terrible attitude if they know you are getting other opinions. They must feel threatened in some way. Is it an ego thing? As a physician, I fail to see why other opinions are so hard for my colleagues to embrace and suggest. As a patient, I fail to see why patients fail to trust their instincts about seeking other opinions.
Whenever, I have felt that another opinion was needed for my health, I did so. I told my primary doctor - after the fact. I brought in the other doctor's notes and recommendations, and I expected them to be followed. I found that when doctors don't know about a new test or treatment they tend to discourage you and get you out of their office quickly. Instead they should be yearning to know more about it, and what you have found out about it.
Unfortunately, I have had to seek other opinions on more than one medical condition I have had. Each time it was the best decision and the right thing for me. Then my doctors embraced it. Being a physician patient does not get you better care as most think.
It is good to trust physician, but you must be cautious. Trusting someone else is far from enough when it comes to your health and well being. You must help yourself - Help, Empower, Lift, Prepare.
Get another opinion if you need to it. And another, until you have the best. That's the way Lance Armstrong did it.
Bravo again, Dr. Oz! Thank you and Ms. Winfrey.
Most doctors do get a terrible attitude if they know you are getting other opinions. They must feel threatened in some way. Is it an ego thing? As a physician, I fail to see why other opinions are so hard for my colleagues to embrace and suggest. As a patient, I fail to see why patients fail to trust their instincts about seeking other opinions.
Whenever, I have felt that another opinion was needed for my health, I did so. I told my primary doctor - after the fact. I brought in the other doctor's notes and recommendations, and I expected them to be followed. I found that when doctors don't know about a new test or treatment they tend to discourage you and get you out of their office quickly. Instead they should be yearning to know more about it, and what you have found out about it.
Unfortunately, I have had to seek other opinions on more than one medical condition I have had. Each time it was the best decision and the right thing for me. Then my doctors embraced it. Being a physician patient does not get you better care as most think.
It is good to trust physician, but you must be cautious. Trusting someone else is far from enough when it comes to your health and well being. You must help yourself - Help, Empower, Lift, Prepare.
Get another opinion if you need to it. And another, until you have the best. That's the way Lance Armstrong did it.
Bravo again, Dr. Oz! Thank you and Ms. Winfrey.
martes, 9 de septiembre de 2008
Follow UP!
A news story on colon cancer follow up revealed that if you are older, a minority, or have other health problems you may be receiving less screening for colon cancer follow up. Many that have colon cancer, about 60%, are failing to get proper tests for follow up of their cancer. This is unacceptable. Why are so many being neglected? Do our doctors care, or do they really not know what to do? The article actually suggests the latter may be true!
The deputy chief medical officer of the American Cancer Society said that he was not surprised by these findings. He felt that the doctors' ability to give the proper care was under par. Now this is truly a sad situation. The person you trust with your health may be less qualified than you think.
It is up to you to be on top of your own health care. Follow up is so important. Make the choice to call your doctor, and to make your appointments. More importantly, make it your business to know all you can about your health - what you have, what you need. Follow UP!
The deputy chief medical officer of the American Cancer Society said that he was not surprised by these findings. He felt that the doctors' ability to give the proper care was under par. Now this is truly a sad situation. The person you trust with your health may be less qualified than you think.
It is up to you to be on top of your own health care. Follow up is so important. Make the choice to call your doctor, and to make your appointments. More importantly, make it your business to know all you can about your health - what you have, what you need. Follow UP!
viernes, 5 de septiembre de 2008
Stand Up To Cancer
"Stand Up To Cancer" is the best medical TV event ever! Broadcast simultaneously on the three major broadcast networks at 8 P.M. tonight, this event was magnificently powerful! Much information on cancer cause, early detection, treatment and more was provided throughout the hour. This also included written information in large letters at the bottom of the screen.
TV is a powerful information source, yet used the least for providing basic medical information and news. Hopefully this TV event will set the precedent for more real medical productions, maybe even a commercial free, 24-7 medical channel.
Stand up to cancer! Do your self breast exam. Do your scrotal exam. Do your preventive screening tests ordered by your health care providers. Do it routinely. "Just do it!"
A thorough medical history and physical exam includes the basic cancer screening. Some tests considered for routine cancer screening are:
-mammogram, MRI, sonogram - breast cancer
-PSA (prostate specific antigen) - prostate cancer
-colonoscopy - colon cancer
-stool blood check - colon cancer
-PAP smear - cervical cancer
-complete blood count - blood cancer
-CT or MRI scan - lung cancer, brain cancer, pancreatic cancer
and cancer in other body areas being scanned
-pelvic sonogram - ovarian cancer
-body scan (neck to buttocks and in between) - checks
body for cancer and other medical conditions.
Screening exams and tests save lives. Talk to your doctor. Be sure your doctor goes over the test results with you and explains EVERYTHING! Leave with your questions answered! Be sure to follow up to prevent any delays.
Stand up for cancer!
TV is a powerful information source, yet used the least for providing basic medical information and news. Hopefully this TV event will set the precedent for more real medical productions, maybe even a commercial free, 24-7 medical channel.
Stand up to cancer! Do your self breast exam. Do your scrotal exam. Do your preventive screening tests ordered by your health care providers. Do it routinely. "Just do it!"
A thorough medical history and physical exam includes the basic cancer screening. Some tests considered for routine cancer screening are:
-mammogram, MRI, sonogram - breast cancer
-PSA (prostate specific antigen) - prostate cancer
-colonoscopy - colon cancer
-stool blood check - colon cancer
-PAP smear - cervical cancer
-complete blood count - blood cancer
-CT or MRI scan - lung cancer, brain cancer, pancreatic cancer
and cancer in other body areas being scanned
-pelvic sonogram - ovarian cancer
-body scan (neck to buttocks and in between) - checks
body for cancer and other medical conditions.
Screening exams and tests save lives. Talk to your doctor. Be sure your doctor goes over the test results with you and explains EVERYTHING! Leave with your questions answered! Be sure to follow up to prevent any delays.
Stand up for cancer!
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