When Do You Need to Change Your Doctor?

Have you ever just stuck with your doctor because it was convenient? I know I have. I don't know whether I'm afraid of change, or it's because my doctor's office if close by, but I am guilty of this. I have decided though that it's time to change my doctor, and I'll tell you why.

I've only seen my doctor twice in the three years that I've been her patient. She's very pleasant to talk to, but doesn't seem to interested in follow-up appointments. There was an 18 month gap between my first appointment and next appointment with her. I never heard from her in between appointments, and she refilled my prescriptions, no questions asked. I'm only on a blood pressure medication, but I think after a year she would have said I needed to come in and be rechecked. My last appointment was last October. I scheduled a physical and it took six weeks to get this appointment. Three days prior to my appointment, I ruptured my Achilles tendon and I asked her to look at it. She examined it, which took maybe a full minute and said to keep on what I was doing. She asks me routine questions about my health, then looks at her watch and says she only has a few minutes left to finish my exam! At this point I was perplexed!!! She did the female portion of the exam and nothing else. No listening to my heart, lungs, looking at my throat or ears. Nothing. Oh, she did order annual lab work.

To this day I still can't believe that I didn't say anything to her. I've worked in doctors offices. I know what a physical is. I was just so dumb-founded when she made that comment, that I didn't think to respond.

I have an HMO for insurance, so it's pretty easy for me to change doctors. All I have to do log on to their website, find doctors that I'm interested in, then see if they are accepting new patients. I've also used YELP to look at reviews of doctors as well, and to see what other people/patients have commented about them. If I see someone who looks good, but after reading reviews see that he/she is frequently behind schedule, I probably wouldn't choose them.

Now, not all people have the luxury of changing doctors as easily as I do. With Obama Care now, more and more doctors offices are feeling the impact of additional patients and having a hard time keeping up with the ones that they already have. Also, you may have to call around and see if the doctor you have in mind accepts your insurance. Not all doctors take every insurance that is out there.

If you are thinking about changing doctors, ask yourself these questions?

• Do I like my doctor? Is he/she pleasant and does he/she listen to me?
• How easy is it to get an appointment?
• Are same day appointments available for urgent issues?
• What are her/his policies when they're unavailable?
• What is his/her refill policy?
• Are they on time or frequently run behind?
• Is their office staff pleasant?
• Do they call you back if you have a question?
• Does he/she feel rushed when you see them?
• Do they take family members?
• Do they accept and bill my insurance?
• Do they have positive patient reviews?

These are just a few of the questions I would ask. I would also ask friends and family members for recommendations. As a consumer, you have the right to the best medical care possible and shouldn't accept anything less.

How to Get the Most out of your doctor appointment

Have you ever gone to a doctor appointment, only to leave and forgot to ask questions or forgot what was told to you at your appointment? Well, you're not alone. Most appointments last, (or are scheduled) for only 15 minutes, and you usually have to cram as many questions and receive suggestions, prescriptions and additional information to act upon. Unfortunately, a lot of this is forgotten as soon as you get home. It's not that you've intentionally forgotten it, it's that a lot is done in a short amount of time, and you're not wired to recall that much information. I too have experienced this first-hand; not only after working in a medical office for several years, but as being the child of an aging parent who easily gets facts confused.

I have come up with a list of suggestions to make your appointment easier for both you and your doctor.

Carry a medical notebook with you

On the first section, write down your name, address, phone number, emergency contact information and insurance name. Include illnesses, previous surgeries, and all your prescriptions that you take and any allergies that you have. Make sure you include the milligrams, (strength) and how often you take it. Also note which provider prescribed it for you. Also include a list of vaccinations that you had and the date you had them. Next, include important family history that your doctor should be aware of. Now, make a list of all your providers, including their names, specialty, address and phone numbers.

Make a list of your appointments and who you see

This should resemble the list of chapters in a novel, but you keep adding to it with each appointment.

Keep a separate section for each provider that you see

Write (again) the providers name, address, and phone number at the top of their section. Always write a date and time of appointment for each visit. Keep it in chronological order, just like you would do with a diary. In the provider section, write down any questions and answers that you have when you have an appointment. Make sure you include any changes and tests that have been ordered. Also attach any copies of orders or records that they have given to you that day.

Hopefully this will give you some ideas on what will help you gain the most from your medical appointments for both you and your providers. I know that it's been a big help for both myself and my family members.

Sports Injuries in Seniors!!!

I've always liked to be active. I am not much for going to the gym and working on the weights, but I do like to participate in classes and sports. Now mind you, I'm not a spring chicken anymore. In fact, this year I'll turn 60, but I don't believe in stopping what you love because of your age.

This brings me to sports injuries. Never in my wildest dreams did I ever think that I would be in my first cast in my late 50's!

I was playing pickleball (I call it tennis for old people), at the local YMCA. I had been playing twice a week for quite sometime now. I was probably an hour into playing, (you take turns, so I did have some down time), when I went after a routine ball and it felt like someone came up from behind me and hit me in my right calf and I heard a loud pop. I immediately went to the ground, (more to protect myself than anything), and knew instantly that something was wrong. I was helped over to a bench where it was apparent that something was seriously wrong with my achilles tendon.

I ended up getting a ride to urgent care where I was misdiagnosed with a sprain and put in a walking shoe. Three days later I saw my own doctor, who examined it, but didn't suggest anything else. I finally asked for a referral to an orthopedist as my leg was swelling. 

I saw the orthopedist 16 days after my initial injury where he thought that I ruptured my achilles tendon. Neither the urgent care doctor or my physician knew they correct way to test for this. I ended up having an MRI which verified his diagnosis and was put in a cast for four weeks. I recently had it removed and now am in a air cast/boot with wedges that have to be removed weekly. This will go on for about five weeks, then lots of physical therapy. Did I mention this was my right foot? That means NO DRIVING which is driving me crazy!!!! Not only can I not drive, I also have to have help taking a shower.

If you think you've been misdiagnosed, trust yourself and get a second opinion immediately. If I had, I probably would have been on the road to recovery sooner and possibly have a better resolution to my overall healing. Sports injuries can happen at any age. Even if you think you know your limits and are doing all the appropriate things, (stretching, diet, etc), it can still happen to you. And always, check with your medical provider to make sure you are healthy enough to participate in any physical activities before you start.

RIP Dad, You're the Best!

My father passed away on July 28th. He was 84 years old and had been in declining health for quite awhile. He had lung cancer, (was a long-time smoker, but had quit 20+ years ago), went through radiation, (which gave him an additional 6+ months), but succumbed to a heart attack, as his cancer was putting pressure on his already weakened heart. He spent his final days at his summer home in Brookings, Oregon, and unexpectedly passed 3 days after he came back to his permanent home in Northern California.

My parents were proactive a few years back and planned for their deaths.  My father was a Korean War Veteran and requested a memorial service at the local funeral home first, followed by internment at a nearby Veterans Cemetery. His wishes included the 21 gun salute, bugle, and the flag folding ceremony with all the bells and whistles. 

My mother has since found out that all your best pre-planned arrangements may not go as smoothly as hoped. To start off with, both my parents signed up for a pre-paid cremation service. That was fine, but since my father passed at home, (after family members paid their final goodbyes and hospice was notified and had come and gone), we called the cremation organization to pick up his body.  Little did my parents realize, that the organization they signed up with was two hours south of them. They first had to get a team in place, then drive up and pick up his body. Next, another surprise was the length of time that it actually takes to get the cremation done. They first need a signed death certificate from the physician, which can take up to 5-7 days, then they seemed to need additional paperwork faxed over from my mother. They indicated the whole process could take up to 15 days! Lastly, the cremains were to be shipped back to my mother with the proper permits and such for burial.

My mother was hoping to have the local memorial service and internment all at the same time, but due to the uncertainty of the cremation timeline, she did the memorial first. Next, we had to plan a time for the internment. As the Veterans Cemetery has only certain days that they do services and also have to rely on retired Veterans to do the gun salute, we were at another standstill. We finally were able to get all the pieces in place, and the actual internment took place a month after his death. It was a lovely service and actually FREE to military members. My mother will also be interned next to my father, but as she was not a Veteran, there will be a cost of ~ $750.00 for her. 

This brings me to what a nice benefit the Veterans have for their loved ones passing. The Cemetery we went to was nicely kept and very professional. They did a nice service and all expectations were met. You can actually have the full service at the Chapel at the Veterans Cemetery, but as I previously mentioned, my father wanted a separate one at the local funeral home first. 

If you have a love one that served in the military and hasn't made their wishes known, it might be time to have the "talk" with them. It's a great benefit for their service to their country and one that families may not be aware of.

Ca Veterans Cemeteries

Kevin MD - A Great Site to Visit

I'm going to keep my blog post short and sweet today. I have found a blog called KevinMD.com that is a wealth of information from a physicians point-of-view. It talks from everything from abuse by patients using the Emergency Department as their personal physician, to people going broke because they can't afford care.

Please take the time to check this very informative blog out. It's great to see that there is a MD that is rooting for patients and patient care. Oh, and have a happy and safe 4^th of July!

http://www.kevinmd.com/blog/

http://www.kevinmd.com/blog/

Have Healthcare Changes Impacted Your Life?

Healthcare has changed significantly over the last several decades. It used to be that you had a Primary Care Physician (PCP), which may have been referred to as your "Family Doctor", that took care of all of yours and your families health care needs. He (and in rare circumstances she), would see you for the common cold, deliver your baby, and possibly make a house call if you were too sick to come to their office. And, if you had to be admitted to the hospital, your PCP would most likely be the one who cared for you the entire time.  

Nowadays, it's a new ball game. You may have a PCP, but if you need specialized care, you will most likely have a different physician for that. For example, my daughter had a perinatologist for her entire pregnancy care. (I had my Family Doctor.) When it came time for her to deliver her baby, her perinatologist wasn't on call. It was actually a midwife that delivered her baby. Her perninatologist never even saw her during the time she was in the hospital. She did see her for her six-week postpartum check up, and that will be her last visit with her. Also, if you get admitted to the hospital, you might have a hospitalist to take care of all, (or most), or your medical needs and never see your PCP. You also will probably have a barrage of doctors to take care of your different healthcare needs.

I'm also sure that you're used to having to pay a co-pay or your portion due now at the time that you're seen. It used to be that you could pay when you received your doctors bill in the mail, and if need be, make payments on it.

Also, remember when your doctor could just order a test if you needed it? Now it usually has to go through a whole pre-authorization process with your insurance company, and even at that, it could get denied.

What do you think? Do you like all the health care changes or would you rather see it go back to the "Good 'ol Days"? I for one, prefer the way it used to be. I had my family doctor from the time I was two years old, until the time he retired. He took care of four generations of my family and was not only my doctor, but a friend as well.

     

What to Expect if a Relative Goes Into a Nursing Home

My eighty-eight year old father-in-law recently fell at home, (he was by himself), and broke his hip.  

Unfortunately, his Life Alert alarm was in his nightstand drawer, and his fall took place in his living room. It took him two hours to make it to a phone. He called his daughter and son (who lived about twenty minutes away), to come over and help him BUT, unfortunately once they got there, neither of them had a key to his house. When they both arrived, they both came prepared with screwdrivers in hand, hoping to find a window that they could budge.

To make a long story short, they were able to crawl in through an unlocked window and call an ambulance. At the hospital, it was determined that his right hip was broken. He ended up having surgery that night, where he had a rod and three screws placed. After surgery, he was transferred to the ICU, (Intensive Care Unit), then shortly moved to a regular room. He ended up staying four days in the hospital, then he was transferred to a SNF, (Skilled Nursing Facility), for rehabilitation. At this point, his insurance covered his first twenty days in rehab.

Situation	Is my SNF stay covered?
You came to the Emergency Department (ED) and were formally admitted to the hospital with a doctor’s order as an inpatient for 3 days. You were discharged on the 4th day.	Yes. You met the 3-day inpatient hospital stay requirement for a covered SNF stay.
You came to the ED and spent one day getting observation services. Then, you were formally admitted to the hospital as an inpatient for 2 more days.	No. Even though you spent 3 days in the hospital, you were considered an outpatient while getting ED and observation services. These days don’t count toward the 3-day inpatient hospital stay requirement.

Now, this is where it gets tricky.  His orthopedic surgeon told him that due to the severity of his break, he would have to remain completely non-weight bearing on his broken hip, for up to four months. According to Medicare guidelines, they will only pay the first twenty days of rehab. After that, if you don't have a supplemental that picks up the balances, (he has Vetrans insurance), you are reponsible for $161.00/day for days 21-100.  This is exactly where he fell; paying $161.00/day.

Your costs in Original Medicare

You pay:

• Days 1–20: $0 for each benefit period.

• Days 21–100: $161 coinsurance per day of each benefit period.

• Days 101 and beyond: all costs.

Medicare Guidelines

Thankfully, he was able to go home after about two weeks of paying $161.00/day. His daughter was able to make arrangements for caregivers to be with him basically 24 hours/day. It's actually costing more than the SNF for now, but he is at home and mentally doing much better. 

If you are of Medicare age, or have parents or relatives that have Medicare, PLEASE take the time to review your supplemental insuance policies. It was quite shocking to find out how much money a serious injury can cost you, and not all people are prepared for this expense. You may even need to talk to your insurance agent to see if there are any supplemental policies that cover instances like this.