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You have a say in your health care plan.

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July 9, 2013 by inspiritpt

Choices.  We all have them—usually we like having them.  Chocolate or Vanilla?  The red one or the blue one?  Channel 2 or Channel 5?  But sometimes we don’t know we have choices, OR we know there are choices, but we don’t understand them enough to make a decision.  That seems to be the norm in healthcare—people don’t understand the choices they have when it comes to their well being.  Those choices can include what type of care they get, where they get it, whom the provider is, and even how the treatment is performed. All of those pieces affect the COST and timing of the care and may ultimately affect the outcome of the care as well—how your health improves may depend on all of these things. 

YOU always have the right to choose your healthcare provider.  Most people will choose their primary care doctor (PCP) without knowing anything about them—which is why people often feel their PCP doesn’t connect well with them. When choosing your PCP ask people for recommendations—people you know will be honest with you about doctors they have worked with.  Since your PCP usually starts the process of most healthcare decisions, you must trust them and be able to communicate well with them, including telling them if you DISAGREE with them.  (It is okay to disagree with your care providers—I do it all the time J Just be respectful and firm with them).  Choosing the right PCP is a very important decision.

You also can choose your other providers:  surgeons, specialists, diagnostics and especially physical and occupational therapists!  Most people will go where there PCP sends them, but you can make your own decision.  Again, ask people for recommendations—how was their experiences with certain doctors, nurses, hospitals, and staff? You can also call and ask questions before you make a decision—if they won’t answer them for you, maybe that’s not where you want to go.  I know sometimes the insurance companies seem to dictate where you go, but you still have the right to choose.  You CAN go out of network—although I admit it may seem to change the upfront cost of things, often it doesn’t really cost more.  If the out of network provider gives you better care in a shorter amount of time you may actually save money and time.  Also most providers offer cash discounts to people which will reduce the out of network costs in comparison with in-network amounts.

I could relate many stories of people who have “just gone where my doc told me to go” and later they found different providers gave them better care or a better outcome.  That’s not unusual.  But when the person says to me “I wanted to go somewhere else but felt I couldn’t disagree with my doctor”  or “I felt I HAD to go where I was sent”  I get upset.  We always have the right to choose who takes care of us and how they do it.  Healthcare is very expensive (I have to pay for services for my family, too) and we have to be SMARTER consumers.  Recently someone in my family needed an MRI.  We found that there was a $1200 discrepancy between where our doctor sent us and the “other place”.  When I told the nurse we were going to the other facility she said, “OK it doesn’t matter where you go”  so I asked “Why don’t you recommend the less expensive place?”  She said “We try to keep you in our system”—Huh?  Who benefits?  The patient or the “system”?  Physicians often receive incentives to send patients to certain other providers or to keep them within their own healthcare system.  We should be sent to the best providers, not just ones that are convenient or that earn bonuses for the doctors making the referral.

In the next few months, there will be many decisions to make about healthcare—especially in the insurance area.  The new healthcare exchanges will be weird to navigate (to say the least.)  Even as providers we are uncertain what the changes will be.  But one thing won’t change:  you always have the right to ask questions, disagree and make CHOICES that are best for you and your family when it come to your healthcare.

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