When you go to your doctor for some new symptom, realize that there will be a clinical process for your workup that could involve many steps, so think ahead!

I’m not suggesting that you will know exactly what tests will be necessary to evaluate your condition, but you can still think ahead.  In many instances, your PCP will have a pretty good idea what kind of treatment your symptoms will require.  In most cases, the tests he orders are done to confirm his suspicions.  With that in mind, if surgery is a strong possibility and you have a history of a chronic condition such as diabetes or heart disease, you may wish to schedule a pre-op evaluation by the specialist who cares for you for that condition.  Why?  Because these doctors are often very busy and you may have a long delay to get such an appointment.  At the very least check with the receptionist how quickly you can be seen if you need clearance before surgery.  In my case because of my heart history I knew I needed to be cleared by my cardiologist.  I also knew because I hadn’t had a recent stress test, he would probably want me to have that done prior to his giving me clearance. I was correct & getting these done added about two weeks to the process.

Next time I’ll discuss evaluating your treatment options to make sure you get the best care you can!

For Your Health – Dr. Bob

I truly believe that a lot of smart people don’t understand and don’t apply some basic concepts about wellness, illness, treatments, the roles of the members of the health care team and how to interact with these pieces.  Throw into the mix the varying levels of coverage health insurers provide and the rules they have in place, and it’s no wonder many people are confused about what to do when they face a medical situation in their lives.

This gap in health care literacy is costly in terms of people’s health and additional cost to the system when they make choices that are ill-informed from the viewpoint of basic health principles.  Some may make a distinction between health literacy and health care literacy.  Health Literacy would be defined as the knowledge of wellness, illness, managing one’s acute and chronic conditions and responding medically appropriately when things change with one’s health.  Health Care Literacy might be defined as the knowledge of how to use the health care system, including where to get care when necessary and efficiently and effectively using your health care insurance benefits.  For simplicity, I’ll use Health Care Literacy in this blog to include both of these concepts since they are closely related.

So what are we talking about here?  In a recent (March 1, 2011) Washington Post article, Sandra G. Boodman from Kaiser Health News, cited several examples of low levels of health literacy, such as, misunderstandings of discharge instructions leading to the development of life-threatening infections, or individuals not using prescribed medications properly because they don’t understand the directions.  I would add to this list instances where people misjudge the severity of their symptoms and wait too long to contact their physician.  The delay often allows their condition to deteriorate further so that when they do seek care, the physician is forced to send them to the emergency room or admit them to the hospital.  Antibiotics that could have been taken by mouth if begun earlier must now be taken intravenously, often in the hospital with added risk of complications, poorer outcomes and higher cost.  I have personally heard about examples of this happening many times.  And these incidents add up.  Boodman references a 2007 study that estimated the cost of this problem to the US economy could be as much as $238 billion annually.   This problem is widespread as demonstrated by a 2006 survey published by the U.S. Department of Education which found that only 1 in 8 adults has the skills to deal with complex health material.

I plan to publish posts to help improve a person’s health care literacy.  They’ll talk about some basic approaches a savvy health care consumer can take to optimize their health, minimize the impact of illness and save money.  I welcome comments about this post as well as suggestions about related topics of interest to help guide the discussion.

Regards,

Dr. Bob