Shortly after publishing my last post, The $29,000 Appendectomy! (Brought to You by Cost-Shifting), my daughter e-mailed me a link to a video on the CNN website in which Dr. Sanjay Gupta gives some further insight about hospital charges and cost-shifting. As always, he did a terrific job, and I urge you to Click Here to check it out.

I’ve always admired Dr. Gupta’s interviewing skills and ability to clearly explain some complicated medical issues to his audience.

As always, I welcome your comments!

For Your Health – Dr. Bob

(To view the case of the original post, go to Case 1.)

Follow-up care is essential to assure good outcomes, but for some people getting a ride to the doctor can be a problem.  So, put yourself in Susan’s shoes.  If you couldn’t drive yourself, what would you do?  Here are some options:

• Most would jump at the chance to be of help.  After all, some day you may be able to return the favor. 
• Depending on where you live that could be quite expensive or cumbersome. 
• Contact them to find out.
• The social workers there are aware of all sorts of programs in the community to help its citizens with a variety of needs, such as transportation. 
• He may know of another way to address your transportation difficulty.

I used Case 1 under Cases To Consider to describe an actual situation that a real person faced after she came home from the hospital.  I named her Susan and outlined the problems she encountered getting the care she was supposed to get along with how I would overcome those obstacles.   I hope you found these to be useful in understanding some of the important components of a hospital discharge and how to work within the healthcare system to stay your healthiest.  I welcome your comments and questions. 

For Your Health – Dr. Bob

There are some basic things to consider about any medications you may be taking and things you should do to use them effectively:

1. Make sure you tell all your doctors about any vitamins, supplements, herbals, prescription or non-prescription medications you may be taking.  Any of these may cause an interaction with certain prescribed medicines.
2. When prescribing any medication for you, your physician should explain a few things to you.  He should tell you how the medicine is going to help you and how often you should take it.  He’ll explain whether you should take it with food or without?  Be sure to take them as prescribed.
3. You’ll need to know whether it is a medicine that you should take for only a certain length of time or indefinitely to control a certain condition.  Be sure to take it as long as your doctor wants you to.  This is worth further explanation:

Antibiotics that treat infections are usually taken for a specific number of days.  Antibiotics truly cure infections.  The doctor gives you the number of doses that need to be taken to completely cure the infection.  Stopping the antibiotic too soon can lead to a recurrence of the same infection that may be more difficult to treat.  Pain medication is another class of medications that needs only be taken while you are having pain.  They are often given to relieve the pain after surgery while the tissues heal.

Other drugs that control conditions such as high blood pressure or cholesterol need to be taken indefinitely.  If you have high blood pressure and are taking a medication that lowers your blood pressure to normal levels, the medicine has not cured your hypertension.  It is controlling it, and will do so only as long as you are taking it.  When taking medications that control a condition, you should not stop them without discussing it with your doctor first.  Abruptly stopping some medications may cause a worsening of the condition they were controlling.  In the case of blood pressure, stopping a medication suddenly may result in the blood pressure reaching dangerous levels.

4. Your doctor should warn you about potential side effects the medication may cause.  Notify him if you notice any new or worsening symptoms after you start the medicine.
5. Because some drugs may affect other systems of your body without causing symptoms you would notice, your physician may want to check some blood tests after you have been taking the medication for awhile.  Make sure you get the recommended tests.

If you have any questions about any of your medications, ask your doctor or pharmacist.  Next time I’ll talk a little bit more about using your medications effectively and controlling your costs.

For Your Health – Dr. Bob

On my last post I listed some questions to ask your new PCP. Today I’ll mention some of the things I would look for at the doctor’s office even before I meet with the physician.

The doctor relies upon his office staff, and the caliber of that staff dictates the service you will receive and some aspects of the quality of medical care as well. After all, it is the receptionist who will set up your appointment when you call in, and you will rely on her judgment. So rather than thumbing through magazines or checking your e-mails in the waiting room, I suggest you pay attention to a few things:

1. Is the waiting area clean and orderly? While the magazines may not be the most recent issues, does it look as though someone takes pride in maintaining a professional appearance?
2. How courteous is the staff on and off the phone with other patients?
3. Do they gossip about patients?
4. Do they seem to be interested in helping the patients?
5. Are they purely business-like or do are they more personable?
6. Do they talk about other patients who aren’t present so the patients waiting can overhear? If they use identifying information and discuss personal health information this is a breach of confidentiality.  They may be talking about you someday in front of one of your neighbors.
7. Do they keep to the schedule or at least inform the waiting patients when the doctor is running late?
8. When you are brought into the exam room, does the nurse take the time to listen to you and answer your questions?

Now that I have you thinking along these lines, I’d be interested in some other things you look for in a doctor’s office. Please send me your thoughts so I can add to this list. Next time I’ll talk about how to prepare for a visit to your doctor including how to describe your symptoms.

For Your Health – Dr. Bob

In the last post I talked about what characteristics of your symptoms should lead you to contact your physician. This time I want to discuss what else to consider.

Sometimes they know the on-call doctor isn’t their own, and they don’t want to talk to them.  The reality is that all physicians are trained to handle such after hour calls.  Delay can sometimes lead to complications that can be life threatening.