First PCP Visit – Questions to Ask Your New Doctor

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Your first visit with your new PCP is your chance to see if this doctor and his practice are right for you. It’s always a good practice to make a list of your questions and concerns before any visit with a doctor, but there are a few more to have answered as well as some observations to make during this initial visit. In this post I’ll mention some of them, and on the next I’ll talk about some observations you should make. So before you go, make that list and be sure to take it with you:

Questions to Ask

· What’s the waiting time for a routine appointment? These are typically non-urgent follow-up visits for chronic conditions like high blood pressure or diabetes.

· How does the doctor handle acute illnesses like sore throats, the flu or back pain? Can you have an appointment the same day you call or will you be sent to an emergency room or urgent care center? Remember most insurance requires you to pay a higher copay when you use an emergency room instead of going to a doctor’s office.

· Are his office hours flexible enough for your schedule?

· How does the doctor handle calls after hours? Does he have other doctors with whom he shares call?

· Which hospital does the doctor use? Is it convenient for you should you need hospitalization?

As you get these answered, you’ll have a chance to gauge how well your new doctor relates to you and you to him. In my next post I’ll mention the kinds of things you will want to look for at the doctor’s office.

For Your Health – Dr. Bob

More About Milestones

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I had a few more thoughts on milestones that I wanted to share.  When setting targets for your weight loss milestones you don’t necessarily have to use weights.  Since a weight loss program combines making changes in your eating habits and your activity level, there are many none weight targets that you can use.  In fact many people find that concentrating on changing the behaviors that will lead to reaching their goal weight to be a better strategy than just focusing on their ultimate weight loss goal.  After all, attaining a 50 pound weight loss will take time, but a milestone tied to changing some aspect of your eating habits can be reached much sooner.  For instance, let’s say that snacks are your downfall, and you typically eat 6 unhealthy snacks every evening while sitting at the computer or watching TV.  A milestone for you could be to eliminate 1 evening snack per week for the next 5 weeks.  By the end of those 5 weeks you will have decreased your snacks to one each evening and hit that milestone.  At the same time you need to improve the healthfulness of the snacks and not increase the amount of each snack.

Once you reach your milestone, you reward yourself.  This brings up the other point I wanted to make about using milestones.  You can choose any reward except food.  So, buy a new pair of shoes or go out to a play or movie, but don’t go out to dinner or have an extra slice of pie for dessert.

Finally, it should be obvious that when you use the attainment of a changed behavior as a goal as in our example, you need to continue that behavior and build on it.  Most experts say that you need to work at maintaining that behavior change for at least six months before you can consider it part of your lifestyle.  With that in mind, you may want to set monthly milestones that you will maintain the new healthier behavior that you adopted in order to prevent backsliding.  And that brings us to the topic I’ll talk about next time – backsliding.

Meanwhile be sure to set attainable milestones for your behavior change program, whether for weight loss or smoking.  It’ll make it more fun as you chart your progress towards your goal.

For Your Health – Dr. Bob

Choosing A PCP

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Since your relationship with your PCP will be a long standing one you need to focus on qualities & competence of the physician, and that of his or her practice. But before you can do that you need to identify your choices.

Start With Your Insurer

Your health care insurer is the place to start since health plans often require you to select your physicians from a specific list of providers who are in their network. If you choose one outside the network you won’t get the same level of coverage and possibly none at all, so making that mistake can be quite costly. These days most insurers have a website to help you with selecting an in-network physician. They often let you search by location, specialty, and gender. Often you’ll find information about their training and office hours. Some insurers have rating information available, too. If they don’t have such features on their website or you want to speak with a person, call the Member Services number on the back of your insurance card. Someone should be able to give you much the same information over the phone.

Do Some Research

Once you have the list, you’ll want to do a little research about them. If you are getting your insurance through work, ask your coworkers who they see and how they like them and the practice. This will give you a sense of the doctor’s bedside manner and the quality of their office staff. Remember, the office manager, receptionist, and nurses in the doctor’s office are critical to a smoothly run practice. You want to be sure that when you call with a problem, your issue is handled efficiently and brought to the attention of the doctor when appropriate. If you happen to know a nurse at the hospital where that physician practices, ask their opinion. This would give you a clinical perspective on the doctor, too.

Finally, you should check with your state’s medical licensing board to see if there are any issues with any of the physicians you are considering.

Time For An Office Visit

Once you have done this research, it is time to visit the doctor to see if you will work well together. I’ll cover how to prepare for that visit and what to look for in my next post.

For Your Health – Dr. Bob

Making Milestones Work For You

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Usually when we are making changes to our lifestyle behaviors we have set a goal for ourselves that won’t be attained for many months.  Once we reach that goal we usually reward ourselves.  In fact, often the attainment of our goal is the reward in and of itself.  The sense of accomplishment is powerful.  Very often, our goal is related to getting a benefit or reward.  For example, a woman losing those 50 pounds she set as her goal may enable her to feel more attractive and confident when she attends her college reunion.

But if we just tie a reward to attaining our ultimate goal, we can lose the value of some motivational opportunities along the way.  This is where the concept of milestones comes in.  When writing out your plan it is a smart idea to identify some milestones along the way & link them to some small reward.  For instance, for the woman in our example, she may want to set up 10 pound milestones as she works toward her 50 pound weight loss goal.  She would tie a reward for every 10 pounds she loses.  It may be going to a movie or buying a new blouse or sweater.  Whatever reward she values would work as long as it doesn’t involve straying from her eating plan.  Ideally you should tie a due date to each milestone to help you stay on track.

So be sure to harness the power of milestones.  After all, we all respond to rewards.

For Your Health – Dr. Bob

What Is A PCP And Why Do You Need One?

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PCP stands for primary care physician.  These are physicians whose specialty gives them training in broad areas of medicine that enable them to diagnose most of the common illnesses that people develop.  When they can’t treat the condition themselves because of the limitation of the depth of their knowledge or skills, they will refer the patient to the appropriate specialist.  For infants and children, pediatricians and family practitioners serve as PCPs.  Adults have internists and family practitioners as their PCPs.  All three of these primary care specialties spend three years after medical school graduation learning their specialty.   So, for three years an internist in training focuses on adult medicine, a pediatrician in training studies pediatrics exclusively.  A doctor learning family practice spends their three years learning pediatrics, adult medicine, obstetrics and surgery.  Training for the medical subspecialties such as cardiology or gastroenterology requires several more years of training after the three years of internal medicine.  A similar progression of training takes place for surgical subspecialties beyond general surgical training.

In essence a PCP is trained to provide preventive care, make diagnoses, treat what he can and refer the rest.  They serve a role in coordinating their patient’s care and that can be invaluable.  They will recommend what screening tests and immunizations are appropriate for each of their patients based upon their age, gender and other factors.  Though there are times when you may need the expertise of subspecialists such as a cardiologist or an orthopedic surgeon, they don’t have the broader perspective of the PCP in regard to prevention.

It pays to have a PCP not just for prevention but also for acute medical problems such as colds, sore throats, rashes, body aches and pains.  While these can be diagnosed and treated in an emergency room, there are definite disadvantages to going to the ER.  First of all most health insurance plans will require you to pay more when you go to the ER rather than a physician’s office.  I’m aware of health plans where the copay for a doctor’s office visit is $25 and the ER visit copay is $250!  In addition, you can’t make an appointment for the ER so you can wait in the waiting room for hours while patients with more serious (and infectious) problems get seen before you.  Lastly, the ER physician usually views you as a single visit and doesn’t have the same preventive perspective as a PCP does.

In the next post I’ll talk about things to consider in identifying your PCP.

For Your Health – Dr. Bob