Access to Medical Service
- What are HMOs and PPOs?
- Members of a health maintenance organization (HMO) pay a set monthly fee no matter how many (or few) times they see a doctor. Usually there are no deductibles or claim forms but you will have a co-payment for doctor visits and prescriptions. Each member chooses a primary care doctor from within the HMO network. The primary care doctor coordinates all care and, if necessary, refers members to specialists.
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A preferred provider organization (PPO) is a network of doctors and other health care providers. The doctors in this network agree to provide medical services to PPO health plan members at discounted costs. Members can choose to see any doctor at any time. Choosing a non-PPO provider is called ‘going out of network’ and will cost more than seeing a member of the PPO network.
- Getting Ready for an Appointment with Your Doctor
- Be prepared: make a list of concerns.
- Take information with you.
- Make sure you can see and hear as well as possible.
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Consider bringing a family member or friend.
- Find an interpreter if you know you’ll need one.
- Plan to update the doctor on what has happened since your last visit.
- Finding and Using an Interpreter
- Look for an interpreter through community or neighborhood association, the doctor’s office staff, and your own network of friends and family.
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If possible, select someone with whom you will feel comfortable if they learn about your symptoms or condition. For example, you may not want to ask your children to interpret a conversation on sexuality.
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Consider telling your interpreter what you want to talk about with your doctor before the appointment.
- If you language is Spanish and your interpreter does not come from the same country or background as you, use universal Spanish terms to describe your symptoms.
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Make sure your interpreter understands your symptoms or condition before he or she conveys your message to the doctor. You don’t want the doctor to prescribe the wrong medications!
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Don’t be afraid to let you interpreter know if you did not understand something that was said, even if you need to ask that it be repeated several times.
- Making Good Use of Your Time
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Be honest: It is tempting to say what you think the doctor wants to hear: for example, that you smoke less or eat a more balanced diet than you really do. While this is natural, it’s not in your best interest. Your doctor can suggest the best treatment only if you say what is really going on. For instance, you might say: “I have been trying to quit smoking, as you recommended, but I am not making much headway.”
- Decide what questions are most important: Pick three or four questions or concerns that you most want to talk about with the doctor. You can tell him or her what they are at the beginning of the appointment, and then discuss each in turn. If you have time, you can then go on to other questions.
- Stick to the point: Although your doctor might like to talk with you at length, each patient is given a limited amount of time. To make the best use of your time, stick to the point. For instance, give the doctor a brief description of the symptom, when it started, how often it happens, and if it is getting worse or better.
- Share your point of view about the visit: Tell the doctor if you feel rushed, worried, or uncomfortable. If necessary, you can offer to return for a second visit to discuss your concerns. Try to voice your feelings in a positive way. For example, you could say something like: “I know you have many patients to see, but I’, really worried about this. I’d feel much better if we could talk about it a little more.”
- Remember, the doctor may not be able to answer all your questions: Even the best doctor may be unable to answer some questions. Most doctors will tell you when they don’t have answers. They also may help you find the information you need or refer you to a specialist. If a doctor regularly brushes off your questions or symptoms as simply a part of aging, think about looking for another doctor.
- Information about Medical Tests:
- http://medlineplus.gov/
- http://www.nlm.nih.gov/medlineplus/laboratorytests.html
- Understand Your Prescriptions
- Some of the most common abbreviations you will see on the labels of your prescription medications:
p.r.n. |
as needed |
a.c. |
before meals |
q.d. |
every day |
p.c. |
after meals |
b.i.d. |
twice a day |
h.s. |
at bedtime |
t.i.d. |
three times a day |
p.o. |
by mouth |
q.i.d. |
four times a day |
ea. |
each |
- Advance Directives
- Advance directives allow you to say what you’d prefer if you are too ill to make your wishes known. There are two main kinds:
Living wills – A living will describes your decisions for medical treatment at the end of life. Living wills typically refer to life-prolonging treatment when death is imminent.
Healthcare proxies – Also known as a medical or health care power of attorney, a healthcare proxy is more detailed than a living will. It allows you to appoint the person or persons you trust to make health decisions for you if you cannot. It also allows for more detailed advance care planning, letting you state your wishes about resuscitation, feeding tubes, antibiotics, hospital transfers, respirators, and more.
- Because the healthcare proxy involves more decisions, you may want to talk to your doctor about various options for care. For instance, many people would be willing to try a feeding tube or a ventilator for a while, but then would want it to be stopped if there condition did not improve. Also talk to family members and the person you have appointed as your proxy to be sure they understand your wishes.
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Advance care directives are legally valid everywhere in the United States, but laws concerning them vary from state to state. Forms approved for the State you live in are available from many different health care organizations and institutions.
- Discussing Sensitive Subjects
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Don’t hesitate to discuss sensitive subjects with your doctor.
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Use brochures or booklets as props to introduce topics you may feel awkward discussing.
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If you feel the doctor doesn’t take your concerns seriously, it might be time to think about changing doctors.
For More Information
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