On Trial at the Doctor’s Office...

How many times have you dreaded going to the doctor's office because you just felt that you would be judged? Have you even been asked questions like, why aren't you performing this medical task or ridiculed because you had not followed through with the plan from the last visit. How does that make anyone feel when they have yet to develop a relationship with their healthcare provider? Let me say I do believe that when you are already comfortable with whom you are seeing and the relationship is established there is more room for direct conversation, but still respectful and honest. But the problem for me is when that relationship is not yet to be established. Don’t get me wrong there still has to be honest, respectful medical conversations sometimes with bad news or things that you need to do immediately to improve your health, but can it be done in a way that patients don't feel like they are being judge or labeled the "bad patient"? As a patient I have had the similar situations where I felt that I was being judged (whether real or perceived) and it just didn't make for a pleasant healthcare experience for me. So I thought about it and here were some things that I did to improve my healthcare experience because I too have to play my part:

 

· Changed healthcare providers (after two visits)---I wanted to give the previous healthcare provider a chance because maybe I was a little more sensitive on the first visit.

· Asking, open and honest questions---No matter how uncomfortable they made me feel to ask because as a nurse I don't know everything about everything; but that was my issue with being judged that I also had to address with myselfJ

· Participate in dialogue and initiate it---I don't have to make it a you ask me a question and I answer session.

· Listen and clarify---Listening is important to learn anything, but I also learned to clarify statements that I perceived as judgmental; sometimes it was a misunderstanding on my part and this cleared it up immediately.

Tell me about times that you felt judged at the MD office. What did you do to improve your future experiences?

Health care Savings: How to See the Doctor and Save Money

How can you save money and still remain healthy? In this economy, it seems almost impossible to do both; as pay goes down or remains the same, copays and deductibles increase and more healthier foods are costly.  I decided to develop a list from what I know as a health care consumer and what I have heard others say have made the most differences to them.

Savings at the Doctor's Office or Pharmacy

• Use urgent care offices or your regular doctor for non-life threatening issues. Ask your doctor's office if they offer sick, after hours, or weekend visits or ask where they would encourage  you to go during those times for non-life threatening issues.
• Review office billing policy make sure you know the rules; know if you will be charged for after hour calls, or when your doctor returns a phone call, or spends phone time talking to referral sources on your behalf. 
• See the same doctor, whenever possible. This will help you develop a relationship with your doctor which may mean that they become more in tuned with past or current problems and easily are able to pick up on new problems. This will also help you feel comfortable and more willing to share your thoughts and wishes regarding your health care plan.
• Educate yourself, so you can ask questions and get answers. The more you know the more you can prepare and do what you need to do to stay healthy.
• If you are diagnosed with a medical condition, ask about all of your options and the costs.
• Make sure you keep in contact with your insurance company so you can ask questions and know your benefits.
• Go to the your yearly wellness appointments, the healthier you are able to stay the less it will cost you, plus most of these appointments are covered by your insurance so the cost to you is little to nothing.
• Ask for itemized bills from whomever you see, look it over and make sure what you are charged for what was actually done.
• Ask your doctor's office what services they provide, some offices do their own x-rays, EKGs, and other tests that may cost more if you have to go to another facility.
• Talk to your doctor's office about payment options and possible discounts. Some healthcare agencies may give you a % off your bill in you are able to pay in full or if you need a payment plan, ask you may be surprised at what your options are {I would add ask first, when you are scheduling new appointments.}
• Ask about generic medications vs. brand names
• Ask about low price medication lists; some pharmacies have a list of medications that you can get some times cheaper than through using your insurance.
• Look into any store reward deals for using their store for pharmacy benefits
• Shop around for the best prices for eyeglasses and other medical equipment/devices when possible; ask health care provider and other agencies about lower prices {they are out there}.
• See about having labs and the appointment performed on the same day or ask if labs are done earlier what the charges will be.
• Be prepared, always prepare for your doctor's appointment--have your list of questions or symptoms you are having. Make the time spent useful and worth every penny.
• Look into health care flexible spending, it is pre-taxed and it allows you to plan for those unexpected medical expenses.

Saving at the Grocery Store

• Use your rewards savings cards at the grocery or coupons.
• Shop around online for the best savings; now a days there are so many online resources/blogs/etc. to help you determine the best deals that are more cost effective and healthier.
• Use farmers markets for fresh fruits and produce.
• Plan your meals, look at healthier options/recipes that suggest ingredients that are budget friendly.

Tell me how you save and stay healthy? We could all use the extra bucks:)

Reveal or Not? Airing Medical Mistakes.......

I saw this article Airing medical mistakes and was amazed! It gave me hope; I think that hospitals/clinics that take ownership in their part in improving patient care/patient outcomes is one I wouldn't mind working with and working for. We all have to do our part.

A Doctor or Nurse who Listens Goes a Long Way in Patient Care!

As a nurse, I have wondered occasionally why patients seek medical care but do not follow through with the "doctor's orders.” It was not until I became the patient, that I knew what that really meant and why I too was not the best patient with follow-up compliance. I believe that one of my issues, was I was told what I needed to do, and never was the question asked of me as to what I could do or wanted to do. I remember the nurse saying my blood pressure was high and the doctor coming in to confirm that, then she ordered, without asking me as she quickly left the room, an EKG (heart test) and as I walked out the door I was given a prescription for blood pressure medication all within about 30 minutes. I remember thinking, "that doctor doesn't even know me how is she looking out for my best interest, she hasn't even considered my thoughts or discussed with me the least restrictive alternatives, and I am a nurse." Well it was no surprise, at least to me; she was quite shocked that when I went for a follow-up appointment three months later that I was not taking the medication, but instead  I had my new diet and exercise regime. In that experience, it allowed me to reflect on how important as a nurse that I acknowledge my patients’ ability to make decisions over their lives or at least listen to their priorities and intentions; after all it is their lives and I am not moving in with them to ensure compliance. This lead me to reflect on the term “doctor’s orders” I think it may be best stated as a “patient’s plan of care”, as I realize now as a nurse if/when health care professionals don’t address or include the patient when making decisions over their lives, they won’t listen when it’s time to follow through. In my personal interactions with doctors, I have learned to value a doctor who listens to me and generally those are the ones who have better health care outcomes and compliant patients. So would you follow through with the “doctor’s orders” if you were allowed to be involved in developing the plan of care, why or why not?

Should Healthcare Agencies be Transparent?

Should Health care Agencies be Transparent? I thought about this, after talking to my cousin, who is also a RN and she told me that her floor at the hospital she works was having open interviews, after the top nurse manager candidates were picked, to allow nurses to have direct input in the hiring of a new nursing manager. I have personally never worked for an agency that allowed this practice, but it sounded like a great opportunity to allow those who will be directly impacted to have a say, whether real or perceived, in such an important decision. I think this was a great way to start or maintain a trusting nurse-employer relationship. Health care agencies that leave nurses in the dark when reviewing or strongly considering important proposals for nursing changes/new products or other nurse-related issues are often accused of not being transparent. The reality is, nurses realize that they are not privy to all information that takes place in making health care decisions and nor do they always want to be included in the small details, but when questions can't be asked or answered and it appears that there is a "secret project" it can be perceived by many as negative or unreasonable changes because those are the ones that no one wants to share until it is time to "enforce them". Many times the lack of transparency can also breed gossip and "grapevine" talk which may further impact the response to the change or diminish the trust in the nurse-employer relationship. Transparency is a great way to build a trusting nurse-employer relationship and create loyal nurses in a time when nurse retention is so vital for agency success and positive patient outcomes. In remaining transparent it does not mean that nurses need to know all the details behind all the nursing-related decisions, like who sat that the table, who disagreed with what, or who said what. It just means letting them know that the conversation will or is taking place and information will be shared from the appropriated channel {i.e. supervisor, nurse manager, nursing executive, etc} when it is available to be shared. A transparent health care agency for this nurse is a respected one by its nurses, but not always agreed with, but that is discussion for another post  Share how your agency remains transparent with it's nurses?