“The element of choice, and having your personal preferences heard and respected, is what attracts thousands of people to Concierge Medicine, Direct Primary Care, UC Memberships and PA-led subscription-based healthcare programs each year.” ~Michael Tetreault, Editor
By Michael Tetreault, Editor
I struggle with the same relational and communication issues with my Physician as you might expect, even under a membership medicine program. I may forget to bring up something that has concerned me for weeks and together, we may go off on rabbit trails on certain topics. It happens to all of us.
I recently sat down in a local park with a Mother of two elementary school kids. While listening to her latest woes about her 7 year old son who was recently injured she described her latest encounter with her Pediatric office and then, the ER.
“At the end of the say no one wanted to see him,” she said. “They wanted to shift the responsibility and say ‘oh, you need to take him over here. That’s an ER issue, not something we can do in the office.’ Come on, really?”
She got a similar response from the ER physician and nurses as well.
“They told me I should just take him across the street to their office and that he doesn’t need to come here,” she said frustrated. “Now, I have a $400 bill and the ER literally did nothing. I’m so frustrated”
Sadly, this situation happens every single $&%* #*$&%! day! Come on people, lets get our act together.
For far too long we have never really gotten to know our Doctor. We chose him or her from a web site or even worse, because he or she are listed in a directory as big as a phone book!
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There was no criteria for selection, it was simply based on coverage, is he or she in or out of my network? There was no asking ‘hey, where did you go to school?’ or ‘what do you do with a patient who has XYZ?’ The interview process and relationship building between a Patient and a Doctor today is almost non-existent. If that doesn’t scare you, it should. But like you, we’re all numb to it.
While on vacation with my family I usually try to disconnect from all things healthcare and re-calibrate. It is in those times where I might find new ideas to help Doctors and patients connect in a more relational way. One such story last week while vacationing with my family crossed my feed and caught my eye.
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NY TIMES | “A Doctor’s Guide to a Good Appointment …”
Focus on The Family wrote a story entitled “Family Q&A: Building a Good Relationship with Your Doctor.”
Some of the content we may disagree with, particularly regarding staff. That’s fine. But the premise of the story is the important issue. What cues and steps can I take to build a better relationship with my Doctor?
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“People ask, ‘Why would I pay far and above?’ Well, ‘Why did you spend $150 on a haircut that you could’ve gotten at Cuts 4 Less for $25?” Berzin says.
The article started with this statement which I think everyone can relate to. I’ve had some pretty lousy experiences in the past, but I’m having some health problems and I know I shouldn’t put off getting the attention I need. A friend just told me about a new doctor that I’m considering seeing. What can I do to make this a good experience?
1. They started with this suggestion … Consider a “get acquainted” visit.
Lets get real. This isn’t always practical. Inside a Concierge Medicine office or Direct Care clinic, maybe and most likely.
This is still a great idea. Especially if you are considering a Concierge Medicine program or enrolling in its monthly familial program, Direct Primary Care.
2. Another great suggestions mentioned in the article is … Bring pertinent information to your first (and any other) visit. If you have records from another physician, lab results, a summary of your health history, and a list of medications you are taking (including supplements), by all means bring them. Some people who have trouble keeping track of their medications may find it valuable to bring a Ziploc bag containing all their pill bottles to their visit.
Recently I visited my allergist whom I’ve been seeing for quite sometime. I absolutely love it when I get the reminder call the day or two before my appointment and they ask me about my kids, confirm my appointment time and remind me to bring in all of my current prescription bottles and vitamins. Why is this small detail important? I love it because it tells me that my Physician is taking a deep, long look into my health. It tells me he cares and it shows me that ‘I matter to him.’
When was the last time you felt like your Physician and his team really cared about you beyond charging you for the co-pay?
You might disagree with this and that is just fine. This is just my personal experience and it happens to be a good one.
3. Here’s another good suggestion mentioned in the article … Don’t be afraid to do your own research. This does not mean that you should search the Internet for an alternative diagnosis if you don’t like what your doctor tells you. There are countless “medical” Web sites that will offer you nothing but false promises and bad information. However, whenever you do receive a new diagnosis, it might benefit you to visit a reputable Web site such as a university-sponsored health site for further information. Many university Web sites host a wide range of information that has been properly vetted by the scientific and medical communities. Feel free to discuss those findings with your doctor. If your physician is truly interested in your receiving the best care possible, he or she won’t feel threatened if you raise questions based on information from another reputable source. Keep in mind, though, that your physician has amassed a wealth of knowledge and expertise through years of experience and training. Diagnosing or treating yourself based on one or two hours of Internet research rather than relying on your doctor’s judgment may not be in your best interest.
I’ve spent hours on this topic and had multiple conversations with Physician after Physician about the role of research, evidence, data and making the right decision based on data vs. opinion. If I have something that concerns me that I read online, heard from a news story, read in a medical journal (yes, I do read those occasionally … pursuant to my own health issues.) I will jot a note down or highlight something that I want to ask my Doctor. I won’t say ‘Here, can you read this and get back to me?’
I am respectful of my Physician’s time. He has other people who are important too. But, we all want to felt heard by our Doctor. We want to know he or she is listening. I want my Doctor to consider not just one option for treatment, but many options and decide with me [not for me] what is the best and what are we both comfortable with. In some cases, yes, there won’t be many or maybe any choices. However, lets talk about it vs. mandate it, write a script and show us the door and the way to the ‘Customer No-Help Desk’ to pay our co-pay. Don’t you deserve more than that from your Doctor?
4. Here’s another suggestion mentioned in the article … Take notes if necessary. If your visit results in a “to-do” list involving several items – diagnostic tests, medications, perhaps a referral – hopefully the caregiver will write these down or print them off for you. If not, write them down yourself. You should not leave the office without a clear idea – which should be in writing – of what you’re supposed to do next.
If you are like me, you’re not always carrying a pen and paper into the exam room while you’re sitting on that noisy paper. Yeah, you know what I’m talking about.
This is a great suggestion and while a good one, not always practical. Nor is taking notes on your phone while your Doctor is trying to tell you something. Today, there are Patient Advocates and groups like Pinnacle Care that can help with this if your case or situation is advanced.
They wrote a great story back in 2015 that I believe is helpful today to this topic. It was titled 5 questions to ask when selecting a doctor.
Does your Doctor want to make time for you? If he or she looks rushed, more than likely, it won’t improve.
Below is a comprehensive list of the questions we see patients ask their concierge-style and direct pay doctors frequently. Feel free to share this list with those thinking about concierge medical care and email us if you have any additional questions to add or input to our list.
- Doctor’s Full Name?
- Total years in Practice?
- Years in practice as a concierge or direct primary care doctor?
- Do you have multiple locations? If so, where?
- Do you have a web site? Can I read patient reviews about the doctor and his/her practice? Does it have the Doctor’s bio. on it?
- What is your annual fee?
- How do I pay the doctor? Do you accept quarterly or monthly fees?
- What services are covered by the annual fee?
- Do you offer any discounts for couples and/or families that join (if applicable)?
- What additional fees are not included in the annual membership fee?
- Will I be required to pay even if I do not need to use your services?
- What services can I expect to receive directly from your nursing staff or other healthcare professionals at the practice each year during my membership?
- Do you accept Insurance? How compatible is your concierge medical practice and services with my health insurance plan?
- Do you participate in Medicare? (If applicable)
- Do I need insurance to enroll or sign-up?
Do you have any thoughts you’d like to share or quick how-to steps? Share them with us by emailing us at email@example.com or firstname.lastname@example.org. We look forward to hearing your stories and your experiences.