Monday, April 28, 2014

Patient Advocacy: Healthcare on your Side



Patient Advocacy: Healthcare on your side

   by Martine G. Brousse
Healthcare Specialist, Patient Advocate, Certified Mediator
ADVIMEDPRO


Avoiding Medical Mistakes: 
                                       Be an Involved Patient


As reported during the recent National Patient Safety Foundation "Patient Safety Awareness Week", medical errors are costly to patients' health and wallets, and to the healthcare system as a whole. 

Due to a lack of accurate information from patients, difficult symptoms, inadequate diagnosis, improper treatment, dismissal of patients' complaints, test results inaccurately interpreted, poor or no access to other records, medical mistakes occur more often than previously thought. Read more here: http://www.npsf.org/wp-content/uploads/2014/02/Myths-and-Facts-About-Diagnostic-Error-Patient-and-Families.pdf

As reported by Patient Advocate Martine Ehrenclou, MA, patients' involvement is crucial to help reduce errors and minimize consequences. At every step of the way, patients must be involved and  informed by their physician, but also remain alert to and communicative of their own observations. While no process is full proof, patients' participation and understanding are essential.

Here are some recommendations to follow to bring about a more accurate diagnosis and treatment, and ensure a successful outcome. 

1. Keep your Med List current and accurate


2. Keep track of symptoms

Without a complete and accurate narrative, your doctor may not be given all the relevant information in order to make the proper diagnosis. Before your appointment, make a list of every ongoing or new symptom, detailed description and occurrence, and any trigger or means of amelioration.

Throughout treatment, be alert to worsening or acute symptoms, new side effects and improvements. Be sure to contact the office for sudden or severe reactions, or whenever you have a question. 

3. Provide records and History

As related in this blog about your preparation to an office visit, you should present your doctor with a list of allergies, important health events, previous diagnoses and treatments, and the names and contact information of any physician you have recently or are currently seeing. 
A family history of relevant or serious medical conditions is also in order, especially if genetic or affecting several members. 

4. Ask Questions

Many errors could be avoided with appropriate and timely questions to your physician. Ask if a diagnosis is the only probability, or if others are possible. Question if a treatment prescribed is the only option or if a less severe/expensive/radical one is available. 
Without questioning every step your physician undertakes, ask the general necessity of a surgical intervention or procedure, and if it can be safely postponed at this time. 
Ask about expected side effects, effectiveness and anticipated time frame for a cure.
Ask and understand your responsibilities: what to do, what to take, what to change, when to return, when to call, what constitutes an emergency. Be aware of diet restrictions, of impact on your daily and professional life, of specific requirements on your part, especially if following an oral medication regimen.

5. Communicate

Do not rely on a follow-up appointment down the line to indicate a worsening of your condition or the appearance of new problems. If the treatment is not as effective as you were led to understand, call to check on an alternative option. Do not miss a scheduled lab or imaging test. 
Repeat the doctor's instructions, or write them down so that you leave the office with full recollection and understanding of your involvement. 
Communicate any new treatment prescribed by another physician, even if seemingly unrelated. 

6. Do some research

Several federal agencies post up-to-date information on conditions, medications, nutrition and other health-related topics on their website. Consulting them to learn more about your diagnosis and most effective behavior can assist you on your journey to recovery. While your physician is always your primary source, his time to educate you may be limited. These websites might be valuable tools.
Here are two good ones: http://www.nih.gov/ and http://www.nlm.nih.gov/medlineplus/

7. Be proactive

Set reminders for medications, appointments or to check your health status at regular intervals. Keep a chart or journal for observation of symptoms and self-administration of prescriptions. Forward any record from a new medical provider, or older ones that might be important. 
Contact the office before any planned intervention, medical or dental, as a drug you take or might be given may provoke negative side effects. 
Check about any refill several days before you run out. Authorizations may take a few days to clear, or for your pharmacy to get an unusual prescription in stock.
Call for lab or test results if the office does not contact you. No news do not necessarily mean good news. Your results may not have been sent to the physician or your report could have been misplaced. 

8. Trust your gut feeling...to a point

A dozen years ago, I ended up in the ER with pains which I, with a high pain threshold, could not bear. Because of serious allergies to medications, taking care of my health with an emphasis on preventive care, was always a priority. Given a specific diagnosis by the ER DR, I kept insisting I "knew" this was not the case. My gut feeling and experience of so many years living in that body rejected that improbable diagnosis. Hearing "I am the doctor, you are not", I felt unheard and insignificant but accepted a discharge. It tuns out he was wrong, so wrong I had to have emergency surgery when it could have been avoided with a proper earlier diagnosis. 
I should have requested another physician, should have been more vocal, should have been more trusting of my intuition. 

If your physician is not listening, treats you like a body rather than a person, does not care about your questions or feelings, or expects you to follow directions without education or understanding, you may want to consider your options. Express your need (and right) to disclosure, trust and self-expression. Physicians are often so tied to a busy schedule that their communication skills take the back seat. You should be heard as your input is invaluable in helping establish a diagnosis,  and adhering to the best prescribed treatment.

In Conclusion:

All every step of the medical process, communication is essential. Nurtured by trust and mutual respect,  the relationship between patients and doctors can only be optimum if all parties are equal participants.

The NPSF offers a patient toolkit to help you become as involved and educated as you can, and should.
http://www.npsf.org/wp-content/uploads/2014/03/PatientsToolkitforDiagFINAL.pdf



Any comments or questions? Contact us!
©  [2016] Advimedpro.
©  [2016] Martine G. Brousse.
All rights reserved.

My objective is to offer you, the patient, concrete and beneficial information, useful tips, proven and efficient tools as well as trustworthy supportive advice as you deal with a system in the midst of sweeping adjustments, widespread misunderstandings and complex requirements



AdvimedPro        (424) 999 4705 or (877) 658 9446       fax (424) 226 1330
                                         www.advimedpro.com           contact@advimedpro.com

Tuesday, April 22, 2014

Patient Advocacy: Healthcare on your Side



Patient Advocacy: Healthcare on your side

   by Martine G. Brousse
Healthcare Specialist, Patient Advocate, Certified Mediator
ADVIMEDPRO



Managing your Med List


One of the first things your new or long-time physician will ask at each visit is to review your medication list for accuracy. It is one of the mandates of the ACA ("Obamacare").

It is vitally important that you stay on top of your meds. Consequences of not doing so could lead to non-compliance of a prescribed treatment, dangerous interactions, unsafe indications, grave allergic reactions, potential side effects and duplication.

As all of those scenarios could end up costing you significantly from a financial point of view, it is prudent that you spend some time and efforts getting it under control. When an estimated  3/4 of patients do not take their prescriptions as indicated, this poor compliance with treatment costs the country billions of $ each year.

Here are some tips to help you list your medications and manage your list.

1. Keep a Journal

First go to your cabinet or tray, and index every bottle, pill and box you see. Divide them into "prescription" and "over the counter", and indicate next to each its indication (reason or diagnosis for taking it), dosage, prescribed use (PRN or "as needed", or at specific times of day), frequency of use (times in a day and times in a week), name of the MD who prescribed it, and how long you have been taking it.

Think of keeping a Pill Card on you at all times, especially if suffering from a serious condition. Use a laminated index card, or use the template at http://www.ahrq.gov/patients-consumers/diagnosis-treatment/treatments/pillcard/pillcard.html

Now is also a good time to indicate each medication price, as well as whether it is a generic or brand. When you can, won't it be fun to check for generic versions of a drug, or shop around for cheaper alternatives? Saving $ is never a waste of time.

2. Ask your Pharmacist

Don't recall what those yellow gel caps in your travel pillbox or those blue pills in the box without a label are for? Your pharmacist should be able to help you identify them and find out from your purchase history if they are expired, and what their use is for.
He can also give you instructions on how to dispose of them properly if necessary.


3. Don't forget Supplements

Supplements, vitamins, herbal remedies, Chinese-medicine tonics, natural therapies and other similar preparations may interfere with some prescribed treatments, lower drug effectiveness or cause side effects. Include them on your list, especially if taken for a specific medical condition.

Check them out at:


4. Consult your insurance records

Your insurer keeps on file a detailed and accurate list of all the prescriptions you have filled under your policy, as well as where and when. You may request a print-out or download a list via the website.
This is also a good way of looking at pricing, and how prices vary by place of purchase.

5. Question refills

Unless you have Medicare Part D, and must now approve every refill before it is automatically dispensed, the refill process will likely bypass you, and more often than you think your physician as well. A well-oiled machine, it may not need to be approved by your doctor if the original order covers that refill.

Because a prescription has a refill status open for many months, or even unlimited, does not mean you should automatically get it. If your condition has improved, if your symptoms are gone, or if they are worse, is when a call or visit to your physician is advisable. Do you still need the drug? at the same dosage or frequency? should you switch to a better or more appropriate medication?


6. Use Apps

In these days and age, technology is everywhere. Apps help us keep that med list up-to
date, remind us to take a pill or let us know a refill should be called in. They can also transmit updated prescriptions or new information to physicians electronically. These apps (listed here are those with high reviews), are also helpful at keeping track of dosages and use when we are not a home. 



My Medications from the AMA - iTunes app store
Store, carry and share your medical information. 






Pill Monitor by Maxwell Software - iTunes app store
Great for setting different alarms, it allows you to take pictures of your medications, and emails your med list, current and detailed, to your physician. 



Mango Health - iTune app store
Learn more about every medication or supplement you take, get rewards and discounts by adhering to your schedule, manage your schedule easily. This app is geared to help you be more compliant with your treatment. 





In Conclusion:
If you have not yet, do make this med list a priority. Even if you are not under active treatment, you might still want a list of supplements and over the counter medications you use. An efficient and up-to-date management is an easier task, and may well save you dollars and health issues. 



©  [2016] Advimedpro.
©  [2016] Martine G. Brousse.
All rights reserved.

My objective is to offer you, the patient, concrete and beneficial information, useful tips, proven and efficient tools as well as trustworthy supportive advice as you deal with a system in the midst of sweeping adjustments, widespread misunderstandings and complex requirements



AdvimedPro        (424) 999 4705 or (877) 658 9446       fax (424) 226 1330
                                         www.advimedpro.com           contact@advimedpro.com