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Communicating with your Physician

Communicating with your Physician. Dr. Evan W. Kligman Arizona Center on Aging agewell100@aol.com www.aging.arizona.edu.

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Communicating with your Physician

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  1. Communicating with your Physician Dr. Evan W. Kligman Arizona Center on Aging agewell100@aol.com www.aging.arizona.edu

  2. Aim for a PartnershipLet your PCP know what you want Do your own research Ask “why” Ask about alternatives Consider watchful waiting State your preferences Compare expectations Accept responsibility Geriatrics

  3. Partnership • Five ways to be a good partner • 1. Take good care of yourself • 2. At the first sign of a health problem, observe and record your symptoms • 3. Practice medical self-care at home • 4. Prepare for office visits • 5. Play an active role in the medical visit Geriatrics

  4. Problems in Communication • Misinterpretation • SOB • Surgical • Big words • Frightened, anxious people misinterpret information • ASK Questions. Geriatrics

  5. Check list for Office Visits • Make a list- • What are the top 3 things you want to address? • Make a list of all medications. • Write down your questions. • Be prepared to take notes. • Review your progress with your provider. Geriatrics

  6. Be Prepared! *Old medical records *Current medication and OTC list, including herbals and vitamin supplements *Names of current physicians *Bring notes about items you want to bring up *Emergency contacts; allergy lists

  7. Be Prepared - 2 *Insurance card (make sure your coverage is active for particular physician BEFORE making appointment) *Symptoms: when first appeared, how long, severity, where, same symptoms as before, self-care (what are you doing?), what makes symptoms better or worse

  8. Be Prepared - 3 *Advance Directives *Hidden Agenda: Don’t wait until the end; begin with these issues

  9. Present Emotional Problems as Well as Physical Problems Over 50% of Common Symptoms Result from Overactive Arousal System (Stress)

  10. Common “Stress” Related Complaints Neck, back, and shoulder pains Myalgias and arthralgias Headache Crying Poor sleep Appetite changes Poor concentration

  11. Stress Related Symptoms - 2 Skin tension and rashes Frequent urination Diarrhea and constipation Shortness of breath Chest pain Fast heart rate Poor immune function

  12. Request Adequate Visit Length Ask for greater than 15 minute visit if you think you need more time when scheduling

  13. Take Notes during Visit Don’t leave until you have clear understanding of diagnosis, treatment, and your role in recovering health Your role - what you need to do to be a partner in care If you can’t write, have an advocate or tape recorder

  14. If you are Hard of Hearing Consider owning a pocket-talker if hearing aids don’t work sufficiently

  15. Feel Free To Inquire About Options to Conventional Tx Many common conditions, if not very serious, can first be treated with nonpharmacologic agents (drugs) Exercise, good nutrition, and stress reduction Herbs, supplements, and vitamins Mind-body therapies

  16. Common Problems Best Treated Initially Without Medications Glucose intolerance, early type II diabetes Mild hypertension Mild osteoarthritis Tinnitus Anxiety and depression Viral upper respiratory infections

  17. If cost of medications a concern, ask about generic efficacy and safety and other options Indications Contraindications With, without food Impact on trace vitamins and minerals, and other prescriptive medications How long to take medicine What to do if not feeling better May ask pharmacist

  18. Appreciate Your Provider’s Limitations • Most are not accessible 24/7/52 • Inquire about back-up and whether or not hospitalists are used for inpatient care • When is best time to make routine, non-urgent phone calls (Rx refills, schedule appointments, etc.) • Time and reimbursement issues (over 60% of revenue for overhead expenses); panel size Geriatrics

  19. Know Provider’s Office Policies • Walk-ins seen? • If urgent care needed, can be seen within 24 hours? • If need routine care, can be seen in 3 days of a week? • Penalty fee for no show to visits or cancellations less than 24 hours? Geriatrics

  20. Know When to Use Primary Physician Vs. Specialist Know policy of your insurance coverage and whether second opinions are covered

  21. 3 big questions • Is this PCP well trained and experienced? • Is this PCP available when needed? • Is this PCP going to work in partnership with me? Geriatrics

  22. Training and experience • Board certified Internist or Family Practice • Adult or Geriatric Nurse Practitioner • Geriatrician- board certified in care of older people • Specialists Geriatrics

  23. Availability • Questions: • What are the office hours? • If I called right now, how soon could I be seen? • How much time is allowed for a routine visit? • Will the PCP discuss health problems over the phone? Geriatrics

  24. Money- Cost • Ways to cut your health care costs: • Keep your immunizations current • Don’t put off needed services • Reduce your medical test cost • Reduce your medication cost • Avoid surgery when the risks outweigh the benefits • Substitute home care for an office visit when appropriate • See your PCP in his or her office instead of going to urgent care or the emergency room Geriatrics

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