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Be Your Own Advocate

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Being your own Advocate

What does it mean to advocate for yourself?

Being your own advocate means that you ask for what you need while respecting others.

Self-advocacy is asking for what you need in a direct, respectful manner.

Why is this skill important? Self-advocacy helps you:

• Obtain what you need

• Make your own choices

• Learn to say no without feeling guilty

• Express disagreement respectfully

pacer.org/parent/php/php-c1...

Without doubt, communication is crucial to good health care. When people take an active role in their care, research shows they fare better -- in satisfaction and in how well treatments work. A passive patient is less likely to get well.

Yet patients often don't speak up for themselves, says Dr. Paul Haidet, staff physician at the DeBakey VA Medical Center, in Houston.

The average patient has three issues he or she wants to address during a visit with a doctor. Because time with the doctor is limited, it helps to make a list of the most important issues to cover and take it with you.

"If you have something that's really scaring you, it's best to get that on the table early on," Haidet says.

Avoid "doorknob complaints." Those are things you suddenly remember, or pluck up the courage to mention as you're walking out the door: "Oh, and by the way, I'm having chest pain." At that point the doctor can't do anything but tell you to make another appointment, or to go to the emergency room, as the case may be.

How to Pick Your Health Care Team

An actively involved patient knows what he or she expects from a doctor. Everyone should expect to be taken seriously and treated with respect, Gruman says. Accept nothing less.

Beyond that, people's expectations vary greatly. The kind of relationship you want to have with a doctor may depend not only on your personal preferences, but also the reason why you need medical care.

"If you're just trying out a new primary care doctor, that's a very different kind of relationship-building experience than if you were just referred to an oncologist because you have a very bad case of ," Gruman says.

In the first instance, there's plenty of time to evaluate the relationship. In the other, things have to click immediately.

How many doctors are involved in your care is another worthy consideration. Seeing too many doctors can sometimes cause unnecessary hassle and costs for patients, and can contribute to errors.

"I think patients benefit from having one main doctor," Alexander says.

Your primary doctor should orchestrate your care -- or at least be kept in the loop about care you get from specialists. There are always exceptions, but as a general rule, it's best not to crowd your health care roster with specialists. Not all pain needs to be treated by a rheumatologist, for example.

Specialists can play an invaluable role in diagnosing a condition and deciding the best course of treatment, but eventually they may be no longer needed. At some point, a primary-care doctor may be able to take over. "Don't be afraid to terminate a relationship with a specialist if they're no longer really important," Alexander says.

Can You Stand Up to Your MD?

The things that will make you an active advocate for your health care are simple, but not easy for everyone to do. The doctor's role as an authority figure is still deeply ingrained in the culture.

Do you follow doctor's orders, or do you participate in shared medical decision-making? The latter sounds better, but when you are in the room, with the paper on the exam table crinkling under your bare bottom, you may not feel so empowered.

"What we're doing is fundamentally challenging a lot of patients' basic notions of what the doctor's and the patient's roles are," Haidet says. "That's a huge bar for patients to leap over."

C: Communicate Concerns and Desires

Communication means asserting yourself if you have a problem with the care you're getting, or if there's an issue you want your doctor to consider.

Your out-of-pocket costs, for example, may be a concern. Nearly 46 million Americans lack health insurance, and even those who are insured end up paying about one-third of what they spend on health care out-of-pocket. Nevertheless, many are shy about bringing up financial concerns with a doctor.

"There are many barriers that prevent patients from raising concerns," says G. Caleb Alexander, MD, an assistant professor of medicine at the University of Chicago. Some are embarrassed, he says, while others don't bring it up because they think there's nothing doctors can do, or that they don't have enough time to talk about it. What's more, some people fear they will get substandard care if they mention money is an object.

"The fact of the matter is that in almost all cases physicians have good options available to assist patients who are burdened by their out-of-pocket costs," Alexander says.

For example: the doctor may know about financial assistance programs or other resources to help you pay your bill. Or the doctor may be able to help by discounting the fee for the office visit, or by sending you home with free prescription drug samples. You might also find out that a less expensive treatment option could potentially work just as well as a newer and pricier option.

webmd.com/healthy-aging/gui...

Can You Stand Up to Your MD?

The things that will make you an active advocate for your health care are simple, but not easy for everyone to do. The doctor's role as an authority figure is still deeply ingrained in the culture.

Do you follow doctor's orders, or do you participate in shared medical decision-making? The latter sounds better, but when you are in the room, with the paper on the exam table crinkling under your bare bottom, you may not feel so empowered.

"What we're doing is fundamentally challenging a lot of patients' basic notions of what the doctor's and the patient's roles are," Haidet says. "That's a huge bar for patients to leap over."

C: Communicate Concerns and Desires

Communication means asserting yourself if you have a problem with the care you're getting, or if there's an issue you want your doctor to consider.

Your out-of-pocket costs, for example, may be a concern. Nearly 46 million Americans lack health insurance, and even those who are insured end up paying about one-third of what they spend on health care out-of-pocket. Nevertheless, many are shy about bringing up financial concerns with a doctor.

"There are many barriers that prevent patients from raising concerns," says G. Caleb Alexander, MD, an assistant professor of medicine at the University of Chicago. Some are embarrassed, he says, while others don't bring it up because they think there's nothing doctors can do, or that they don't have enough time to talk about it. What's more, some people fear they will get substandard care if they mention money is an object.

"The fact of the matter is that in almost all cases physicians have good options available to assist patients who are burdened by their out-of-pocket costs," Alexander says.

For example: the doctor may know about financial assistance programs or other resources to help you pay your bill. Or the doctor may be able to help by discounting the fee for the office visit, or by sending you home with free prescription drug samples. You might also find out that a less expensive treatment option could potentially work just as well as a newer and pricier option.

webmd.com/healthy-aging/gui...

The things that will make you an active advocate for your health care are simple, but not easy for everyone to do. The doctor's role as an authority figure is still deeply ingrained in the culture.

Do you follow doctor's orders, or do you participate in shared medical decision-making? The latter sounds better, but when you are in the room, with the paper on the exam table crinkling under your bare bottom, you may not feel so empowered.

"What we're doing is fundamentally challenging a lot of patients' basic notions of what the doctor's and the patient's roles are," Haidet says. "That's a huge bar for patients to leap over."

C: Communicate Concerns and Desires

Communication means asserting yourself if you have a problem with the care you're getting, or if there's an issue you want your doctor to consider.

Your out-of-pocket costs, for example, may be a concern. Nearly 46 million Americans lack health insurance, and even those who are insured end up paying about one-third of what they spend on health care out-of-pocket. Nevertheless, many are shy about bringing up financial concerns with a doctor.

"There are many barriers that prevent patients from raising concerns," says G. Caleb Alexander, MD, an assistant professor of medicine at the University of Chicago. Some are embarrassed, he says, while others don't bring it up because they think there's nothing doctors can do, or that they don't have enough time to talk about it. What's more, some people fear they will get substandard care if they mention money is an object.

"The fact of the matter is that in almost all cases physicians have good options available to assist patients who are burdened by their out-of-pocket costs," Alexander says.

For example: the doctor may know about financial assistance programs or other resources to help you pay your bill. Or the doctor may be able to help by discounting the fee for the office visit, or by sending you home with free prescription drug samples. You might also find out that a less expensive treatment option could potentially work just as well as a newer and pricier option.

webmd.com/healthy-aging/gui...

Arthritis Foundation

One of the crucial issues facing us today is how to improve health care quality, access, costs and coverage for all Americans. You can improve your odds of getting the care you need by advocating in your own behalf. Here are some tips to get you started. Learn more helpful information about navigating the health care system in the Arthritis Foundation's Access to Care for Arthritis guide.

Ten Tips for Improving Your Care and Your Coverage

• DO read your policy or coverage information carefully to become familiar with what is covered and what is not.

• DO speak with the benefits specialist at your workplace, through your group insurance, or even at your doctor’s office to explore options for getting lower premiums or better coverage for your needs.

• DO ask your doctor or pharmacist if a generic drug is available for your prescription in order to save costs or get coverage for your drug.

• DO explore discount programs from the company that manufactures your prescribed drug. Find drug discount and biologic-specific resources.

• DO consult your state’s insurance commissioner’s office or Web site for state-specific laws and resources that help you maintain your coverage or access to care.

• DO contact your insurance company directly to ask questions about getting a lower premium, more coverage under your existing premium, approval for drugs or treatments that are not included in your formulary, or to appeal denials for treatment coverage.

• DO ask your doctor to help when you are denied coverage for a drug or cannot afford your portion of the costs for the drug. He or she may be able to appeal on your behalf to your insurance company.

• DON’T take no for an answer until you have explored all of your options for maintaining your coverage if you lose your benefits due to job loss, company failure, divorce or other changes. Many people who persist in their efforts to get coverage find a solution.

• DON’T be afraid to ask questions. Your insurance company should have a toll-free information number and a Web site. Call the company to ask questions or visit the Web site and email questions.

• DON’T choose between paying for your medical care and paying for rent, food, utilities or other necessities. Explore all of your options, including contacting your state insurance commissioner, and get help now

arthritis.org/be-your-own-a...

Mount Sinai Hospital

We encourage patients to be advocates for their own health care. To help you, we offer the following suggestions:

While you are in the hospital ...

• Bring a paper and pen to write down your questions for your caregivers (doctors, nurses, etc.) as you think of them and ask for answers to these concerns.

• Consider keeping a journal if your health care experience is extensive, involving many health care professionals over a prolonged period of time.

• Ask caregivers for their names and titles, and write them down.

• Ask what tests and procedures are being done and why.

• Find out when your doctor's rounds will be done and have a family member or friend there to listen to the information, to ask questions, and to talk with after the team leaves.

• Before you sign any consent forms, make sure you read and understand for what you are giving consent. Ask questions such as what is the nature of the procedure and who will be performing it.

• Bring a list of all medications you've been taking at home.

When it is time to go home ...

• Ask about and understand the normal or abnormal side effects of your procedure. (For example, how much pain should be expected.)

• Ask for educational material on your condition, procedures and treatments.

• Ask how much you should do when you get home and what you will need help with. Ensure that you, your family and your caregivers make arrangements for help.

• Ask about your home care options. Find out exactly what home care arrangements have been made and ask for the contact name and phone number. If something is not covered, make sure you plan for the help you need. Home Care can be reached at 416-586-4800 ext. 8732.

• Ask about your expected recovery time. Find out when can you return to work.

• If you or your loved ones do not feel you are ready to return home, state your concerns to your caregivers and ask for some time to discuss these concerns in detail.

• Ask about follow-up procedures. Find out what future appointments you will have and with whom.

• Ask if you should have a follow-up visit scheduled with your physician.

mountsinai.on.ca/patients/y...

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my last gp told me i was taking too much of an interest in my own treatment

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