Successful Strategies as a Health Care Consumer

1. Successful Strategiesas aHealth Care Consumer HES 1

2. Are you a health care consumer? • Have you ever been sick? • Do you ever plan on getting sick? • Have you ever taken medications? • Chances are, you are a consumer. If not, you will be! • The most important part of being a good “consumer” is knowing your body. Knowledge is power.

3. How do you manage your medical problems? • Live in denial? • Diagnose yourself? • Home remedies? • Purchase medicines? • Herbal remedies? • Emergency room?

4. Self-assessment • 1. Observe symptoms • Its hard! You must first know your body. • Anything different? • Pain, swelling, fever, cough. • When you know your body, there is less fear or anxiety. • 2. Medical self-tests • These help you determine if you need to see a doctor. • Temperature • Blood pressure • Blood sugar • Pregnancy • Urinary infections

5. Self-treatment Options: • Watchful waiting • Let body attempt to heal itself. • Non-drug options • Massage, ice packs, stretching. • Rest, exercise, food, water. • Self-medication • Over 100,000 OTC medications. • 70% of Americans use OTC medications every two weeks.

6. How do you know when to see a physician? • Evaluating symptoms often leads to mistakes: • Go to doctors when you don’t need to. • Delay seeing a doctor when needed. • Symptoms? • Severe conditions • Unusual conditions • Persistent or recurrent

7. Getting professional help. • How urgent is the problem? • Most ER cases are not emergencies. • True emergencies - go to the ER: • Major trauma or injury, bleeding. • Severe shortness of breath. • Severe abdominal pain. • Poisoning or drug overdose. • Stupor or drowsiness. • Severe/worsening reaction to insect bite.

8. Efficient Medical Care • Prerequisite skills: • Knowledge of your body. • Good communication with providers. • Studies show that patients that ask more questions live healthier lives. • Are college students healthier? • 20-30% of students have significant misunderstandings of their health.

9. Efficient Medical Care • Patients tend to not ask questions. • Fear of being “stupid.” • There are NO stupid questions when it comes to your health! • Physicians share some responsibility: • Throw big terms around. • If you don’t understand them, ask.

10. Patient/physician relationship? • The best scenario? • A sympathetic, caring physician. • A prepared, assertive, inquisitive patient. • What expectations to you have of your doctor? • Can your expectations be achieved?

11. How should you talk to your doctor? • Prepare a list of concerns and observations. • Do your homework! • Present concerns at beginning of visit. • Be specific and concise. • Ask questions – write down answers. • Share all medical decisions. • Clarify instructions (repeat them).

12. How is a diagnosis made? • Examine your medical history. • Make physical examinations. • Medical testing. • All of these areas narrow the areas of concern to a few specific topics.

13. What are the treatment options? • What is the ailment? • What are risks? • What are costs? • What are expected benefits? • Are there alternatives?

14. Prescription Medications? • “Do I need this prescription?” • “What is its name, what does it do?” • Get information. • “How and when do I take it?” • “What are its side-effects?” • “Can I take generic drugs?”

15. Is Surgery An Option? • Surgeries are performed in U.S. more than anywhere else in the world. • 20% of surgeries are required. • 80% of surgeries are elective. • “Why do I need surgery?” • “What are the risks and complications of the surgery?” • “Can this be performed on an out-patient basis?”

16. This is YOUR life. • Be educated. • Think rationally. • Ask questions. • Be precise. • Understand options. • Know who to ask for help. • Know when to ask for help.

17. What about the health care system? • Do you diagnose and treat your own health? • Do you see a doctor? • Do you see a “faith healer”? • What options do you have?

18. What is a doctor? • A person who is trained, and is licensed, to diagnose and treat disease and injury. • Qualifications: • Graduated from an accredited professional institution. • Clinical experience. • Passed a licensing exam. • Maintains competency.

19. What is an “Independent Practioner”? • Medical Doctors (M.D.) • Diagnose/administer medicine/treatments. • “Board Certified” • Osteopathic Physicians (C.O.) • Related to M.D., emphasizing musculoskeletal problems. • Podiatrists (D.P.M) • Primarily concerned with conditions of the lower leg and feet. • Optometrists (O.D.) • Primarily concerned with conditions of the eye. • Dentist • Specialists that require 2 years of training.

20. Allied Health Care ProvidersThese assist independent practioners, and are of vital importance. • Registered Nurse (RN) • Licensed Vocational Nurse (LVN) • Registered Dietician (RD) • Psychologists • Social Workers • Physicians Assistants (PA) • Physical Therapists • Occupational Therapists

21. Unconventional Practitioners • Complimentary and Alternative Medicine • Philosophy and practice clash with accepted knowledge and practice. • Methods are unproven and unlikely to be successful. • Reliance on these methods may delay other forms of care. • Most is not covered by health insurance.

22. US National Center for Complementary and Alternative Medicine • Defines “Complimentary and Alternative Medicine” • Alternative medical systems, or complete systems of therapy and practice; mind-body interventions, or techniques designed to facilitate the mind's effect on bodily functions and symptoms; biologically based systems including herbalism; and manipulative and body-based methods such as chiropractic and massage therapy.

23. Chiropractic MedicineDaniel David Palmer • He was a magnetic healer, and developed chiropractic medicine. • Basic tenet: All disease is misplaced spinal position. • A man became deaf when he hurt his neck spine, “healed” when spine was realigned. • “Amount of tension determines health or disease.” • “Chiropractors correct abnormalities of the intellect as well as those of the body.” • “The kind of disease depends upon what nerves are too tense or too slack. “ • Palmer, D.D. 1910. Chiropractor's Adjuster (also called The Text-Book of the Science, Art and Philosophy of Chiropractic). Portland Printing House Company, Portland, Oregon. • D.C. (licensed and have accredited degrees) • Not allowed to prescribe drugs or perform surgery. • Many insurance policies cover chiropractic therapy. • Still an area of scientific controversy.

24. Acupuncture • An ancient practice of China. • Insertion of needles at “acupressure points.” • “Points” represent various organs/systems. • Manipulation of organs = return to “normal” state. • Some evidence for: • Nausea (chemotherapy, pregnancy, anesthesia). • Secretion of hormones/neurotransmitters, blood flow.

25. Homeopathy • N.D. (Doctor of Naturopathy) • Licensed in 11 states. • One of three schools is accredited. • Based on belief that disease is caused by violation of one of “natures laws.” • Disease is the body’s effort to “purify” itself. • Cures are caused by the patients “vital force.”

26. Other Non-conventional Practices • Iridology • By looking at the “eyes map” you can foretell disease. • The iris is a “..structure has detailed fibers and pigmentation that reflects information about our physical and psychological makeup.” (http://www.iridologyassn.org) • Applied kinesiology • The belief that “muscle testing” will diagnose disease. • “Therapies utilized can include specific joint manipulation or mobilization, various myofascial therapies, cranial techniques, meridian therapy, clinical nutrition, dietary management and various reflex procedures.” (http://www.icakusa.com/general.html) • Reflexology • Manipulation of the feet to treat: • Back pain, migraine, infertility, arthritis, sleep disorders, hormonal imbalances, sports injuries, digestive disorders, stress-related conditions. (www.reflexology.org) • Faith healing • The notion that prayer, divine intervention or the ministrations of an individual healer can cure illness. • “..the deep concentration by you or others to tell the right side of your brain to concentrate on and put more effort into healing a specific problem. Nothing new, just a chat with your brain to place more effort on a particular repair!” (http://health2us.com/faith.htm)

27. Should health care be free? • Ever think of paying cash for your health care? • Do you like to pay for medicine? • Who should pay for it? • It allows policyholders to receive care they could not otherwise afford. • 58% of Americans have health insurance.

28. Health Insurance • Indemnity plans • “Fee for service” which means you pay as you need it. • You pay a deductible (usually 20%). • Read coverage carefully. • Managed care plans • HMO (health management organizations). • Use the term “health plan” mainly. • Small co-pay and physicians are encouraged to avoid unnecessary costs. • PPO • Arranged plans between members of a “network.”

29. Government Programs • Medicare • Federal program for Americans who are 65 or older, or with certain disabilities. • Physicians bill government directly. • Government limits care options. • Part A (provides hospital insurance – FICA) • Part B (pays for physicians – US general revenues) • Medicaid • Joint Federal/State program for low income families. • Balanced Budget Act (1997) – one million children first year. • Veterans Health Administration • Indian Health Services

30. Pay attention in lecture: • Think about how you as a consumer can be more efficient in your health… • In addition, information is found in the supplemental e-book chapter 18 on your publishers website.