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On Thursday Jeff appeared on 11 FOXNEWSRADIO affiliated stations across America as their Healthcare Policy Analyst reviewing President Obama’s Healthcare Reform Press Conference last Wednesday from the White House.

Saturday, June 20th at 10a.m. -11a.m. Jeff appeared on FoxBusinessNews distinguished panel of 4 discussing the Healthcare Reform draft proposal by President Obama. The lively TV show took call-in questions and discussion amongst the panelists.

Much work and negotiating on both sides of the aisle are needed before a final reform is passed. Neither party is going to be completely satisfied in the final outcome but by working together a bipartisan healthcare much needed healthcare reform is finally likely.

Again, it was reiterated that patients and doctors need to work closely together-consumer  empowerment in healthcare. Healthcare consumer literacy is so vital in this whole process. We can no longer be oblivious to all that has and is going on in the healthcare arena.

How To Use Hospital Emergency Rooms Wisely

By Carolyn M. Clancy, M.D.

August 19, 2008

Deciding whether to go to the hospital emergency room (ER) is often a clear-cut decision. For instance, if you thought you were having a heart attack or realized that your child just swallowed a bottle of medicine, you would go to the closest hospital as quickly as you could.

Many other situations aren’t as clear. Should you go to the ER if you have a high fever but can’t get an appointment to see your doctor right away? Does a twisted ankle need attention tonight or can it wait until your doctor’s office opens in the morning? Most ER visits take place after regular business hours (8 a.m. to 5 p.m.). That’s when 63 percent of adults and 73 percent of children younger than 15 arrive for treatment, according to the Centers for Disease Control and Prevention.

Deciding whether your situation is a true emergency can be a tough call when you feel sick or are in pain. To help you decide what to do, you can call your doctor’s emergency phone number and ask for advice. Some health plans offer advice from nurses over the phone that can help you make decisions about your care. These call lines can be helpful and are often available on a 24/7 basis.

It’s a good idea to find out how your health plan defines an emergency. Some plans require you to call your primary care doctor before you go to the ER, unless your condition is life threatening. If you don’t follow this policy, you could end up paying for the entire visit.

But don’t worry that you’ll have to foot the ER bill if you thought your condition or injury put your life at risk. Most States have enacted laws that forbid health plans from denying payment for ER care if patients believed they had life-threatening health conditions. Similar laws apply to people covered by Medicare, Medicaid, and other Federal health insurance programs. A major study found that these laws did not cause people to use the ER more often.

If you have a medical emergency and go to the ER, you should notify your health plan as soon as possible about that visit. If you are admitted to the hospital from the ER, you could be transferred to another hospital if the one you went to is not part of your health plan’s network. This is another good reason to find out about your health plan’s policies before you face a medical emergency.

Depending on where you live, you may have seen or used urgent care or retail medical clinics. These are often located close to hospitals or doctor’s offices or inside some drug or large discount stores. Many health plans have added these clinics to their networks.

Although urgent care or retail clinics are not able to take care of emergencies, they are staffed to handle conditions that require fast medical attention, such as sore throats with fever and ear infections. And, if you have a real emergency, the urgent care center will help you get to an ER for the care you need. If you can’t decide if you need urgent care, call your doctor’s office and ask for advice.

As much as I wish everyone had health coverage and a primary care doctor, I know that’s not the case. Many of the 47 million Americans without health insurance use ERs as their only source of health care. And some people who have health coverage but don’t have a regular primary care doctor do the same.

In fact, a 2005 report from my Agency found that children from poor families were almost twice as likely as kids from higher-income families to use hospital ERs. Our report also found that most children used ERs for non-emergency problems, such as asthma, bronchitis, cuts, bruises, and sprains. Medicaid, the health insurance plan for low-income Americans, pays far more for care provided in an ER than it does for care given in a doctor’s office.

Besides the higher cost, an ER visit usually isn’t recorded in a patient’s medical record. That’s why I advise patients who use ERs or urgent care clinics for primary care to create a personal health record. This can be a simple folder or binder that includes medication lists, lab results, and treatment records. Having these documents in one place can reduce the chance that important information about your medical history will be overlooked.

ERs can literally save your life when you face a medical crisis. Use them wisely so they can continue to serve this function.

I’m Dr. Carolyn Clancy, and that’s my advice on how to navigate the health care system.

A great important starting point I found was to be completely prepared for my first primary doctor’s visit.
We learned that the more prepared I was, the more confident I became, but yep- I had a check list and I had a complete file on everything I needed for my doctor’s visit that was put in a accessible place so if I was in need of emergency care the family knew where to find it .
I kept building on the file from previous various doctor visits to a point where I was ready to see my new primary doctor. Boy I now felt so much more confident than before!

Interestingly I found the doctor responded like never before I had seen such a reaction..he actually respected my preparedness, answered my questions clearly and my goodness I felt I received better answers, I actually listened and I have a gut feeling I got a more accurate diagnosis. WE WERE WORKING AS A TEAM YEAH!!!!

IT WORKS… TAKE MY WORD FOR IT!!

If you have additional tips or experiences, let us know so we can all share them. It is the starting point of less errors and a better chance of a quicker cure.

REMEMBER BETWEEN 48,000 -98,000 PATIENTS DIE EACH YEAR IN THE U.S. DUE TO MEDICAL ERRORS..DO YOU REALIZE THAT’S 3 JUMBO JETS FULL OF PASSENGERS DYING EVERY 3 DAYS IN THE U.S. CAN YOU IMAGINE THAT KIND OF RECORD IN AVIATION/AIRLINES ON THE NEWS EVERY 3 DAYS!!??

The starting point is in being prepared with your primary doctor in most cases. And don’t forget to give us your feedback!

YOUR BEST SMART CASUAL (easy to disrobe in case of examination) AND YOUR BEST JEWELERY (psychological importance when the doctor’s office people see you for the first time-it does make a difference in their reception to you then and onwards.)

NOTEPAD AND PEN
Write down your questions and answers-the doctor will wait for you to finish your notes, or even help “dictate” the notes for you).

MEDICAL RECORDS
Ask for a copy of the 3-5 page form you are given as a new patient to fill out-you then have a copy of your health history, to keep with your other medical records-keep this up to date).
If you have not yet completed this form, ask your doctor to send you a blank copy of the form-this one will give you an opportunity to complete the form, find all the answers (especially items such as family history. And diseases and /or surgeries that you had as a child-before your memory kicked in).
Obtain detailed family history-for some diseases (cancers), e.g. breast, colon the treatment is CRITICALLY dependent upon the family history-you might have to contact several aunts, uncles, grand parents etc. to obtain this full history.

COMPLETE LIST OF MEDICATIONS
Very important to write down indication/purpose, dosage, frequency, doctor who prescribed, phone number of your pharmacist(so they can call in your prescriptions before you leave the doctor’s office). Bring all your medications in a zip lock bag.
*Note the reason you are taking each medication-many medications are used “off label”, e.g. heart pills (beta blockers) can be used for fast heart rates, high blood pressure, or anxiety states (nerves). Anti-epileptic medications can be used to chronic pain of the “shooting” variety”. Bring the actual pill bottles in a zip lock bag.

INSURANCE CARD, IDS, CREDIT CARDS, AND MEDICATION CARDS
Sometimes various aspects of the insurance is underwritten by different companies (e.g. dental, medical, pharmacists, psychiatric etc) Different telephone numbers might be needed for different “insurance clearances”-bring these along if known after previous “ experiences”).

BE HONEST AND WRITE DOWN IN DUPLICATE YOUR SYMPTOMS
Make duplicate copies to go over with the doctor.

DUPLICATE COPIES OF QUESTIONS YOU WANT TO ASK THE DOCTOR
If you happen to have a relatively uncommon disease, send your questions to the doctor 1-2 days prior to your visit.
If you have found excellent web sites with “up to date”, and new knowledge, send these web sites (URL’S) to your doctor. Also bring printouts of the web sites on your visit for the doctor to place in your chart.

DO YOUR HOMEWORK
Go to web sites and look up your symptoms, but not to become paranoid, but to be more knowledgeable and to be more confident and able to ask questions. Know which questions to ask.

TAKE AN ADVOCATE IF YOU FEEL NECESSARY TO ENSURE YOU HEAR PRECISELY WHAT THE DOCTOR SAYS.
A second pair of ears to help listen and remember-there is a HUGE amount of information that will be presented to you. Ask for a telephone number to call, if you have further questions.

TAKE A BOOK YOU ENJOY OR MAGAZINE THAT RELAXES YOU RATHER THAN SITTING THERE STARING INTO SPACE.
Keep your paper and pencil handy in case you think of more questions and concerns.

SMILE
Be friendly, even if the coffee is cold!.
Typically, the patient does not listen to ANYTHING the doctor says until these burning issues have been cleared up. Once these major issues have been addressed, the patient relaxes and listens to new information.

LIST OF PREVIOUS DOCTORS AND HOSPITALS
Have addresses, telephone numbers that might have medical records (or any information).

LIST OF SPECIALISTS THAT YOU MIGHT HAVE SEEN IN THE LAST 5-10 YEARS
e.g. cardiology visit information, last cardiac stress test, last ECG etc..

LIST OF SPECIALISTS WHO GAVE YOU A CLEAN BILL OF HEALTH
e.g. heart murmur as a child, echo-cardiography done as a teenager, with a report that “all is fine”, had epileptic fits as a child, neurology “cleared “ you as a teenager (or college student-“no further treatment needed”.

LIST OF SURGERIES/PROCEDURES
With or without anesthesia or conscious sedation, type of procedure, result, complications, doctor/surgeon, proceduralist, hospital. Anesthesia information if anesthesia complications occurred.

LIST OF IMMUNIZATIONS
Last tetanus shot, needed for trauma visits and auto accidents, ever had anti-bodies (snake bite, rabies etc)-the potential for severe allergies to horse serum.

LONG TERM EFFECTS OF MEDICAL THERAPIES
e.g.some cancer therapies make the lungs sensitive to high oxygen concentrations for many years. Make sure these are communicated to the care team (trauma and routine surgeries).

Wear a Medicalert bracelet if you have had a specific medical condition and if you are on medication
Auto accidents happen quickly and you may not be able to talk or communicate to your care team, e.g. multiple sclerosis, myastenia gravis, rheumatoid arthritis with neck vertebra subluxation which may lead to paralysis (quadriplegia) after routine intubation.

IF POSSIBLE KEEP ALL THIS INFORMATION IN A DIGITAL FILE THAT IS EASY TO UPDATE AND EASY TO SEND TO YOUR DOCTOR.

GO THROUGH (CHECK OFF) YOUR LIST OF QUESTIONS AND CONCERNS TOWARDS THE END OF YOUR VISIT TO ENSURE YOU AND YOUR DOCTOR HAVE COVERED ALL YOUR QUESTIONS

Stay Well My Friend~ Jeff