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Making Wise Health Decisions

Skills for Reducing Costs (But Not Quality)

Skills to Use in the Hospital - Wise Medical Consumers

Making wise health decisions can help reduce health care costs. The goal is to get just the care you need, nothing more, and certainly nothing less.

It is likely that you will be faced with one or more of the following health decisions at some time. Use the Skills for Making Wise Health Decisions described on See Skills for Making Wise Health Decisions See Work in Partnership With Your Doctor to help you decide if the services or treatments in question are right for you.

  • Should I see a doctor about a health problem?

    If your symptoms and the guidelines in this book suggest that you should see a doctor, don't put it off. Ignoring problems often leads to complications that are more expensive to treat.

  • Should I have a test (X-rays, blood test, CT or MRI scan, etc.) to diagnose my health problem?

    Don't agree to any medical test until you understand how it will help you. The only good reason to do a test is because the benefits to you outweigh the risks and costs. No test can be done without your consent.

  • Should I take medication to treat my health problem?

    Always ask your doctor about any medication he or she prescribes for you. Ask what would happen if you chose not to take a medication.

  • Should I have surgery to treat my health problem?

    Get as much information about the surgery as you can and consider your needs and values. If you are not convinced that the benefits to you outweigh the risks, don't have the surgery.

  • Do I need to go to the emergency room?

    In life-threatening situations, modern emergency services are vital. However, emergency rooms cost 2 to 3 times more for routine services than a doctor's office would. They are not set up to care for routine illnesses, and they do not work on a first-come, first-served basis. During busy times, people with minor illnesses may wait for hours. Also, your records are not available, so emergency room doctors have no information about your medical history.

    Use good judgment in deciding when to use emergency medical services. Whenever you feel you can apply Home Treatment safely and wait to see your regular doctor, do so. However, if you believe your situation requires urgent care, by all means go to the emergency department.

  • Do I need to be hospitalized?

    More than half of this country's health care dollars are spent on hospitalizations. A stay in a hospital costs far more than a vacation to most luxury resorts. (And hospitals are a lot less fun.)

    Don't check in to the hospital just for tests. Ask your doctor if the tests can be done on an outpatient basis. If you agree to control your diet and activities, your doctor will usually support your request.

    If you need inpatient care, get in and out of the hospital as quickly as possible. This will reduce costs and your risk of hospital-acquired infections. Try to avoid additional days in the hospital by bringing in extra help at home. Ask about home nursing services to help while you recover.

    Hospitals are not the only choice for people who have a terminal illness. Many people choose to spend their remaining time at home with the people they know and love. Special arrangements can be made through hospice care programs in most communities. Look up "Hospice" in the Yellow Pages directory, or ask your doctor.

  • Should I see a specialist about my health problem?

    Specialists are doctors who have in-depth training and experience in a particular area of medicine. For example, a cardiologist has years of special training to deal with heart problems. A visit to a specialist often costs more than a visit to your regular doctor, and the tests and treatments that you receive may be more expensive. Of course, specialists often provide the information you need to help you decide what to do about a specific health problem.

    When your primary care doctor refers you to a specialist, a little preparation and good communication can help you get your money's worth. Before you go see a specialist:

    • Know your diagnosis or expected diagnosis.

    • Learn about your basic treatment options.

    • Make sure that any test results or records on your case are sent to the specialist.

    • Know what your primary care doctor would like the specialist to do (take over the case, confirm the diagnosis, conduct tests, etc.).

    • Ask your primary care doctor to remain involved in your care. Ask the specialist to send new test results or recommendations to both you and your regular doctor.

    Skills to Use in the Hospital

    When you need to be in the hospital, there are things you can do to improve the quality of the care you receive. However, if you are very sick, ask your spouse or a friend to help watch out for your best interests.

  • Ask "why?" Don't agree to anything unless you have a good reason. Agree only to those procedures that make sense for you.

  • Provide an extra level of quality control. Check medications, tests, injections, and other treatments to see if they are correct. Your diligence can improve the quality of the care that you receive.

  • Be friendly with the nurses and aides, and they may pay more attention to your needs.

  • If you get a bill, check it and ask about any charges you don't understand.

  • Wise Medical Consumers:

  • Ask to be spoken to in words that they understand.

  • Ask to have their medical problems explained to them.

  • Ask to read their medical records.

  • Ask about the benefits and risks of any treatment and its alternatives.

  • Ask what treatments or tests will cost them, if anything.

  • Share in all treatment decisions.

  • Know they can refuse any medical procedure.

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