Navigating A Modern Medical Practice
The contemporary practice of medicine has taken a major shift for physicians and patients alike. The reasons for this are multifaceted:  managed care, expenses, insurance, technology…the list goes on and on. Certainly, physicians and hospitals are finding it challenging and feeling a lack of control as they adjust to the rapid changes in the practice of medicine. And so, patients must make adjustments as well, in order to feel they have control over their health care

Historically, progress has two sides to it. We usually have great benefits, but we often lose something that is unique to the old way of doing things. Medicine is no different. The solo practice where a patient and the “ole family doctor” have a close one–on-one relationship is becoming rare.  However, this does not mean a patient cannot have a meaningful and effective relationship with their physician in a large group and get excellent medical care. It does mean that the patient may have to shift their thinking and adjust their approach. Patients who take more responsibility for their health and learn to work the system and their physician’s practice effectively can reduce the poor communication that is a common complaint today.

Some tips to navigate a modern medical system are:

• Be proactive before you get sick, if possible.
• Know the routine of your physician’s office.
• Try to see the same physician at every appointment to enhance continuity of care  and to establish a relationship.
• Learn the names of the medical staff you deal with, in person, and when you place a call.
• Learn when to place a call to the office. Avoid Monday mornings at 9 am, before lunch and minutes before the office closes.
• Ask for, and keep copies of your own health record and that of your family members.
• Plan ahead for prescription refills. Don’t wait until week-ends or the last minute.
• Learn how to navigate the telephone system by asking for the extension number of the nurse and how to get a “live” person.
• Understand their protocol for emergencies.
• Find out what hospital your physician goes to? Many medical groups split the hospitals for efficiency. Your physician may not  make rounds or have privileges in your preferred hospital.
• Know the people who are providing your care.  If the staff or physician does not let you know who they are, introduce yourself and ask their name and title/ position.
• Turn off your cell phone! Taking calls during your appointment is rude and disruptive.
• Understand your physician’s protocol for receiving test results. Some offices only call patients with negative test results. If  in doubt about the expectations or if you are anxious about a test results, call.
• Call ahead and see if your physician is running behind if timely appointments are a concern. Ask again when you arrive and check periodically if your wait is getting lengthy.
• Be familiar with the privacy guidelines and be sure to document the family members who are privy to your medical information.
• Consider taking a family member or trusted friend to your appointments. If you are elderly or have serious medical issues another person can act as an advocate and help prevent errors in information transmission.
• Take notes or ask if you can record the conversation for other family members.
• Note when making an appointment if it is essential to arrive 15 minutes ahead of your appointment time to fill out paper work.
• Understand that courtesy is infectious on all sides and very important. Make sure you are considerate. If you encounter rudeness from a staff member or physician, respond kindly. It will often diffuse the behavior. We all have a bad day, but if it is one individual, and the behavior is persistent, let the physician know. They can’t fix a problem if they don’t know about it.
• Change practices if the personalities and attitudes of a particular office are something you can’t live with.  Be sure to let the office know why you left.
• Document serious glitches. For instance, if you call multiple times and no one returns your calls, let management know. Your time is valuable and waiting for long periods of time without a response can hold up progress.

Sooner or later we all become consumers of the medical system, even physicians. Staying informed and up to date will help with the frustrations that plague the modern practice of medicine. Dr. Welby, as we knew him, may be passé, but there are many fine caregivers who have replaced him. On the surface, their style, accompanied by advanced technology may make things seem very different, but the ultimate goal of most physicians is to care for people and make them better.