By Betty Long, RN, MHA, President and Founder of Guardian Nurses Healthcare Advocates
Below are the main questions to ask your primary care doctor during your visit.
- What is the #1 thing you think this could be?
This question is really intended to get the conversation started. You need to know what your doctor is thinking, where he or she might be going. As you’re describing your symptoms, your doctor is probably thinking, “Well, it’s likely to be A, B or C. I think D is unlikely.” Sometimes diagnoses are easy to confirm; sometimes they’re not so clear and physicians will “rule out” each one systematically. In my experience with patients, they’re often quite relieved to know their doctor has some idea about what might be going on and is putting a plan in place to figure it out.
- What do you hope to learn?
This is a critical question. By the end of your appointment, you should be very clear about what I call "the game plan" for your treatment. This includes 4 items:
- What is being ordered (studies, drugs, any additional health-care provider appointments) and why are you ordering them? What are you hoping to learn? You want to know why tests are being ordered. And if they’re negative, then what? What will be next?
- What is the timeline for this plan? Are we talking days, weeks or months? It will frame your expectations as to how long it may take to figure out what’s going on or better yet, to resolve it. Tests can take time to schedule and get final results, some drugs need time to do their job, and appointments, if needed, may take time to schedule.
- How will we communicate with each other during this period? Email? Phone? Never assume that no news is good news. You deserve to know every result, whether it’s normal or not. The important thing is that you should not wait passively. I have known way too many test results to get lost or not reported.
- How can I confirm that my health insurance will cover what you are ordering? Though your doctor may not be the best resource for answering this, there may be resources in the office who can guide you. As healthcare reform evolves and insurance coverage changes, you need to be thinking about your coverage. For example, if your insurance coverage has an annual deductible of $500 or $1,000, you are responsible for meeting that deductible before insurance will kick in. If the test that your doctor ordered is going to require payment out of your pocket, and you don’t have it, you need to communicate that with your doctor. It may change the game plan.
3. What are my other options?
Patients need to know that they have the right to accept, decline or ask for modifications to what their physician may be suggesting. That’s what being an engaged and empowered patient is all about. You have the right to express your concerns, your fears, and your doubts. Most importantly, know that you have the right to seek another opinion from another physician. In fact, I always remind patients, particularly with a difficult diagnosis, that they should absolutely get a second opinion. Even though it may be a hassle, it is worth the effort and it could save your life!
The reality is that even though doctors get similar medical training, they can have their own opinions and thoughts about how to practice. Some take a more conservative approach to treating patients while others take a more aggressive approach, using the newest tests and therapies.
Getting a second opinion from a different doctor might give you a fresh perspective and new information. It could also provide you with new options for treating your condition. You can then make more informed choices – and that is critically important to your treatment.
Here are some tips to getting a second opinion:
- Ask someone you trust for a recommendation.
If you don't feel comfortable asking your doctor, then call someone else you trust. You can also call university teaching hospitals and medical societies in your area for the names of doctors. You can also research doctors on the web. And do not worry about hurting your doctor's feelings. Good doctors welcome a validation of their findings. You are entitled to seek a second opinion regardless of how he/she feels. If your doctor resists, or expresses negative feelings, it’s time to find another doctor!
- Check with your health insurance provider.
Just to be sure, call your health insurance company before you get a second opinion just to confirm that they will pay for the office visit/consultation. Most health insurance providers will. Also, be sure to ask if there are any special procedures you or your primary care doctor need to follow to make sure the second opinion is covered.
- Ask to have medical records sent to the second doctor.
Ask your primary doctor’s office staff to send your records to the new doctor. You should also ask for your own copy of your records for your files. You are entitled to have them.
- Do your homework.
Learn as much as you can before you attend the second-opinion visit. Ask your doctor for more information. Go to a local library. Search the Internet. Find a teaching hospital or university that has medical libraries open to the public. The information you find may be hard to understand, or just confusing. Make a list of your questions, and bring the questions with you to the visit with the second doctor.
- Do not rely on the Internet or a phone conversation.
When you are interested in a second opinion, you need to be seen by a doctor. You will be given a physical exam and may be given other tests as well. The second doctor will also review your medical records, ask you questions, and address your concerns.
Remember, empower yourself to improve your health-care experience!
Betty Long, RN, MHA is the president and founder of Guardian Nurses Healthcare Advocates, a patient advocacy organization in Philadelphia, PA. Founded in 2003, Guardian Nurses contracts with employers, unions, insurance brokers and private individuals to help light the way for patients and their families when they’re experiencing a health issue. Through their advocacy and care management services, the organization has saved millions of dollars for their clients.