About.com Patient Empowerment

Does Your Doctor Have the Right to Fire You?

Fri, 06 Nov 2009 10:01:24 +0000

I've posed this question before - about whether your doctor has a right to fire you.

I've written articles about doctors who blackball their patients, but most blackballing is based on the fact that a patient becomes so difficult that the doctor no longer wants to tolerate him or her.� It's called "denial of care." Some of you have even shared your stories about being denied care by your doctor.

However -- this question actually comes from a magazine that is subscribed to by physicians - not patients.� And the question the doctor posed was, Can I fire a patient who refuses to pay his bill?"

Turns out that most states have a specific process doctors must take to dismiss you as their patient, no matter what the reason.

But the reason I ask the question today is this:� Suppose you work hard all week and at the end of the week, your boss decides not to pay you.� Is that fair? That's the effect on a doctor when he or she doesn't get paid for appointments.� It's not fair.� And honestly, I find it sad that a doctor would even need the question about whether he or she can legally dismiss a patient who doesn't pay his or her bill.

Yes, there are reasons bills don't get paid -- I understand that.� Of course there are just as many people who can afford to pay them, but choose to use their money in some other way (not staples or shelter, but video games or cell phone bills perhaps)...� but it seems only fair that if we ask for service from a professional, we expect to pay for that service.

Although, of course, this problem is uniquely American.� In another country, we wouldn't even ask the question.

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Does Your Doctor Have the Right to Fire You? originally appeared on About.com Patient Empowerment on Friday, November 6th, 2009 at 10:01:24.

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Putting Some Fun in Influenza? Good Messages for Kids, Too

Wed, 04 Nov 2009 19:30:41 +0000

OK -- FUN might be a bit of a stretch -- but I've been sent links to some videos with some great messages for helping kids understand why hygiene is important and to help parents understand how to protect their kids from flu.

Here's a run down and links to the videos, which run for only 30 seconds to 1+ minutes each:

�� DocRoc Music Video -- Dr. Mache Seible's 5 Steps to Avoid Swine Flu

�� This one is called Moon Landing (actually looks like a Halloween Costume!)

�� The Gambler is a message for parents, as regards their kids.� (Note -- be careful if you are allergic to peanuts!)

�� The least entertaining, but with an important message, Spring Lockdown makes its point, too.

It makes no difference whether you're talking about H1N1 swine flu, or seasonal flu.� Good hygiene, and keeping our children protected is paramount.� These videos may be mildly entertaining, but I hope you'll take their messages seriously.

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Screenshot from the Moon Landing Video � National Foundation for Infectious Diseases

Putting Some Fun in Influenza? Good Messages for Kids, Too originally appeared on About.com Patient Empowerment on Wednesday, November 4th, 2009 at 19:30:41.

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Your First Medical Opinion - Don't Ask Don't Tell?

Mon, 02 Nov 2009 23:32:18 +0000

An article that turns the idea of medical opinions on its ear -- first opinions, second opinions and sometimes more - crossed my email. I share it with you, because I'm curious if you agree. I have a feeling that most, if not all of you, will concur wholeheartedly.

Penned (or is that keyboarded) by Lisa Gualtieri, PhD, a health communications professor at Tufts University, it suggests that many patients have turned opinion-seeking behavior upside down. We no longer seek a first opinion, then a second opinion from a physician. No -- now we seek a first opinion from the Internet -- then a second opinion from our physician. If we look for another physician opinion, it may be the third opinion we get.

Dr. Gualtieri also explores the fact that most of us don't own up to that fact to our physicians. Further, that physicians don't ask either. She provides some explanations for the lack of inquiry by the doctor -- not enough time, no training to do so, and so forth. But she also reveals why we patients don't tell our doctors. We are afraid we can't pronounce some of the more difficult words, or feel that we are being disrespectful.

There is much more to this article, which you can read here: The Doctor as the Second Opinion, and the Internet as the First.

But I'm curious. Is this how YOU access the medical information you need? When you experience symptoms do you make a bee line for the phone to make a doctor's appointment? Or do you sit down at your computer, do some Internet research first, then make your own diagnosis or assessment before you call your doctor?

Then - if you do scope out possibilities on the Internet, do you tell your doctor?

Let's see if our About.com Patient Empowerment family reflects Dr. Gualtieri's thoughts. Take this poll and let us know.

Then, if you need some help owning up, learn how to approach your doctor with what you have learned on the Internet.

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Your First Medical Opinion - Don't Ask Don't Tell? originally appeared on About.com Patient Empowerment on Monday, November 2nd, 2009 at 23:32:18.

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Almost 10 Years Later, We're Still Losing Ground on Medical Mistakes

Mon, 02 Nov 2009 09:13:21 +0000

In 1999, the Institute of Medicine, a highly respected public-private, non-political, research-based, health and healthcare think tank in Washington, DC issued a report on research it had done called, To Err is Human. The research had explored the numbers of medical errors that took place in the United States, and they reported that somewhere between 44,000 and 98,000 Americans DIE each year from mistakes made by their providers.

That's DIE. That doesn't even account for those people who are injured and possibly debilitated for life -- at the hands of the very people who have taken an oath, and whose job it is, to help improve their health, life and limb.

The idea behind the report was to bring awareness, so providers and provider-organizations would begin looking at ways to decrease those horrible numbers..... however.... Fast-forward these 10 years and the numbers have not decreased at all. In fact, today more than 100,000 people per year die from hospital-acquired infections alone. That doesn't even account for other ways people are hurt or killed by providers and the system, like surgical errors, or addicted doctors or even my own personal experience, misdiagnosis.

Put another way, since the original report, well more than one million, that's 1,000,000 people! have died, and tens of millions have been injured by the medical system in the United States. It's unfathomable, and it's unforgivable.

Consumer's Union's Safe Patient Project is holding a forum later this month, to review theses more horrible statistics, their causes, potential for improvement and more, and you are invited to attend. Although the forum will be held in Washington, DC, it will also be webcast so anyone who is interested may listen and watch the procedings. Called To Err Is Human, To Delay Is Deadly, it will be held November 17, 2009 from 10am-3:30pm EST.

The speaker list is like a who's who in the world of public safety. From professionals who deal with public safety issues daily, to the loved ones of people who have been lost to medical mistakes, they'll be there discussing the report, and the 10-year report card.

You'll need to register to attend the forum by web, or you can get more information about attending in person if you're so inclined. I'll be online with my ears open all that day. Won't you join us, too?

In the meantime, you can read more about the 10 year report To Delay is Deadly.

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Almost 10 Years Later, We're Still Losing Ground on Medical Mistakes originally appeared on About.com Patient Empowerment on Monday, November 2nd, 2009 at 09:13:21.

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Health Insurance Open Enrollment - Yes, It's That Time of Year

Fri, 30 Oct 2009 09:06:13 +0000

Your boss, or maybe someone from your HR department, has just given you a handful of papers, or maybe even a fancy folder, full of numbers, rules, smiling faces - and it means a headache for you.� Yes, it's time to figure out what the heck you're supposed to do about health insurance for 2010.

For most everyone, it's a horribly frustrating experience.� Premiums have skyrocketed once again, not to mention the fact that many employers are insisting their employees pick up a larger portion of that premium than ever before. If you are one of them, believe it or not -- you are one of the lucky ones!� Because other employers are simply dropping coverage all together.� They can no longer afford it (as if you, the employee can?)

But here's what I really don't understand.� That is, that the majority of you won't do any kind of review at all.� You'll just sign a piece of paper (or maybe, simply, default by not sign anything at all) that indicates you just want to continue whatever coverage you have already had.

And that default may be costing you an arm and a leg!� Seriously - don't you want to be sure you are spending the least amount of money for exactly the coverage you need?� Of course you do.

So -- a suggestion and a question for you:

A Suggestion:

Learn how to choose the right health insurer for you during Open Enrollment. It will take you maybe 30 to 45 minutes. Max.� It's not difficult, and it could save you hundreds or even thousands of dollars.� Worst case?� You'll find out that, in fact, you already DO have the best coverage for you and your family.

A Question:

Do you review your health insurance plan?� Do you take those few minutes to go over your status, and your choices?� Take this poll and let us know.

Health insurers love it when we don't review, by the way.� Since the majority of us don't have the most efficient plan for ourselves, many of the insurers are making a fortune from us.� We are paying premiums that may be higher than they need to be -- so insurers pocket the difference.� OR, we are paying premiums that are too low -- but that means insurers pay out much less for us!

C'mon!� You can do it!� Don't sign on the dotted line till you know you're making the wisest health insurance choice for you and your family.� Review your health insurance during this open enrollment season.

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Health Insurance Open Enrollment - Yes, It's That Time of Year originally appeared on About.com Patient Empowerment on Friday, October 30th, 2009 at 09:06:13.

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Money Driven Medicine

Thu, 29 Oct 2009 07:46:10 +0000

If you are at all confused about why we need healthcare reform, then you owe it to yourself to spend some time watching Money Driven Medicine.

Based on Maggie Mahar's revealing book by the same name, it will leave you shaking your head, asking how we Americans could have gotten ourselves into the mess we call healthcare, and better understanding why it's so critical we begin cleaning up that mess immediately.

This isn't about politics at all.� In fact, members of the United States Congress had a "watch-in" Tuesday night, spending the hour+ it takes to view the entire documentary. Republicans and Democrats alike, side by side.

The movie is offered for free, here on the web.� Donations are accepted but not required.� The film is available for large screenings if your group would like to share it with its members.

After you watch it, why not return here to the forum to share your thoughts?

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Photo � Money Driven Medicine logo

Money Driven Medicine originally appeared on About.com Patient Empowerment on Thursday, October 29th, 2009 at 07:46:10.

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Land of the Free - and Home of Those With No Health Coverage

Wed, 28 Oct 2009 07:34:54 +0000

Imagine this....

You are happily married to your high school sweetheart, have three great kids, and a job you've worked at for 20 years. You're a responsible citizen, pay your mortgage, have saved some money, and have worked hard to create your life the way you want it to be.

Then one day you arrive at work, only to be given a pink slip.� After a 20 year career -- laid off.� You're 39 years old and have to begin all over again.

A few months later, as if that wasn't enough, your wife learns that her ovarian cancer has returned and she needs chemo -- soon.� Of course, you have COBRA insurance coverage -- but soon the government COBRA assistance will run out, your health insurance bills will triple, and even then, COBRA will run out a few months later.� With a pre-existing condition, there's no way you'll ever be able to purchase health insurance for your wife anyway.� She works, but her employer doesn't offer coverage.

So now -- what are you supposed to do?

If you are Bill Caudle of Milwaukee, Wisconsin, you join the Army. And soon, while his wife continues her chemo treatments and his youngest child finishes high school, he will leave for Ft. Jackson, South Carolina.� He won't be there to support his wife, or share his daughter's high school experience.� But his wife will have her treatment covered, because Bill will be in the Army for four years.

And that, my dear readers, is what is wrong with the American healthcare system.� It exemplifies everything that's wrong with it -- and it highlights the solution, too.

What's wrong is that the United States of America has a healthcare system that leaves hardworking and worthy citizens out in the cold when it comes to options for getting the care they need.� Bill and his family don't qualify for any existing assistance programs -- no -- they've worked too hard and they own a home.� They don't have the tens or hundreds of thousands of dollars needed to fight wife Michelle's cancer.� They have just enough to be sure they can't get coverage.

Their story shows why denial based on pre-existing conditions is so wrong, and how families can soon bankrupt through no fault of their own.

But their story shows an upside.... that there is good GOVERNMENT, single payer insurance out there that will do what needs to be done -- get Michelle the treatment she needs.

Yes -- good government healthcare.� It might surprise you to know that the biggest government payers in the world are all based right here in the United States!� While conservatives continue to fight a public option, it's the public option that helps the most people already.� Medicare, Medicaid, the Veteran's Administration and TriCare (payer for the military) -- are all public options, public payers.� And they work well.

In the past several months, I've heard the comment repeated many times that "Every American deserves the same coverage the President and members of Congress have!"� Well, guess what -- the President and Members of Congress have the same coverage mentioned above. With the public option, we could have it, too.

So while the bureaucrats continue hashing out the healthcare reform details in Washington, I ask you to consider the public option.� Bill Caudle joined the Army because he knew that was how he could participate.� We aren't all "lucky" enough to be able to join the military....

But then, when you are responsible and love your family, sometimes it takes an extreme decision to provide for them.

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Land of the Free - and Home of Those With No Health Coverage originally appeared on About.com Patient Empowerment on Wednesday, October 28th, 2009 at 07:34:54.

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Obesity Discrimination Takes on New Meaning

Mon, 26 Oct 2009 08:26:21 +0000

Three interesting news stories crossed my desk this week, all related to obesity and discrimination. See what you think:

The first story is about a family in Great Britain. The parents of seven children are obese. According to the news article in the London Times, the mother weights 23st (stone) which equals about 325 pounds. Because she is so overweight, and because authorities fear her children will learn bad eating habits and will become obese, too, all seven children have now been removed by the UK's version of Child Protective Services.

There have already been a handful of obesity interventions here in the United States.� Time Magazine reports on a number of cases where parents have lost their children, or have been arrested for allowing their children to gain too much weight.

Do you wonder why authorities would care?� Should it be up to the government and/or law enforcement to run interference on the weight children gain?� You have to wonder -- why don't they arrest parents when underage kids are caught smoking?

The second story is about what is, in effect, an obesity tax.� Perhaps the best example of how this would be implemented is being discussed in New York State where the governor, David Patterson, wants an additional tax on high fat- and sugar-content foods and beverages.� For each purchase you might make of sugary soft drinks, or fat-laden potato chips, you'd pay extra tax which would then go into a fund to pay for those obese people who need additional medical care because they are overweight.

Is this kind of tax fair?� There's extra tax tacked onto cigarettes, specifically to curb sales.� Sales are down, presumably based on the higher tax.� The tax does seem to make people quit smoking.� So do you think a tax will compel people to cut down on their consumption of those fat-producing foods?� Will a tax help to curb obesity?

The third example comes from within the medical profession, and is, honestly, disturbing.� A study being published in the Journal of General Internal Medicine shows that physicians have less respect for obese patients than for those who are not obese.� The assumption, of course, is that less respect will lead to substandard care.� Just ask an older black person (who suffered high levels of discrimination not so long ago, and in some cases continues to suffer from discrimination) or a gay person today, and you'll better understand what this means.

Three pieces of news about obesity.� I'm going to guess this is just the tip of the iceberg.

What do you think about these stories?

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Obesity Discrimination Takes on New Meaning originally appeared on About.com Patient Empowerment on Monday, October 26th, 2009 at 08:26:21.

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Party Time? Is It Time to Throw a Swine Flu Party?

Sun, 25 Oct 2009 14:14:04 +0000

In the "old days' -- yes, when I was a child -- one of the kids in the neighborhood would get the chicken pox, or the measles or the mumps, one of the childhood diseases that was truly just a right of passage. Their parents would invite over the rest of us kids from the neighborhood to intentionally expose us so we would catch that childhood disease on purpose. (I know - seems odd - but it's true!)

Except some children got really really sick, and once in a great while, children or even adults who had never had one of those diseases as a child, would die.� But that was extremely rare.

So vaccines were developed to protect children from those diseases.

Now some people are asking about the wisdom of throwing an H1N1 swine flu party.� Does it make sense to expose ourselves to the swine flu while we are healthy? Would that provide us with an immunity for later?

Read what doctors and infectious diseases experts have to say about throwing a swine flu party.� (Hint:� save those party hats and noisemakers!)

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Party Time? Is It Time to Throw a Swine Flu Party? originally appeared on About.com Patient Empowerment on Sunday, October 25th, 2009 at 14:14:04.

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H1N1 Swine Flu - A Heads Up on More Fraud

Sat, 24 Oct 2009 17:49:25 +0000

The FDA and FTC have gotten together now -- (read, bigger guns!) to warn us all about even more fraudulent products being offered to people who are searching for products that will protect them from the H1N1 swine flu.

This is an update on a H1N1 swine flu scam warning first offered last spring. No difference in the warnings, just a bigger list of products and services that are only intended to separate desperate people from their hard earned money.

I spent a few minutes reading about some of the listed products. I have to shake my head at some of them:

One site offers a "swine flu reading." For a mere $69 you can talk with someone on the phone who will "read" you and tell you whether you are at risk of catching the flu.
Another offers flu survival packs -- you know -- because the end of the world is coming. I laughed out loud when I saw they are discounted -- 25% off! I guess if the end of the world is coming, they want to get your money first.
Even Dr. Andrew Weil got his wrist slapped by the FDA. Dr. Weil, a popular and well-regarded provider of integrated / complementary and alterntive medicines had made some claims on his website the FDA did not approve of. He has since removed them.

In fact, I found that many of the websites, if they still exist, have removed any mention of helping us with flu-related products. Sites like "SwineFluGone" and others -- poof!� They have disappeared.

If you are tempted to purchase any products or services that claim to help you either prevent or cure the H1N1 swine, or any flu, then first make yourself familiar with the fraudulent items being offered for sale.� Snake oil salesmen are alive and well and just waiting for you to cough up your credit card number!� Don't give them the satisfaction.

In fact, did you know you can report fraudulent products to the FDA? If you feel as if you have been scammed, why not blow in the perpetrator? Selling any products that have not been proven to be helpful is against the law. It's criminal activity. You have an opportunity to save others the trouble and their money by reporting scams and frauds to the FDA.

Your better bets are to make yourself familiar with these scams, protect yourself from the flu as best you can, and prepare for the swine or seasonal flu -- just in case. That's what a smart patient does.

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H1N1 Swine Flu - A Heads Up on More Fraud originally appeared on About.com Patient Empowerment on Saturday, October 24th, 2009 at 17:49:25.

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