Advocacy for Excellence in Medicine

For those in Connecticut this one is especially for you. http://www.healthcare4every1.org/site/PageServer

It pleases me greatly to tell my readers that I am pro-active on this committee for health care reform in Connecticut. If you need information on what we are doing, just click on the link. There is active participation mostly by religious groups, small business groups, labor unions and some of Connecticut's largest companies including insurance companies. We are still trying to enlist as many individuals and small business owners in order to enable everyone in the state to have affordable, accessible and continuous access to health care. Currently we have begun to work toward the President's national health-care plan as well.

The Citizens Health Care Working Group
By Jeff Cruz | bio
The Citizens Health Care Working Group

For the first time, the federal government is asking what its citizens think is important for health care to work for everyone. This is being done by the Citizens Health Care Working Group, which was created to prompt a national dialogue on health care in the U.S. The finding will be presented at a congressional hearings in 2007. There are a variety of ways to get involved, from internet polling to town hall meetings. The Universal Health Care Action Network (The UHCAN Coalition) is one of the groups working to ensure that proponents of universal coverage get heard, and they have lots of resources available. We need to make sure all the excellent points that everyone has been making on this site about why we need health care for all are know by those Representatives working on this issue!

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Most people have many questions about medical situations. Here is a case scenario to begin your thinking in the direction of the types of occurrences which I have been witnessing......
......You are in the emergency department with a child or elderly parent, or sister, brother, spouse, etc.

Will she/he be sedated? If so, with what? What are the side effects? How will you be monitoring her/him to be sure that the patient is safe?

The doctor states surgery is necessary. You ask, “Is there any other less invasive option? Is it possible to wait until tomorrow or is it life threatening to wait? Why?"

To begin, you need to ask the doctor how much experience he/she has in this particular area of his field - in the surgery recommended for _______. Are there other places in the area with greater experience? (Some local – especially community hospitals – don’t have full service resources for all surgeries and treatments.

I know that where I live, our local community hospital does now have the equipment and physicians to do cardiac catheterization making it more convenient for a heart patient to not have to travel to the state capitol for this procedure. However, perhaps you do not realize that although this procedure (aka “the balloon procedure”, “angiogram”) is very common now, it is no less life-threatening. (see WebMD for a description of the details of this procedure). A surgeon passes a tiny plastic tube with a fiber optic camera from the groin through the major arteries up to the major coronary arteries (usually ka RCA, Circumflex, RDA, etc). While this is quite easily done under sterile conditions with a physician known as an “interventionalist”, it is no longer a new procedure and has been in use in this country for about 20 years; it is still not perfect and is still life threatening. If the catheter should puncture the artery wall, the patient will bleed out and die within five minutes. In most settings, this procedure is done only when an operating room and full cardiac surgical team 'on call' are ready to bolt into action immediately to prevent heart attack or other complications.

There are many hospitals and doctors who might perform this or other procedures without that safety guard in place. You need to know such things - for yourself and your loved ones, you have a right and a responsibility to be informed. If the procedure can wait, do so until you talk it over with your own private specialist or Primary Physician or at least to look it up on the Internet.

Some of us were raised in an era when questioning the doctor was simply unacceptable. In this age of technological advances and complicated procedures, we must ask. It is not appropriate to challenge the doctor. Your responsibility is to question him in a way that will lead you to a comfort zone with what is going on or will prompt you to seek help elsewhere. If your doctor is reluctant to answer such questions, you probably need to seek the help of another.

A word of caution however, depending upon the complexity of the situation, many doctors simply will not accept a new patient who is seriously compromised as it becomes both an ethical and a legal issue.

These are guidelines of a particular situation but there will soon be more to further reiterate how to best carry on with the healthcare of both your loved ones and yourself. Additionally I will provide more and more forms that you can quickly fill out and keep on hand for that all-important visit to the doctor, clinic or emergency room.

Going to the doctor? Here are five things you can do to make the most of the time you have with your doctor.

1. Prepare:
    (a) Make a list of symptoms and how long you've been experiencing them.
    (b) Research the specific condition or problem you have to become familiar with related medical terminology. (You can do that in medical journals, health journals or online.)
    (c) Write down your questions and refer to your list frequently.
    (d) Bring your medical records or have them transferred in advance. (Always call your doctor's office after each visit and request a copy of that day's physician's notes and pertinent lab values and test results.) Leave a new medical release form with your signature in blue at each office visit, for this purpose. Always list the name of who the information is to be released to. You don't want anything faxed ever because there is no control over who sees what or when. If your signature is blue you know it was not faxed!
    (e) Arrive early to fill out paperwork.
    (f) Bring your insurance card and another form of photo ID.
    (g) Bring a pen and paper to take notes when your doctor explains things to you or gives you instructions.

2. Speak Up! Ask questions.
(a) Find out why medication is being prescribed and inquire about possible side effects.
(b) Find out what you should do if side effects do occur.

3. Share Information -- Tell your doctor everything about your health status -- there is no reason to be embarrassed or intimidated.
(a) Disclose all medications (including illicit drug use), vitamins and herbs, and all over the counter medications . Also inform this doctor what other health care providers are caring for you. (Physical Therapists, Chiropractor, Social Worker, any and all. He needs to know.

4. Bring Support! -- For some appointments, you may want to bring a friend or family member to help you relax or remind you of concerns you might have forgotten about. Later, he or she might be able to help you clarify what your doctor said.

5. Follow Up! -- Call your doctor's office if you have questions or problems later. If you need to speak directly to your doctor, be patient -- he or she might not be able to take your call immediately. Usually they have specific times during a day when they return patient's calls. -- Follow through if you schedule another appointment.

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