Changes In Who Decides Your Medical Treatment

What my husband and I perceive from recent appointments with several doctors is that doctor's no longer make the decision on what treatment is best for their patient.

Instead, they provide their patient with information and then the patient must choose what he or she wants for their lifestyle.

I liken this new way to handing a person an artist’s palette, some tubes of paint, plus pastel chalks, charcoal, watercolors, brushes, and other artist's tools, and telling the person to create the picture they envision. Or, put a person into a shop full of equipment and tools and tell the person to create what they want!!

It’s true that the good old days recalled by any elderly person, of going to your doctor and having him or her diagnose your illness and provide proper treatment has been replaced. Nowadays, the patient is questioned, is sent for tests, and then the doctor gives a diagnosis based on the tests rather than how the patient feels.

 

This is followed by one or more referrals to specialists ~ who then describe the problem to the patient and offer choices of treatment options  ~ for the patient to decide what is the proper treatment for them so that they will achieve the lifestyle they prefer.

Your doctor’s online Patient Portal may or may not help you with this "NEW" way of doctoring. When we asked if having a Patient Portal was mandatory, the receptionist told us it is not mandatory for a patient to have one, but doctors without a high enough percentage of patients who do have a Patient Portal are fined by the government. Whether or not that’s true, we don’t know.

What is your Patient Portal and is it important?

 

Yes, your Patient Portal is important to you. However, there are many types. Standardization of the technology in the healthcare services industry have been slowed down due to internal factors, such as resistance to changes in medical practice patterns, new costs to train staff and ongoing costs to maintain the validity and relevance of computerized order systems, and concerns revolving around compliance with future medical standards.

 

Your doctor’s office will help you set up your Patient Portal, which provides you with online access to your medical records. When you’ve mastered setting up the portal, which requires a “Signin” name and a “password”, become acquainted with how to navigate it; how it works, where you find what you want to know, how information is edited, and how to contact your medic.

HealthIT.gov has an excellent download for frequently asked questions (FAQ). Scroll to "FAQs about the Patient Portal (for Patients)" and click the Download. Save it on your computer so you can refer to it when you need answers.

Among other things, Patient Portals basically include:

•  Appointments, past and upcoming.
•  Tests and their results
•  Patient's medical history & patient’s family medical histories
•  Patients medications, current and past

 

Beware: Unless you’re educated in reading test results yours won’t tell you what you need to know. However, test results can be a real asset for patients who research, and research, and research until they match their symptoms precisely with a disease or disorder.

Online research can lead to organizations and groups that specialize in disorders you’ve never heard of, and therefore, be hugely beneficial ~ if you study them closely.

Nevertheless, many websites you find can also be dangerously misleading and provide false information. Proceed with caution.

Pay heed to these new changes, because whether you like them or not, it is how medical treatment works today, and it behooves the patient to understand them as fully as possible.

 

Don't Delay When You Need Medical Help

Delay seeking medical help at your peril when illness or injury occurs!

Ambulance Paramedics and Emergency Department medics willingly tell patients that the sooner they get a diagnosis so treatment can begin the faster they'll recover, and the better their outcome.

They are not referring only to heart attacks and other life-threatening events. Recovery from anything ranging from a common cold, skin infection, and subtle unexplained dizziness to diffuculty breathing, dibilitating weakness, chest pain, falls, and obvious illnesses and injuries all respond best when assessed and treated promptly'

Delay often leads to requiring more extensive treatment than if the patient visited their doctor, an urgent care center, or a hospital emergency department as soon as possible.

It's human nature to deny illness, and to rationalize reasons to wait and see. Also, injuries such as a blow to the head, or a stumble that results in bumping into something, or falling, can be serious even when the victim is able to regain their balance and doesn't seem to have hurt themselves.

In many seemingly minor injuries, pain often doesn't set in for 12-24 hours, but during that time. especially in head injuries, tissues can swell and begin resticting normal blood flow, and even lead to a death that could have been prevented

Don't delay ~ seek immediate medical help.

 

Learn Why Everyone Should Plan Beyond Life ~ and How To Do It

Americans dislike talking about death, much less attending to advance planning. Now, a new Washington-based website, PlanBeyond , is a one-stop place to get information on resources that should be high priority for everone, not just those in their senior years.

The website goal is to guide you, and remove the burden of industry jargon while providing one place to go for the kind of help that's scattered all over the web.

You'll find a host of information and resources for end-of-life decisions. Besides estate planning help, it includes links to information such as, Is Life Insurance Without a Medical Exam Worth It?, The Biggest Medicare Mistake You Can Avoid, Alternatives to a Payable On Death Account, and many more.

Of particular benefit are articles by professionals in various fields, and state-specific advice because laws vary in every state.

"A 2012 study by the American Medical Association sugests that 76 percent of people in the United States neglect end-of-life planning, often waiting too long," said Seattle-based Laura Troyanai, founder and chief editor.

Do yourself a favor, visit the site, browse the links, and then bookmark PlanBeyond.

Family History Spotlight

Family history is in the spotlight this season. Learning about your family's health history may help you have a longer and healthier future together.

Because only a third of Americans have ever tried to gather and write down their family's health history, the Surgeon general created a web-based program that creates a 'family tree' that you can download and print to share with your family members or doctor. The information is not kep on the website; it is private.

Family Health History. Use the Links in the panel on the left to get to the following:

Family History and Create Family Health Portrait

[Source: U.S. Department of Health & Human Services]

 

Find Out if Your Hospital or Health Care Organization is Accredited

I hope you'll forgive my lack of posts ~ like many of my peers I've been frequently "socializing" with doctors in hopes of feeling better... which fortunately is helping.

First on my list of information to share with you is what I learned about were to find out whether your hospital or other health care organization is accredited. Go to The Joint Commission.  

The statement at "About Us" says"An independent, not-for-profit organization, The Joint Commission accredits and certifies nearly 21,000 health care organizations and programs in the United States. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards."

Explore the wealth of links on The Joint Commission website to learn what you want to know.

Comments you leave on 21st Century Old Folks Home are always welcome.

 

Don’t Ignore These Stroke Warning Signs ~ Act Promptly!

A major "perk" of living in an assisted living community ~ which as you know, I refer to as A UNIVERSITY FOR 2ND CHILDHOOD ~ is that most of the residents have experiences from which you can learn.

Take for instance what I learned from a recent first-hand experience at Broadway Court Estates, an apartment complex where everyone quickly becomes "extended family".

The lesson: Knowing stoke symptoms ~ and taking immediate action ~ may minimize your chances of suffering a life-changing disability!

One evening, Sue *[fictitious name] suddenly felt so tired at dinner in her Assisted Living Community dining room that she excused herself and went to her third floor apartment. Later, she said her legs hurt, which was unusual for her. But mostly she felt weak and feared she couldn't make it to her apartment. However, when she got there, she didn’t seek help, but went to bed and promptly fell asleep.

Sue was actually suffering a stroke! However, since she wasn’t aware of that unusually painful legs was a stroke symptom, and since she had no tingling, vision impairment or confusion, she didn’t think of stroke. 

In the morning, she called her daughter who came and convinced Sue that her continuing symptoms should be checked by a medic. They went to the nearest hospital emergency room (ER).

After ER medics assessed her, they sent her home saying nothing was wrong.

 

Four days later, when her daughter took Sue to her regular doctor, he ordered an MRI and discovered Sue had suffered a stroke.

 

The doctor also said,

"Unusually painful legs is a stoke symptom too often missed by medics."

Fortunately, Sue’s stroke was mild, and her rehabilitation and recovery are going well.

 

Print, memorize, and post the following STROKE WARNING SIGNS (Guidelines from American Heart Association and American Stroke Association):

• Sudden numbness or weakness of the face, arm or leg – especially one one side of the body 
• Sudden confusion, trouble speaking or understanding 
• Sudden trouble seeing in one or both eyes 
• Sudden trouble walking, dizziness, loss of balance or coordination with no known cause 

Immediately call 9-1-1 or the emergency medical services (EMS) so an ambulance (ideally with advanced life support) can be sent for you.

 

Also, check the time so you’ll know when the first symptom appeared. It is very important to take immediate action! If given within 3 hours of the start of symptoms, a clot-busting drug called tissue plasminogen activator (tPA) may reduce long-term disability for the most common types of stroke.

 

Costly Facts About Medicare Observation and Outpatient Hospital Admittance

I've always been skeptical of email fowards. You know the ones, FWD: followed by some subject that holds little or no interest. However, the title on this one, Hospital Stay - Important please read, indicated a topic that interests me. So I read it.

Having recently been admitted, for medical observation, in a couple of hospitals with Medicare covering all of the hospital and doctor charges except pharmacy, I didn’t believe what the writer described.

However, after doing intensive research, I found the circumstances that made his saga ring true.

Following instructions at bottom of page 40 in the 2016 Medicare & You publication, I studied the important, lengthy explanation. Are You a Hospital Inpatient or Outpatient?

Observation in an intensive care unit, ICU, is not covered by Medicare. Scroll down to see how it applies to this man’s experience!

My advice? Study your 2016 Medicare & You book, because it spells out the circumstances under the various categories on admittance, including "observation", are not covered.

Read also, "Your Medicare coverage choices".

Although doctors would like to admit patients for treatment rather than for observation, today's Medicare rules that govern admittance prevent them from doing what they believe would be in the beset interests of their patients.

The following is the original FWD: Hospital Stay - Important please read. SENIORS BETTER READ THIS!!! from a senior gentleman in Mesa , Arizona:

"Family, Friends, Neighbors, and former Classmates, I just found myself in the middle of a medical situation that made it very clear that "the Affordable Care Act" is neither affordable, nor do they care. 

"I'll go back about seven years ago to a fairly radical prostate surgery that I underwent. The Urologist who performed the surgery was very concerned that it was cancer, though I wasn't told this until the lab report revealed it was benign.

"Since that procedure, I have experienced numerous urinary tract infections, UTI's. Since I had never had a "UTI" prior to the prostate surgery, I assumed that it is one of the side effects from surgery, an assumption since confirmed by my Family Doctor.

"The weekend of March 8-9, I was experiencing all the symptoms of another UTI. By Monday afternoon the infection had hit with full force.  Knowing that all I needed was an antibiotic, I went to an Urgent Care Center in Mesa, AZ, to provide a specimen a requirement for getting the prescription. After waiting 45 minutes to see the Doctor, I started getting very nauseous and light-headed.

"I went to the Receptionist to ask where the  bathroom was, as I felt that I was going to throw up. I was told that I would have to wait for the Doctor because I would have to leave a specimen, and they didn't want me in the bathroom without first seeing him.

"That was when the lights went out. My next awareness was that of finding myself on the floor (in the waiting room) having violent dry heaves, and very confused.  At this point, I tried to stand up but couldn't make it, and they made it very clear they weren't going to let me get up until the ambulance got there.

"By the way, when you're waiting to see the Doctor and you pass out, you get very prompt attention.

"Now, "the rest of the story", and the reason for sending this to so many of you. I was taken to the nearest hospital, to emergency. Once there, I was transported to an emergency Examination room.

"Once I had removed my clothes and donned one of those lovely hospital gowns, I finally got to see a Doctor.  I asked "what is going on?  I'm just having a UTI. Just get me the proper medication and let me go home."

"He told me that my symptoms presented the possibility of sepsis, a potentially deadly migration of toxins, and that they needed to run several tests to determine how far the infection had migrated. For the next 3 hours, I was subjected to several tests, blood draws, EKG's, and demands for specimens.

"At about 7:30 [p.m.], the nurse came back to my room to inform me that one of the tests takes 1- 2 days to complete. I asked if they [the results] could be emailed, at which point she informed me that I wouldn't need them emailed because I wasn't going anywhere. I did tell her I wanted to see the doctor because I had no intention of staying overnight.

"Now, this is what I want each of you to understand. Please read these next sentences carefully.

"The doctor finally came in to inform me that he was going to admit me.  I said, "Are you admitting me for treatment or for observation?"

"He told me that I would be admitted for observation.

"I said, "Doctor, correct me if I'm wrong, but if you admit me for observation, my Medicare will not pay anything. This due to the Affordable Care Act."

"He said, "That's right, it won't."

"I grabbed my bag of clothing and said, "Then I'm going home."

"He said you're really too sick to be going home, but I understand your position. This health program is going to hit seniors especially hard.

"The doctor then left the room and I started getting dressed.  I was just getting ready to put my shoes on when another doctor [the closer] came into the room. He saw me dressed and said, "Where do you think you are going?"

"I simply said "I'm going home."

"To which he replied, quite vociferously, "No you aren't."

"I said, "Doc, you and I both know that under the "Affordable Care Act" anyone on  Medicare who is admitted to a hospital for observation will be responsible for the bill. Medicare won't pay a cent." At which point he nodded in affirmation.

"I said, "You will either admit me for a specific treatment or you won't admit me."

"Realizing he wasn't going to win this one, he said he would prepare my release papers. A few minutes later, the discharge nurse came to my room to have me sign the necessary papers, relieving them from any responsibility.  I told her I wasn't trying to be obstinate, but I wasn't going to be burdened with the full [financial]responsibility for my hospital stay.

"After making sure the door was closed, she said, "I don't blame you at all, I would do the same thing."  She went on to say, "You wouldn't believe the people who elect to leave for the same reasons, people who are deathly sick, people who have to be wheeled out on a gurney."

"She further said, "The 'Affordable Care Act' is going to be a disaster for seniors. Yet, if you are in this country illegally, and have no coverage, you will be covered in full."

"This is not Internet hype folks, this is real. I just experienced it personally. Moving right along, this gets worse. Today I went to a [required] follow-up appointment with my Arizona Family Practitioner.  Since my white count was pretty high, the follow-up was important.

"During the visit, I shared the experience at emergency, and that I had refused to be admitted. His response was "I don't blame you at all, I would have done the same thing." He went on to say that the colonoscopy and other procedures are probably going to be dropped from coverage for those over 70."

"I told him that I had heard that the "Affordable Care Act" would no longer pay for cancer treatment for those 76 and older, is that true? His understanding is that it is true. The more I  hear, and experience the Affordable Care Act, the more I'm beginning to see that we seniors are nothing more than an inconvenience, and the sooner they can get rid of us, the better off they'll be.

"We can have an impact on this debacle by letting everyone in Congress know that their responsibility is to their constituents, not the president and not the lobbyists. We need to let them ALL know that they are in office to serve and to look after the BEST INTERESTS of "we the people," their employers, and not to become self-serving bureaucrats who serve only out of greed. And if they don't seem to understand this simple  logic, we'll fire them.

"REMEMBER: Demand [that]your hospital admission is for TREATMENT and NOT for OBSERVATION! Don't believe this? Ask your doctor.

"SEND THIS TO EVERY SENIOR AND ALL MILITARY [ACTIVE OR VET] AND LET THEM KNOW THIS IS HOW OUR REPRESENTATIVES ON CAPITOL HILL TREAT THOSE  WHO RISK IT ALL SO THEY CAN SIT UP THERE AND ENJOY ALL THE BENEFITS THEY EXEMPT FROM THE REST OF US.

"Lord, keep your arm around my shoulder and your hand over my mouth.”
END of FWD

My advice? Study these:  Are You a Hospital Inpatient or Outpatient? and ,"Your Medicare coverage choices".

When you need help, these agencies have typically provided information about their state's SHIP programs. First, Locate your local Area Agency on Aging by visiting Elder Care Locator. Once on the site, enter your zip code or city/state, and your local agency should populate.

Also, towards the bottom of the search results, the contact information of the SHIP programs in that territory or state are typically displayed.

Another resource where you do not need to register or enroll to locate SHIP information for your locality is, SHIP NPR.

Good luck!