Monthly Archives: May 2011

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Choosing A PCP

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Since your relationship with your PCP will be a long standing one you need to focus on qualities & competence of the physician, and that of his or her practice. But before you can do that you need to identify your choices.

Start With Your Insurer

Your health care insurer is the place to start since health plans often require you to select your physicians from a specific list of providers who are in their network. If you choose one outside the network you won’t get the same level of coverage and possibly none at all, so making that mistake can be quite costly. These days most insurers have a website to help you with selecting an in-network physician. They often let you search by location, specialty, and gender. Often you’ll find information about their training and office hours. Some insurers have rating information available, too. If they don’t have such features on their website or you want to speak with a person, call the Member Services number on the back of your insurance card. Someone should be able to give you much the same information over the phone.

Do Some Research

Once you have the list, you’ll want to do a little research about them. If you are getting your insurance through work, ask your coworkers who they see and how they like them and the practice. This will give you a sense of the doctor’s bedside manner and the quality of their office staff. Remember, the office manager, receptionist, and nurses in the doctor’s office are critical to a smoothly run practice. You want to be sure that when you call with a problem, your issue is handled efficiently and brought to the attention of the doctor when appropriate. If you happen to know a nurse at the hospital where that physician practices, ask their opinion. This would give you a clinical perspective on the doctor, too.

Finally, you should check with your state’s medical licensing board to see if there are any issues with any of the physicians you are considering.

Time For An Office Visit

Once you have done this research, it is time to visit the doctor to see if you will work well together. I’ll cover how to prepare for that visit and what to look for in my next post.

For Your Health – Dr. Bob

Making Milestones Work For You

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Usually when we are making changes to our lifestyle behaviors we have set a goal for ourselves that won’t be attained for many months.  Once we reach that goal we usually reward ourselves.  In fact, often the attainment of our goal is the reward in and of itself.  The sense of accomplishment is powerful.  Very often, our goal is related to getting a benefit or reward.  For example, a woman losing those 50 pounds she set as her goal may enable her to feel more attractive and confident when she attends her college reunion.

But if we just tie a reward to attaining our ultimate goal, we can lose the value of some motivational opportunities along the way.  This is where the concept of milestones comes in.  When writing out your plan it is a smart idea to identify some milestones along the way & link them to some small reward.  For instance, for the woman in our example, she may want to set up 10 pound milestones as she works toward her 50 pound weight loss goal.  She would tie a reward for every 10 pounds she loses.  It may be going to a movie or buying a new blouse or sweater.  Whatever reward she values would work as long as it doesn’t involve straying from her eating plan.  Ideally you should tie a due date to each milestone to help you stay on track.

So be sure to harness the power of milestones.  After all, we all respond to rewards.

For Your Health – Dr. Bob

What Is A PCP And Why Do You Need One?

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PCP stands for primary care physician.  These are physicians whose specialty gives them training in broad areas of medicine that enable them to diagnose most of the common illnesses that people develop.  When they can’t treat the condition themselves because of the limitation of the depth of their knowledge or skills, they will refer the patient to the appropriate specialist.  For infants and children, pediatricians and family practitioners serve as PCPs.  Adults have internists and family practitioners as their PCPs.  All three of these primary care specialties spend three years after medical school graduation learning their specialty.   So, for three years an internist in training focuses on adult medicine, a pediatrician in training studies pediatrics exclusively.  A doctor learning family practice spends their three years learning pediatrics, adult medicine, obstetrics and surgery.  Training for the medical subspecialties such as cardiology or gastroenterology requires several more years of training after the three years of internal medicine.  A similar progression of training takes place for surgical subspecialties beyond general surgical training.

In essence a PCP is trained to provide preventive care, make diagnoses, treat what he can and refer the rest.  They serve a role in coordinating their patient’s care and that can be invaluable.  They will recommend what screening tests and immunizations are appropriate for each of their patients based upon their age, gender and other factors.  Though there are times when you may need the expertise of subspecialists such as a cardiologist or an orthopedic surgeon, they don’t have the broader perspective of the PCP in regard to prevention.

It pays to have a PCP not just for prevention but also for acute medical problems such as colds, sore throats, rashes, body aches and pains.  While these can be diagnosed and treated in an emergency room, there are definite disadvantages to going to the ER.  First of all most health insurance plans will require you to pay more when you go to the ER rather than a physician’s office.  I’m aware of health plans where the copay for a doctor’s office visit is $25 and the ER visit copay is $250!  In addition, you can’t make an appointment for the ER so you can wait in the waiting room for hours while patients with more serious (and infectious) problems get seen before you.  Lastly, the ER physician usually views you as a single visit and doesn’t have the same preventive perspective as a PCP does.

In the next post I’ll talk about things to consider in identifying your PCP.

For Your Health – Dr. Bob

Barriers to Your Success

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Whenever you take steps to change your lifestyle behaviors, whether to stop smoking, eat healthier or begin an exercise plan, it pays to take some time and identify the barriers to your plan.  These are the roadblocks to your success.  They are usually easy to list since they are often related to your list of Cons.

So if we consider the healthy eating plan that must be followed to lose weight, barriers might include:

  • Not knowing what to eat and what to avoid
  • Not knowing what are proper portion sizes
  • Not understanding food labels
  • Having difficulty finding the time to do some research on proper nutrition
  • Being tempted by unhealthy snacks at work
  • Being a frequent snacker
  • Eating out frequently, possibly due to business travel

Barriers to starting an exercise program to help lose weight and for its other benefits often include:

  • Having difficulty finding the time to exercise
  • Not having access to a place to exercise
  • Being embarrassed to exercise in front of others due to self consciousness about being overweight
  • Physical limitations

These are the potential reasons why you may fail in your plan – if you don’t determine how you can overcome them.  So when you make your list of barriers, you need to list next to each barrier what you will do to counteract them.  This way, when you are faced with the barrier, you will know how to respond.  For instance, if you are unsure of what to eat and what to avoid as well as appropriate portion sizes, you need to do some research online or at the library.  To help with portion sizes, you may need to buy a scale and measure all your portions.  When you take the time to identify your barriers you can usually strategize how to eliminate them before you are faced with their challenges.  Including barriers and their solutions in your plan preparation can help assure your success.

Next time I’ll talk about a few more important parts of your healthy lifestyle behavior change plan.

For Your Health – Dr. Bob

 

When Should You Call Your Physician

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In the last post I talked about what characteristics of your symptoms should lead you to contact your physician. This time I want to discuss what else to consider.

Some people are very happy with their doctor, trusting them completely.  While it is great to have so much confidence, there are times when this can cause a problem.  I have heard people who are having significant symptoms say that since their physician is not available when they need to be seen, they will wait. Sometimes the reason is that it’s after hours and they don’t want to bother their doctor. Sometimes they know the on-call doctor isn’t their own, and they don’t want to talk to them.  The reality is that all physicians are trained to handle such after hour calls.  Delay can sometimes lead to complications that can be life threatening.

Another thing to consider when deciding when to contact your doctor is the day of the week.  Since most doctors have limited or no office hours on weekends, you should plan accordingly.  If it is Monday and your symptoms are not critical you can wait a day or two to see if they improve before making an appointment to see your doctor. On the other hand, if it is already Thursday you probably should make an appointment before the weekend so you can avoid a costly trip to the emergency room.  The potential seriousness of your symptoms should always be the deciding factor.  For a potentially life-threatening situation, it doesn’t make any difference what day of week it is – just call 911.

For Your Health – Dr. Bob