While health care reform may seem too complex an issue for meer mortals to understand or influence, I couldn’t help wondering what we could do as individuals to improve the status of health care for ourselves. A series of community conversations called Perspectives on Health Care were developed to help us explore, together, the personal actions we can take to improve health care for ourselves and in our community.

 In our first session, we learned from each other about a few community health care assets. Individual participants also shared some of the things they do to make the most out of the available health care. While this list is not exhaustive, perhaps one of these ideas will help you as well!

­          It is important to establish a relationship with a primary care physician before a crisis or health condition develops. A primary care physician is the person who can help you take care of your general health. 

­       If you do not have a primary care physician, and your condition is not life threatening there are a number of resources you can use to learn more about your condition:

• home/family medical references (available in your public libraries, and Tutu's House)
• reliable Internet sources such as Medline (free Internet research services available through Tutu’s House)
• HMSA’s Online Care, available for a fee to non-HMSA subscribers as well as HMSA subscribers (http://consumersonline.hmsa.com/)
• Urgent Care accepts patients with and without insurance.

 ­          To make better use of the time you have with the doctor, particularly for annual or routine exams, do the following before your appointment:

• Ask if there are any lab tests you can have completed,
• Write down your ideas as they occur to you such as your symptoms and how the symptoms manifest.
• Make a list of what you’re taking including the dosage, frequency, and name of your prescribed medication, over-the-counter-medications, and supplements (herbal, mineral, etc).

­          If you are seeing a doctor to follow up on other medical tests or other visits with specialists, call before the appointment to see if all the reports and results have been received from the lab or the other doctors or other therapists you have seen.

 ­          If the doctors in your area have not been accepting new patients,

§         consider a Federally Qualified Health Center (see insert);

§         contact your insurer to find out which doctors are accepting new patients;

§         establish patient status with a new doctor as soon as you hear of one (just make an appointment to establish relationship).

 ­          If you can afford it, ask the doctor you would like to see if they will accept cash payment. It is possible to negotiate your bill with health care services providers (physicians, lab, pharmacy, therapists). Even if you have medical insurance, paying cash up front can reduce the overall cost of the service. Whether or not you can submit the up front payment to your insurance agent for reimbursement is a question that could be explored through another Perspectives On Health Care conversation with billing and/or insurance experts.

 ­          Doctors, nurses, administrators, and patients all agreed that it’s very important for the health care consumer/patient to be a partner in the health care process. One example of how to be an involved partner in health care: Patients need to speak up when they disagree with their doctor, ask for more clarification if they don’t understand, and develop comfort working with the doctor rather than feeling intimidated by the doctor. 

­          Creating and keeping your own medical record is your right and a good idea. You don’t have to go back to birth. You can begin by asking your doctor or the lab to provide a copy of the laboratory results anytime you have a test. If the doctor asks the lab to provide you with a copy, the copy is usually provided for free.

­          You can use free, secure online services to create and store your health record. Health care reform is encouraging the use of electronic medical records which will help patients receive continuity of care. Creating electronic medical records online is a topic which could be explored through another Perspectives on Health Care.