Here's is something I've always wondered about, with my doctors.
Find Out If We Have a Conflict of Interest
Ask your doctor if he or she is on the payroll of any drug or medical equipment companies. It may make no difference to you as a patient, but if tests are ordered or prescriptions are written for conditions that seem borderline, it may be an issue. Many doctors get monetary compensation for prescribing certain medications or by enrolling patients in a trial, says Dr. Egener. And although most say their decision making is not influenced by these connections, a new law called The Physicians Payment Sunshine Act (part of the Affordable Care Act) will take effect September 30, 2014 that will require pharmaceutical and medical device companies to list all physicians to whom payments are made. You’ll be able to look up your doctor (once the resource is available to patients, the American Medical Association will post a link) and find out whose payroll he or she is on (if any at all.)
Use the Front Office to Your Advantage
“We have appointments of different lengths for different purposes,” Dr. Egener says. “It takes longer to do a physical, but we have a shorter appointment if you come in for a rash.” So, make sure to communicate effectively when calling for your appointment—say, “I have three things I want to talk to the doctor about.” If you hate waiting, ask for the first appointment of the morning or the first one after lunch.
Also important: You should have a clear list of things you want to discuss, and be aware that you may not get to all of them.
Lastly, the office staff will ask about insurance. If you don’t have any, say so, and then ask if there is a sliding fee scale. You may be able to negotiate a fee, Egener says.
We Don't Always Know What Your Medication Costs
If your insurance won't cover a particular medication—or it's still expensive even with what your insurance pays—let your physician know. "If you cannot afford a medication, usually there is another alternative," Dr. Wen says.
Doctors are also willing to discuss the medicines they've prescribed to their patients. "I don't expect that patients are going to agree with me on everything," Egener says. "I'm the expert in medicine, but you're the expert on your body." Doctors may prescribe a medicine that you would rather not take, so discuss your decision carefully with your physician to determine the risks and benefits of not filling a prescription.
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Don't Be Embarrassed—We've Seen It Before
Whatever your symptoms, no matter how crazy, unusual, or embarrassing, your doctor has seen it before, and probably at least once or twice this week. “I want my patients to know that they can bring up any topic with me,” says Barry Egener, M.D., a Portland, Oregon, internist and medical director of the Foundation for Medical Excellence.
“We see and hear everything, and it’s helpful for us to know what’s worrying you. If you’re feeling not sure whether or not you should say something, you probably should say it. If you’re feeling on the fence, bring it up. We accept that people come in with every potential history and past behavior,” he says
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