How to Get the Health Care You Need
When health care is not an emergency, you have more time—time to do a little investigative work and make sure you’re getting the right treatment for your needs.
“This is the kind of research you should do before making any important purchase,” says Michelle Katz, M.S.N., author of Healthcare for Less: Getting the Care You Need—Without Breaking the Bank. “No purchase is more important than medical care, yet people spend more time shopping for houses and cars than they do for their own health care.”
From her training as a nurse and her experience as a professional health care consultant, a doctor’s wife, and a patient, Katz has seen all sides of the health system. Here’s her advice for obtaining the care that’s right for you.
Begin by choosing the right health care provider. This person will coordinate all your care for years to come, become familiar with your medical history and any ongoing health concerns, and act as your partner in every treatment decision.
Pick the right provider
To reduce your costs substantially, choose a provider who is in your insurance plan’s preferred provider network.
“It’s so important to find a doctor who’s good for you. Not every doctor is good for every patient,” Katz says.
She notes that if you have a chronic illness, you may fare better with a specialist as your primary care doctor—for example, a gastroenterologist for chronic digestive problems, or an endocrinologist for diabetes. A specialist often can more quickly hone in on problems related to your illness and thus avoid unnecessary medical tests.
After you’ve found the best doctor for your needs, look at your health care plan. Your plan should meet these needs:
“The best plan for you may be a little more expensive than what you want to pay, but in the end, paying more up front can save a lot of money later,” Katz says. “Make sure the plan has the tools you need to help your doctor give you the care you need.”
Do your homework
Look closely at your coverage. Your doctor doesn’t know everything that’s in your health plan—it’s up to you to read the plan booklet or to call the health plan’s customer service office to confirm that any proposed treatment will be covered.
Use your insurance sooner, not later. Don't delay necessary, appropriate health care to save money out of pocket, Katz says. That's a sure way to miss out on getting the best care for your needs. This rule applies to both preventive screenings and to treatment for existing problems.
Take pains to befriend your doctor and clearly communicate what you need. The more your doctor gets to know you, the more likely you are to receive the knowledgeable, personalized treatment you need.
“If you say you have a cough, the doctor is going to treat the cough and that’s it,” Katz says. “If you forget to add that you’ve also been having stomach pains, your doctor can’t make the right diagnosis.”
This can lead to treatments that address the symptoms but not the cause, and therefore to more office visits and more treatments.
To prevent this from occurring, take the time to write down your symptoms and concerns before you visit the doctor. Take along a list of any medications and alternative remedies you’re taking, the names of any specialists you’re seeing, and your medical records from previous doctors. Then, speak up.
Second opinions
Consider getting a second opinion, especially when a recommended treatment is risky or expensive. This can make a world of difference in ensuring you understand all your options and are choosing the right treatment.
According to Katz, if your doctor makes a treatment recommendation using words such as “almost,” “possible,” “probably,” “maybe,” “chances,” or “unlikely,” that’s a good cue to get a second opinion from another health care provider.
Most important, always be your own advocate in health care.
“Don’t rely on anyone but yourself to ensure things are done the way you want them done,” Katz says. “Your doctor is your first mate, but you’re the captain of your ship. It’s up to you to figure out how to steer your course toward the best treatment for your needs.”