How Patients Can Advocate for Themselves at the Doctor’s Office
James Grant, M.D.
| 4 min read
James D. Grant, M.D., is executive vice president an...
Preventive care aims to prevent health problems from occurring or worsening. It includes check-ups, screenings, tests and discussions with health professionals to assess an individual’s health status and risk of illness. Not only does it save lives, preventive care plays a critical role in making health care more affordable for all.
Equally important to one’s overall health is self-advocacy. Good health care should be a partnership between an individual and their care team. When individuals take a proactive approach in their own health care journey, they often have a more positive experience.
They are able to provide valuable information and insights about their body that can help guide the care team’s recommendations and ultimately, prevent them from spending more money than they should within the health care system.
Becoming your own advocate: How to take a more active role
By collaborating with your care team, individuals can make informed decisions about treatment options and therapies, as well as lifestyle changes that might prevent conditions from worsening.
Here are four ways to be a self-advocate at the doctor’s office:
- Prepare for every doctor’s visit. Before an appointment, write down any symptoms or new concerns. Make note of any health changes in family members, new medications from other doctors, any over-the-counter vitamins or medications, or any other factors that impact health. Bringing the list to the appointment will help guide the conversation with the doctor during the visit.
- Ask questions. If what the doctor is saying doesn’t make sense, ask for clarification. It’s critical that individuals understand any test results, diagnoses or treatment and medication recommendations. Don’t be afraid to ask the doctor to explain the reasoning behind their recommendations, the risks and benefits, and any alternatives.
- Ask for a referral. If there is an issue a primary care doctor cannot address, they may recommend a referral to a specialist for a particular issue. Specialists are doctors that have completed additional training in a specific area of care, like allergy or heart care or cancer. Primary care doctors can provide recommendations, but individuals can always find someone else. Individuals should check to see which specialists participate with their health plan. For individuals with HMO plans, their primary care doctor will probably need to send an official referral to the health plan for approval before the individual can see the specialist.
- Know what’s covered by health insurance. Individuals can guard against surprises by checking with their health insurance to make sure their doctor’s recommended course of action is covered. For most health plans, call the number on the back of the customer ID card.
How does patient self-advocacy make health care more affordable?
Taking the initiative to advocate for your health is empowering, and ultimately, it fosters a better care experience. If you follow the four steps listed above, here's how self-advocacy can ultimately decrease health care costs.
- Self-advocacy can prevent unnecessary procedures and tests, therefore reducing errors and overcharges. Asking questions like, "is this test necessary?" or "are there any alternatives?" can ensure only essential tests are run, procedures are performed and referrals are received.
- Self-advocacy encourages cost transparency. Especially when discussing medication, ask your provider how much the prescription they suggest will cost and whether your health insurance plan covers it. If you're not happy with the price, you could request a generic version.
- Self-advocacy can improve treatment adherence and health outcomes. When patients understand the care plan they walk out of the doctor's office with, and are not skeptical of it, they are more likely to take medications as they are prescribed and follow through with any recommended lifestyle changes. This can prevent complications and further readmissions into an expensive health care system, such as having to rely on urgent care centers or the emergency room.
The Affordable Care Act requires all health plans to cover 10 essential services. However, individuals may be responsible for a portion of the expense, depending on their plan:
- Ambulatory care
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance abuse services
- Prescription drugs
- Rehabilitative services and devices
- Laboratory services
- Preventative and wellness services
- Pediatric services
James D. Grant, M.D., is senior vice president and chief medical officer at Blue Cross Blue Shield of Michigan.
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- What is The Safety Net? Here’s How This List of Michigan Health Care Clinics Support the Uninsured
- We Stand for Innovation
- Should We Pay Hospitals for Results or Volume?
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