<%@LANGUAGE="VBSCRIPT" CODEPAGE="1252"%> Understanding Healthcare
 
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          Understand The Healthcare System, In Order To Be Well Cared For
 
 
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Understand Healthcare
Preventing Trouble
Handling Situations
Careful Planning
Financial Issues
Insurance Issues
Power Philosophy
A man too busy to take care of his health is like a mechanic too busy to take care of his tools. Spanish Proverb

The tools for health are medications and operations, but no less the people and systems that deliver it to you, like government and insurers. As with the sorcerer’s apprentice, what you need will not necessarily come from wishing and wanting alone. If you are not watching carefully things can go awry, unsupervised. The healthcare system needs you, both to double check it and to work with it.

The problems arise largely because the challenge is so great, the resources and time short, and you the patient so complex. Like the mechanic in any area, we can make a great difference by studying both how to help the system treat us and how to protect us against it's clumsiness. No number of regulations or mass of lawyers can make up for healthcare workers short on time, costs that can't be covered, or patients who don't fight for their health. This is why you must step in.

The other critical feature you must understand is that many diseases do not have one right treatment. Why? The answer may not be known, and doctors are trying to help you with what they have. You are asking for or demanding treatment, as well. Then consider that many new treatments cannot be fully understood for years, when wide experience is analysed. New treatments bring blessed improvements and problems that can't be reversed. In this situation some doctors will try a new treatment often, others will wait to see what it does. This creates different opinions, sometimes very strong differences where there is no answer yet. Different areas of the country, different areas of a state or different practice groups can have widely different treatment recommedations for a disease. This has been known for a long time, and creates large differences in medical costs, but also in what treatment you get. It will affect your care, and it is unwise to get a treatment just because it is a new trend. Use consults and second opinions to see past this fog of new treatments for better healthcare.

Then there is the problem of making your care do the most for you. We all need more powerful treatments. Yet many useful or powerful treatments don't get a chance to work in patients. This is a benefit we can't afford to lose. Why? It ranges from the patient to the system. Many patients don't follow the prescription and fail to take the treatment. Others are unwise in their lifestyle. Or they don't explain their symptoms clearly to the doctor. Then there are many problems that can happen in the system from insurance denials and delays to getting the wrong diagnosis or treatment. Do these matter? Yes, they have a tremendous effect on the health of many patients and their families. Much of it can only be helped by you.

Dangerously, we are not taught to be active patients. The very definition is passive. Busy doctors may not teach about the problem well. The legal system sends the message there is a blanket of support that probably can't be delivered, rather than a joint responsibility. We should neither excessively blame health care problems elsewhere nor just accept them. The real world fact is that the best health comes to those that lead the team which cares for them.

This sounds daunting. Clearly there are things about healthcare which only an expert in that specialty will understand. Complicated biology and terminology may seem beyond us. But where diseases and treatments are well understood, there are usually only a handful of options and their outcomes to learn. If you are focused on them, you will usually understand them. Most treatments reduce to fairly simple tradeoffs you can learn.

You understand the healthcare system when you realize your health depends on an imperfect trinity of healthcare: the treatments medicine can offer, how the healthcare system tries to deliver them, and you. You should no more be passive here than in buying a house, or raising your family.

Your body is one key part of your role. After all this is where the illness is, and it has much of the healing power medicine depends on. You are its best steward. In addition there is your will and attitude. Are you involved? Do you inform your doctors accurately? Do you follow directions, take the medicines, and avoid activity that will bring further harm? Too often patients do not.

But you have another role. Like every service you buy or depend on, you have to check it. Is it being provided? Is it what you need? What human problems of those providing the service should you look out for, or make up for? The more complex your problem, or the more worrisome your treatment results, the more you need to supervise.

The extent to which you become active will vary, but the mere fact that you are asking questions, trying to understand, and getting other opinions will focus the attention of those caring for you on your needs. And your attention will be focused on making the most of the healthcare they give you. This alone is usually an advance, and prevents many obvious problems. The more you become a power patient, the more health you are likely to find.

© PowerPatient, FIND, 2003, 2004