A neurologist who treats brain injury told me, as he had to close his practice and enter academia, that he could not see his patients for just 15 minutes as his appointments required closer to an hour. The reimbursement was for 15 minutes, so he was losing money on each visit. The health insurance companies would make no concessions.
The art of diagnosis has been discouraged by the health insurance industry for years. Primary care is and has been, on life support for years. It has led to concierge medicine and a caste system in medicine. Those who can afford quality care, pay for it; those who cannot, get 10 – 15-minute appointments with a rushed medical provider.
How can you change this pattern in your health care experience? You have to demand communication and coordination.
First, bring your other providers’ records to the appointment with your provider. It is easy to order your records either in paper or electronic format. Make sure to read your records and try to understand them. If you do not understand them, ask questions.
Second, go over your records with your providers and share with them what you have and what you have learned from your other providers. Demand answers to your questions, in a polite and intelligent way, and ask why they are doing what they are doing.
Third, ask about their differential diagnosis, what else could it be, and why? What other options are there to treat this condition? What other specialists or alternative providers can or should I see?
Fourth, get your providers to communicate with each other. The more information they have and the more communication that occurs between your providers, the better the health care and truer the diagnosis will be, leading to better treatment and, most likely, a better result.
It will not happen unless you demand it. This is not your parents’ or grandparents’ health care anymore. Demanding or forcing the issue does not mean being nasty or rude. It simply means being educated, having your records with you, asking good questions, and getting the providers to communicate with each other. The more information each has about the other, the better care you will receive and, likely, the better your result will be. Help bring back the art of diagnostics. The medical profession is so sorely giving it up to the health insurance industry. Medical providers want to get it right. The time necessary for medical providers to determine an accurate diagnosis has been taken away. You can help them get it back.
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