June 2012 - The ALS Association Greater Sacramento

How To Be the Core Communicator About Your Health
Page 4
By Barbara Bronson Gray, RN, MN
If you’re like many people, you see several health providers. In addition to a general
practitioner, you may also have specialists, dentists, ophthalmologists, and even an
emergency room doctor or urgent care provider. Unfortunately, you can’t assume one
health provider knows what the other has done or prescribed for you.
So you have to be the central communicator. Unfortunately, that role requires a fairly
high level of knowledge about medicine and the ability to get written information from
one specialist so you can send it to another.
The more complicated your problems, the more fragmented your care will be. The
average Medicare patient sees two physicians and five specialists a year, (according
to The Fragmentation of American Health Care: Cases and Solutions, edited by Einer Elhage). Those with a
chronic illness see an average of 13 physicians a year.
It's important you know that no one is picking up your medical records and automatically delivering them to the
physicians in your life who should know what's happening with you. Consider yourself the person most responsible
to collect written updates, copies of test results and lists of new and changed medications and get them to all your
other healthcare providers.
What should you do?
When you get a test result, procedure or have surgery, get the summary in writing, keep a copy, and send or
bring copies to all your other healthcare providers. Attach a simple note: "Wanted to keep you up to date on my
health status. Please put this in my chart." If it's an important healthcare issue, be sure to bring up the data
or problem at your next visit and mention that you sent a written summary for inclusion in your medical record.
Keep a list of all your medications and update it any time a healthcare provider adds or deletes a drug or
changes a dosage. Bring a copy of that list to your medical appointments and to the emergency room if you
end up there. Keep the list with you when you travel.
Don't leave your dentist or your optometrist/ophthalmologist out of the loop. They need to know the details of
your general health status. It will help them diagnose and treat any issues they may identify with you. Be sure
they know you have ALS, and if you have any infections, immune issues, heart problems, chronic conditions or
are taking blood thinners or antibiotics, as well as other medications.
If you have a test or procedure and you do not hear the results soon afterwards, do not assume the results
were normal. Call the healthcare provider who ordered the test and ask the office staff to email or send you a
written copy of the test summary. Keep a copy in your own "medical updates" file. If the test was indeed OK,
you still should have copy for reference at a later time, if needed.
If you or someone you love ends up in the hospital, your role of communicator will be even more vital. Often
multiple consulting physicians -- specialists -- are called by the admitting physician to weigh in on issues and
questions that develop while you're in the hospital. They don't always talk to each other or even realize who
has changed or added a medication, who has ordered a test, or what results are in. The more you communicate
the better. If you are being asked to go back for a test you already had or if you have questions about
what is happening, don't assume someone at the "nurses' station" has it all managed. Ask questions and be
sure you understand what tests you're getting and why. If you are being discharged from the hospital ask for
the results of any tests or procedures you had in the hospital.
These recommendations may sound a little over-whelming. But it’s usually not so hard. Just remember: Get written
copies of every test, procedure and surgery, keep a copy of each for yourself (you'll be the only person in the entire
healthcare system with a complete copy of your own medical record), and give copies to your healthcare providers.
Ask questions when you don't understand why someone wants to order a test for you. Bring a knowledgeable person
along with you to healthcare appointments, if you like.