The Patient Speaks!

Made a huge mistake today.  I opened the mail.  No bills thankfully, but something far worse.  It was a “notice” from my health insurance carrier that the terms are, once again, changing.  Between wife’s policy and my own, this seems to be a common thing.  In the insurance companies quest to drive down costs, a lot of pressure is brought to bear upon its clients to use generic medications.  As a generality, I have no problem with that.   The insurance company is in business to make money.  That is the whole point of being in business.  My frustration is two-fold:

After decoding insurance-speak of “non-formulary brand”, “formulary brand alternative” and “tier 1, 2 or 3 payment levels”, it seems that an ever escalating list of medications I take are “tier 3″ meaning my copayment is at the highest level – meaning an ever increasing dent in the family budget.  Plus,

As a generality, I get along fine with generic medications.  However there are two in particular struggle with.  I take great issue with the following statements in the insurance company’s notice: “Remember, the generic medications work the same as brand name drugs – in dosage, strength, performance and use….”  Well, no, they do not in my personal experience.  One drug I take is a statin for which there is no generic.  I have taken other brands and generics of statins with severe allergic results.  In my case, there is no alternative.  Insurance company response?  While diplomatic, the end result is “tough”.  For another medication, I have better results with the brand name but have chosen to tolerate the generic as there is a huge difference in the cost, so I deal with the side-effects.  So, if the medication is “the same”, why does my body react differently?  Apparently it is the “fillers” used to package the active ingredient(s).  Treating the human body is not an exact science as everyone reacts differently.  In my experience, every medication, including over the counter, has side-effects.  Even an aspirin.

Do I have a magic solution?  Of course not.  No matter what type of healthcare system we have there will be rules.  If there are rules, someone will be an exception (I excel at that).  If a rule was written that was so broad it included every human contingency, there would be no point in writing the rule.  Plus, an open-ended system would be impossible to fund.  I told you I made a big mistake today by opening the mail.  Now I have a headache.

Here’s a headline that immediately caught my eye: USA Today Wednesday July 25, 2007 Communication now part of the cure – “Movement has begun to help doctors listen and patients understand” by Erin Donaghue.  My first thought was “well, duh”.  I mean, doesn’t everyone who sees the doctor communicate with him or her?  In a blink I answered my own question with a resounding “no”.  Thinking back to childhood (OK, way back), I can remember it took Mom or Dad to give their interpretation of what was ailing me to the doctor as I didn’t want to be there in the first place, never mind the medical dilemma.  Very little patient to doctor communication going on there and therefore I sometimes suffered just as much after the visit because I wasn’t being properly addressed.  After high school, I enlisted in the United States Air Force.  Only time I went to the doctor was when I was ordered to because, after all, I was an Airman and I can tough it out.  Therefore very little communication and a whole lot of flu.  Post military I met my true love and got married.  My outlook on life began transforming into an adult’s (very excruciatingly slow process according to some who knew me).  I started to open up to the doctors and explain just exactly what was ailing me.  Perhaps this happened as I was now responsible for the bill?  But I noticed a different phenomena happening.  Some doctors – not all – seemed to make a speed game out of the office visit.  The faster the doc could get into the examining room, scratch out a prescription and back out, the better.  I had a mental image that a nurse was just outside the door with a stopwatch.  Eventually, as I matured (again, questionable to some) in my medical travels, I began to understand that my physical – and mental – health was greatly enhanced by a good, solid line of communication between the medical professional and myself.  This includes the nurses, technicians, therapist’s and even the desk clerk.  I would leave the office satisfied that my questions were thoroughly answered instead of that nagging annoyance that I should have asked this/that.  Whenever I meet a medical professional that will not give my concerns the proper attention, I’m out of there and seek out one that will.  As I have written before, when seeing a new doctor, I come armed with a complete listing of my medications, who prescribed them, what the dosage is and what pharmacy I buy them from.  In my experience, the doctor takes me more seriously from the beginning.

As evidenced by the newspaper article, the medical community appears to be making communication more of a priority.  Faye Deich, chief nursing officer at Sacred Heart Hospital in Eau Claire, Wisconsin is quoted as saying “The main thing we’re trying to do is listen to our patients”.  Further, “We ask each patient what good care means to them, and that’s communicated to the staff” “If patients know you are there for them, they are more likely to tell you if something doesn’t seem right”.  For me, beyond the immediate care concerns, if I have a positive experience with the staff, I would be more likely to return if I have further need for their services.  In large cities, there are many choices for medical care.  Just as in taking my car in for repairs, I will go where I get the best attention and expertise.  That takes communication from both parties.  The mechanic can’t fix the car unless I tell him what’s wrong.