Finding Good Health Care

You can start by building a relationship with a primary care doctor, such as a family practitioner or internist. Because there are no industry standards for health care quality, a primary care doctor can ensure that diagnostic tests and treatment recommendations from other doctors are appropriate based on your history and health problems. A long-term relationship with your primary care doctor results in consistent treatment that meets your needs. Such coordinated care improves the quality of your care and lowers costs.

Concerned consumers of any products need accurate, up-to-date information to judge the quality of their purchases. The same is true for health care consumers. Most of us hold on to old ideas from the days when we followed the doctors’ orders without question. Times have changed, and so should our attitudes about health care.

When it comes to your health, there are basically four health care providers that have the best chance to offer you successful treatment and prevent problems. Understanding how each of these contributors can influence your choices is the first step in finding quality care.

• You. Many people believe that the doctor’s role is to manage their health care. But when it comes down to it, you are the one who does the real managing. You decide when to seek care and whether or not to follow your doctor’s advice. You also decide how to live your life—whether you will exercise, what foods you will eat, and what risks you will take with your health.
• Your doctor. Doctors can guide you to better health. But they can’t cure everything. Our doctors are our link to medical science, but they might not always have the answers. A good doctor will admit uncertainty and seek help and advice from other health care professionals when needed. Keep in mind that more treatment, testing, or medication doesn’t necessarily mean better care. And no matter how good your doctor is, all medical care involves some risk.
• The pharmacy. Whether it’s self-care, over-the-counter remedies, or a prescription drug, your pharmacy is often the place to find the tools you need to control or relieve illness. Pharmacists can guide you through the maze of over-the-counter drugs. They can also give you clear directions on how to care for minor problems yourself or how to follow your doctor’s advice on prescription drugs.
• The hospital. In the past, most medical tests and surgeries were performed in the hospital and often required an overnight stay. Advances in technology, changes in philosophy, and findings indicating that people tend to recover more quickly at home have led the way for many forms of minor surgery and laboratory tests to be performed on an outpatient basis. When hospitalization is needed, recovery often comes more quickly if you return home as soon as you are medically ready, rather than staying in the hospital an extra day or two.

Choosing Necessary, Appropriate Care

Wise health care consumers choose only needed and appropriate health care services. But just what is needed and appropriate when it comes to health care?

Needed care is health care required to improve or preserve your health. Getting childhood vaccinations, setting broken bones, and treating serious infections are all examples of necessary care.

Appropriate care means weighing your options and choosing procedures that are suited to your circumstances. Appropriate care is different for everyone. If you have severe headaches, appropriate care might be as simple as pain relievers and relaxation exercises. If your headaches and other symptoms make your doctor suspect a serious problem, such as a brain tumor, expensive tests and procedures such as computed tomography (CT) scans, magnetic resonance imaging (MRI), and surgery may be considered appropriate care. Appropriate care doesn’t mean you can’t have expensive tests when you need them. It means not having an MRI when an aspirin will do the trick.

Fortunately, health care financing has changed enough in recent years that expensive, inappropriate, or repeated procedures are seldomly recommended. Practice guidelines and managed care policies have reduced waste in past years. Consumers need to find a balance between protecting their right to receive needed care and refraining from asking for excessive treatment. In the end, we all must pay for inappropriate care through higher medical costs and insurance rates. In fact, that kind of wastefulness is a major reason why our medical costs have skyrocketed.

In part, we’re paying more for health care because we’re getting better, faster, or more effective medical services. We’re also paying more because new technologies and procedures are overused.

What You Can Do

The best way to track down high-quality, reasonably priced medical care is by becoming an active, prudent consumer. This means:

• Staying healthy through lifestyle choices, exercise, nutrition, and preventive health care that can reduce the risk of needing treatment
• Asking questions and gathering information, so that you can actively participate in decisions about your health
• Asking health care organizations for information on how they compare with industry standards and with other health care organizations

A New Direction

Your role as an active consumer is to seek a medical group that is continually improving the quality of health care. Such a group will focus on weighing the results of patient care, using a single medical record that contains your complete medical history, and developing medical practice guidelines. The successful health practitioners of the future will not only follow standard procedures for care, they will be able to show why their approach is more effective than other approaches. Staying informed as new options in health care arise is one of the best ways to keep your own health care headed in the right direction—toward higher quality and lower cost.