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Contract with your Doctor

by Maia Wroblewski

Maia, a senior in high school, has a lot of experience with doctors and hospitals. As a result, she has developed a unique agreement with her health care provider, a contract! In this fact sheet, she shares her advice for creating one with your doctor.

WHY DO YOU WANT A CONTRACT
A person might not think that a contract with a doctor is necessary, but it can come it handy. As a person with an illness I can become sick very suddenly. I find myself constantly seeing doctors, and going through procedures that many people do not.

During one unfortunate time, I became sick after the procedure, and had to be hospitalized. I was sick, tired, and did not want to be talking to a bunch of doctors who wanted to know everything. After a night of fluids I felt better, I was hungry, and I wanted to eat, but the doctors felt this was not a good idea. They were not my normal doctor so they did not know that denying me food was also a problem. So because I could not eat my condition became worse. I was hospitalized for three days, and it was something that could have been avoided, if the doctors had listened to me.

I decided that I was not going to let something like this happen again. I have a very good relationship with my doctors, and I did not want my health, and our different perspectives to ruin that. So, my doctor and I have an agreement. This agreement works for both of us, and allows some room for discussion. I would suggest a working agreement, or contract to anyone who would like to have an understanding with their doctor, or feels that they are not being listened to.

HOW TO MAKE A CONTRACT
In the first steps of making a contract the patient, and the doctor need to arrange for some time to talk. Things that should be addressed during this time are:

  • the rules that you will follow;
  • things you will agree to do, or not do, as well as the doctor; and
  • other specifics that apply to you.

The meeting will also allow you and your doctor to talk about how you feel, and to gain an understanding of your needs

Once you have this meeting, then the contract must be written up. I would suggest that the patient be the one to write up this contract, because it gives them the control. The contract should be fair, and include everything that you and your doctors have talked about. Then, the doctor and patient must sign the contract to make it clear that both of you agree.

One thing that I have found helpful, is a bio sheet. When you are sick, or don’t feel like talking to doctor after doctor, a bio sheet is handy. The bio sheet can include your medical background, along with an up-to-date medication list, and past problems. This eliminates the same old questions doctors always ask. You can keep this information, along with the contract in a folder, and you should be the one to hold on to it. That way you always have it.

A REMINDER
A contract is something that both you and your doctor should follow, but patients do have to remember that doctors are more informed in the medical profession than we are. That is why they are doctors, and so if it turns out that he needs to break your contract for medical reasons, the doctor should be allowed to. The contract is only there to make sure that both you, and your doctor communicate, and understand each other.

A WORKING CONTRACT
Contracts come in handy when you are sick, and don’t feel like talking to doctors, or when you want to make sure that a doctor is completely informed before making a decision to do something. Working contracts are a very useful thing.

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Keeping a Health Diary

by Maia Wroblewski

Maia, a college student, finds that keeping a health diary helps her be independent and take over her health care. She uses the diary to track her health to best inform her doctors, her family and herself.

A health diary is not a normal diary, nor is it like a care notebook. A health diary is a way for you to keep track of patterns in your health, your diet, and other factors. My first health diary was on a calendar, however, they don’t give you a lot of room to write down information. I switched to a notebook, but a date book with one day per page would also work. Write the days down and keep track of anything new or unusual you might eat. Also keep track of anything else you feel is important to your health. It could be things such as; the time of day that you are feeling sick; when you take your medications; or specific symptoms that you have. How specific you are depends on how much information it is important. If you are trying to find the cause of a problem such as an allergy or a medication reaction you will probably need to be very specific. I also use it to help me remembers whether or not I took my medicine. It helps to be consistent on what you report in your notebook. It is best to write the note as soon as you notice a symptom or take a medicine. You may not be as accurate if you wait. Using the same descriptions and taking the time to describe things clearly will help you as you refer back to your health diary.
Why is this important?

If, like me, you have problems that can sometimes leave you stumped it is nice to have an idea of any patterns that take place. For example, I began having “unexplained” pain and could not figure out what the cause was. I changed my medications, tried different doses, and nothing changed. I was itchy, sick and uncomfortable. I began keeping track of my health during the changing of my medication. I also tracked my diet, and the times of the day I began to get sick. I was able to chart all three things together.

It seemed that whenever I ate I would then feel sick 1-2 hours later. I showed this information to my doctor, and he referred me to an allergist. The allergist observed my health diary and was able to suggest that I might be allergic to soy, and not milk. This was the opposite of what we believed at the time. I tried each type of milk in a controlled environment, and discovered that I was, in fact, allergic to soy. My health diary really paid off.

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Tips on Preparing for a Doctor’s Appointment

Kellie Haigh is 25 years old. She lives in Oxford, Iowa.

Going to a doctor’s appointment can be stressful.  It helps me if I prepare for the doctor’s appointment before I go.  Here are some tips on information that you need to get together before you go to the appointment.

  • Gather your insurance information.  You need to bring your insurance card with you to your appointment.  The receptionist will make a copy of this card.  This card has information that tells the doctor’s office staff who is responsible for paying the bill for your appointment.  Some people have more than one type of insurance.  For example, you might have private health insurance and Medicare. If you have more than one type of insurance, knowing which health insurance is your “primary insurance,” the insurance the doctor’s office bills first, is important. Be sure and bring all of your insurance cards with you to the appointment.
  • Make a list of your medications.  The doctor needs to know all of the medications that you are taking.  Write down the name of the medication and the number of the milligrams that you take.  Also, write down how often you take it.  You can find all of this information on the medication bottle.  It is also a good idea to write down the reason that you take the medication.  This is helpful to the doctor because some medications are used to treat more than one condition.  Also, be sure and include on your list any vitamins or herbal supplements that you take. 

  • Think about your health history.  Take some time to think about your health history and what you need to tell the doctor about your health history.  Have you had any major surgeries?  Have you been hospitalized?  Have you been treated for any other serious medical conditions?  Write down when these events happened so that it is easier to remember to tell the doctor. 
  • Think about your family’s health history.  Doctors often ask about your family’s health history.  Knowing your family’s health history will help the doctor treat you.  This is because if someone in your family has an illness, then you may be at higher risk for it.  If you are at higher risk, then the doctor can monitor, or check you over time, for that illness.  It is much easier to think about this before you go to the appointment.  Has anyone in your family had a major illness, such as cancer, diabetes, or heart disease?  It is okay if you do not know the answer to these questions.  If possible, you might want to ask a parent or other relative if they know about your family’s health history.  Be sure and write down what you find out, and bring it with you to the appointment. 

You have prepared for the appointment, and now you are at the doctor’s office.  Here are some tips about the information that you want to get from your doctor during the appointment. 

  • Take notes during the appointment.  It is hard to remember everything that the doctor says, so it is important to write it down.  Don’t be afraid to ask the doctor to stop for a moment so that you can take notes. 
  • Ask questions about prescriptions.  If the doctor suggests a new medication, ask questions about it.  What is the prescription for?  How long does it take to start working?  How will you know when it is working?  Are there any side effects that you should know about?  How much of the medication are you supposed to take?  How often do you take it?  What does the doctor want you to do if you have a problem with the medication?  How much does the medication cost?  Will your insurance pay for the medication? Be sure and get all of your questions answered about the medication before you leave the doctor’s office. 
  • Ask questions about tests.  If the doctor wants you to have a medical test, make sure that the doctor tells you all about it.  What is the test for?  What kind of information does the doctor think the test will provide?  Will your insurance pay for the test?  If the insurance will not pay for the test, how much will it cost?  What does it feel like to take the test?  Does it take a long time?  

You have the right to know these things before deciding whether or not to have the test. 

  • Get copies of your medical records.  You have the right to get copies of your medical records if you want to read them.  You will have to sign a release to get the records, and you will have to pay to have them copied.  If you have questions about your records, then you can always ask for a copy.

Resources:  See “KASA Surviving a Doctor’s Appointment” and “KASA Keeping Track of Health Care Information,” both available on the KASA website.

Este documento en español.

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Your Rights at the Doctor’s Office

Author Kellie Haigh is 25 years old. She lives in Oxford, Iowa.

Doctor appointments to manage your health care should be done in partnership with the doctor. Sometimes it can be hard to know what your rights are and how to advocate for those rights. Below are some of the rights that you have when you are at the doctor’s office.  

You have the right to privacy and confidentiality.  Under the law, your doctor cannot give anyone your healthcare information without your knowledge and permission. This includes your parents. Doctor’s offices will often use the terms “privacy” and “confidentiality” to explain their policies regarding keeping your information. This means that the doctor must keep your healthcare information secret from anyone else unless you give your permission in writing by signing a form for them to share it. There are a few exceptions to this law regarding privacy and confidentiality. If you tell your doctor that you are planning to hurt yourself or planning to hurt someone else, then the doctor is required by law to tell someone and get you help. Except in these situations, your doctor cannot share your healthcare information without your permission in writing, by signing a form. Signing a release form is a choice; you never have to sign a release form.

You have the right to bring someone with you to your appointment.   It is helpful to have someone with you at the appointment. This person can provide support for you during the appointment. They can also help you focus the conversation with the doctor. Also, the person can help you remember and take notes about what the doctor says.

You have the right to have the doctor explain what he/she is doing when he/she is examining or touching you.  When the doctor comes into the exam room, tell the doctor that you want to talk with him/her before they start doing the exam. It can be hard to talk to the doctor about your questions or concerns while they are doing the exam. Say that you want to talk before the exam starts. Use this time to talk to the doctor about your questions or concerns. Ask your doctor to tell you what they are going to do before they start the exam. You have the right to know what the doctor is going to do your body. Ask the doctor to explain what is happening during the exam. It is your body, and you have the right to have your questions about the exam answered, and you have the right to say “no” to an exam if you do not agree that it will be helpful. You also have the right to ask other people such as residents, researchers and medical students (anyone in the room besides your doctor) to leave the room at any time. 

You have the right to ask questions and have them answered.   Your doctor is getting paid to work for you. The doctor is there to meet your needs and answer your questions, so speak up if you don’t understand something. This can include questions about things like treatments, tests or medications. You have the right to ask about risks and side affects of different treatment options and/or what to expect if you do not choose treatment. Don’t be afraid to ask the doctor to slow down or explain something further. That is the doctor’s job.  
It is important to ask this person to not talk to others about what the doctor said or how the appointment went. Remind them they are there to support you.

You have a right to age-appropriate exams.   This means that your doctor should be giving you the same exams as he would anyone else your age. Sometime doctors assume your life experience is different because you have a disability. Ask the doctor what exams they would be giving other people your age (physicals, gynecological exams, etc.).

You have the right to be treated with respect.  If your doctor does not treat you with respect or you don’t like them, consider finding another doctor. You deserve to be treated with respect by your doctor.  

You have the right to decide not to follow the doctor’s advice or to get another opinion.  You are the one who has to live with the decisions related to your health care. It is okay if you decide to not follow your doctor’s advice. It is also okay to decide that you want to talk to another doctor to get a different opinion on the healthcare issue you are facing. 

You have the right to a copy of your medical records.  This can be important for your information or to show other doctors the treatments and medications you have tried in the past. Note: Some doctors may charge a fee to make copies. 

Resources:
These two resources may not be the most youth-friendly, but they do include some good information:

Este documento en español.

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How to Survive a Doctor’s Appointment

Kellie Haigh is 25 years old. She lives in Oxford, Iowa.

I have been a disabled girl for the past ten years (fibromyalgia and migraines), and over that time, I have seen hundreds of doctors.  Because of my disability, I have had to learn how to deal with making and going to doctor’s appointments.  Here are some of the things that I have learned along the way. 

Step 1: Make the doctor’s appointment at a good time of the day for you.  Studies show that doctor’s offices are not as busy first thing in the morning and right after lunch.  In planning for what will work best for you, you should make the appointment at the time of the day that you are most likely to feel your best.  For example, I am not a morning person, so even if my doctor is less busy in the morning, I am not going to make my appointment then.  You can ask the person who is making the appointment for a certain time of day, and they should tell you what is available.  Go when you are going to be at your best. 

Step 2: Before the appointment, write down the reason for the visit or any questions that you have for the doctor.  Is this just a check-up appointment?  Then think about how you have been feeling before you go to the appointment so that you can tell the doctor.  Do you have any questions about medications?  Are there any other problems that you are having?  Write these down before you go.  It will be easier to remember everything that you want to talk about if you write it down. 

Step 3: Do your homework.  I have learned that I often get the best care from my doctor if I do my own research before the appointment.  For example, if I am having a certain problem, I will often learn about the possible treatment options before the appointment.  I will learn about these options by going online or looking at the library.  By knowing about various treatments, I can better talk to my doctor during the appointment.  I can also ask my doctor about certain treatments.  As the patient, you do not have to do this research before the appointment, but I have found that I get better medical care if I look into the treatment options before I talk to my doctor. 

Step 4: If possible, bring someone with you to the appointment.  It is helpful to have someone with you at the appointment. This person can help you focus the conversation with the doctor.  Also, the person can help you remember what the doctor says. 
It is important to ask this person to not talk to others about what the doctor said or how the appointment went. Remind them they are there to support you.

Step 5: Know your info.  When you go to the appointment, you will have to fill out forms with your health history, medications, and insurance information.  Make sure that you know all of this information, or write it down and bring it with you.

Step 6: When the doctor comes into the exam room, tell the doctor that you want to talk with him/her before they start doing the exam.  It can be hard to talk to the doctor about your questions or concerns while they are doing the exam.  Say that you want to talk before the exam starts.  Use this time to talk to the doctor about your questions or concerns that you wrote down and bought with you.  Talking before the exam can also help make the exam more effective.  This is because the doctor can know what to look for during the exam if you state your questions and concerns before the exam starts. 

Step 7: Speak up if you have questions or don’t understand.  Your doctor is getting paid to work for you.  The doctor is there to meet your needs and answer your questions, so make sure to speak up if you don’t understand something.  Don’t be afraid to ask the doctor to slow down or explain something further.  That’s the doctor’s job. 

Step 8: Write down what your doctor says.  It is hard to remember everything that the doctor says, so it is important to write it down.  Don’t be afraid to ask the doctor to stop for a moment so that you can take notes.  Note taking is also a great job for the person who comes with you to the appointment. 

Tips:
Remember that your doctor works for you.  If your doctor does not treat you with respect or you don’t like them, consider finding another doctor.  You deserve to be treated with respect by your doctor.    

You are probably going to have to wait for the doctor, so bring something to do.  Bringing something to do makes waiting for your appointment with the doctor less frustrating.  So bring something like a book, magazine, or music to listen to while you wait. 

Best of luck to you at your next doctor’s appointment!

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Switching to an Adult Doctor

Now that you have finally gotten used to your doctor, you have to pack up and leave because you have turned 21. Planning is the key to being happy with your new doctor. 

  • Start looking for a new doctor before you turn 21. This will keep you from rushing to find someone to take care of your health needs.
  • Make sure that you have your records sent to your new doctor.
  • Ask your doctor if he or she knows of an adult doctor who may be good for you.
  • When you have an adult doctor in mind, see if you can schedule a time to meet with him or her and ask questions.
  • Remember that you do have the right to privacy and can talk with your doctor alone if you need to.

 

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