BE YOUR OWN ADVOCATE

BE YOUR OWN ADVOCATE

OR….

WHO IS LOOKING OUT FOR YOU?

Perhaps you are sick.  Perhaps you have a more major medical problem, cancer, heart disease, or some other scary condition.  Perhaps you just want to stay healthy.  The amount of confusing and often conflicting advice can be overwhelming.

So, who do you think is looking out for you?  Someone has to put your health and wellbeing first. 

Let’s start with who is not.  First, and most obviously, your insurance company does not care about you.  They are all profit-making machines whose interest is maximizing shareholder returns.  Any advice or help you get from them is for their benefit, and if it helps you, it is totally coincidental.  You need an advocate when you try to deal with them.  This is common sense.

How about the hospitals?   Their ads will portray them as friendly and beneficent, but don’t kid yourself.  Even the so-called nonprofit hospitals now act just like the for-profit hospitals.  Their primary concern is to maximize revenues and minimize costs, usually at the expense of the patients who come to them.  Yes, all of these hospitals have many individual employees who are truly dedicated to doing the right thing and who will try to help you.  However, they all need their jobs, and they are constrained by corporate policies and rules.  There is only so much they can do for you.

Further, there are an unfortunately large number of hospital employees to whom it is only a job they have to spend time in to collect a check, and you are only an inconvenience in their day.  When you deal with a hospital these days, expect hassles and confusion.  You need an advocate to stand up for your interests.  Again, common sense.

Then there are the physicians.  These are the ones you should be able to trust to watch out for you.  Indeed, almost all physicians went into medicine because they truly wanted to spend their lives helping others.  And often they do so, but we all need to be careful. 

For anything serious, you are almost certainly going to be dealing with a specialist.  Specialists, as you probably understand, make most of their income from certain specific procedures or treatments.  Naturally, they have a bias toward those procedures and treatments, and they will strongly push them on you.  If you have been referred to the specialist because this treatment is exactly what you need, this is fine, and convincing you to go along with the treatment that will help you the most is a real service to you and your best interests.  We are almost always frightened and reluctant to undergo a course of treatment that will be uncomfortable, potentially dangerous, and usually costly.  A good specialist needs to be an effective salesman, convincing you to do what your body really needs. 

On the other hand, in most cases there are several reasonable alternative treatments.  The specialist will almost always try to sell you on the one he provides.  Naturally.  Don’t expect the Ford salesman to point you toward a Chevy. 

To make things worse, in recent years, more and more specialists have been forced to give up private practices and become employees of the Hospitals or large groups.  They are no longer truly free to advise you as they might, because they are constrained by corporate policies and often rewarded financially for directing you to treatments the maximize the revenues of their employer. 

You will need to sort this out and ask hard questions.  Again, you need an advocate.  In years past, this might have been your primary care physician.  Unfortunately, today’s reality is that an increasing proportion of primary care physicians are also becoming employees, often of the same hospitals and systems that employ the specialists.  They are pushed to feed the employers specialists, no matter their real feelings.  Even independent primary care physicians are now overseeing groups of employed providers, and the only way to make any money, or even survive, is to move you through their system quickly and efficiently.  They just do not have the time or inducement to advocate for you. 

So where can you turn?  The answer is “inward.”  You need to become your own advocate.  Nobody else has the vested interest in your health that you do.  Listen to the opinions of your physicians, think about them, and then take the time to study your situation and think about what makes sense to you.  Getting a second opinion was always the advice you heard, and it can be good advice, but only if you take the time to research your condition and your options.  The internet is filled with erroneous and misleading articles and sales pitches.  However, it is also an invaluable resource, with good and scholarly sites and articles. 

Read about your condition and options.  Usually, your research will support their recommendations and set your mind at ease.  However, sometimes you find other options that seem to make at least as much sense.  You have a right to insist that these be discussed and explained to you.  I encourage the people I treat to make printouts of anything they really want to talk about.  Admittedly, many physicians will feel threatened by this approach and will not want to answer your questions or discuss the options you have found.  Others will simply not want to spend the time doing so. 

In my (humble?) opinion, these are the physicians who are not looking out for you.  In the decades I spent as a specialist doing procedures, I came to firmly believe that people do much better if they fully understand their disease and the proposed treatment, and really buy into the plan so they can intelligently help in their own care.

The bottom line: There is only one person you can trust to truly watch out for you.  You need to become your own advocate.  If you do not feel up to the task, do the best you can, and try to enlist some family member or close friend who is willing to put the time and effort into doing the research, going with you to appointments, and dealing with the emotional strains an advocate encounters. 

The best person to look out for you is…YOU.