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Bob Livingstone, LCSWBob Livingstone, LCSW
Healing Emotional Pain and Loss

We Must Manage Our Own Healthcare

Bob Livingstone, LCSW Updated: Aug 14th 2012

There are many recent news stories about health care because of The Supreme Court's decision that the Affordable Care Act is constitutional.

doctor talking to patientThere is controversy regarding this program raised by all political view points. There are several positives about it including covering more people, ending preexisting conditions, the end of lifetime limits of coverage and covering adult children until they are twenty six years old.

The present system doesn't work on many levels. It is not available to everyone, it is expensive for individuals to pay for and difficult to navigate. No matter if we have Obamacare, Romneycare or some other some other health care program; we must be responsible for managing our own health care.

Managing your own healthcare means that you are assertive enough to ask physicians questions when you are not clear what they are talking about or if you disagree with their opinions. It means being clear when your medical needs aren't being met and a willingness to understand how your health care system operates. Managing your own health care means reaching out to professionals and others who have experienced difficulties obtaining the help they need.

Gone are the days (if they ever really existed) when we can passively rely one hundred percent on doctors to provide us with information needed to make decisions about our health care.

Many of us have experienced doctors either not knowing what the cause of our medical problem and/or being referred out to a specialist for an additional assessment.

It is very rare when primary care physicians look at all your health issues and identify a main cause for multiple health problems.

Many patients, even if they have premium insurance plans, discover there are high hurdles in obtaining necessary tests such as X-rays, CT scans, MRI'S, various blood tests and bone scans.

Another obstacle to good medical care is the length of time it takes to get an appointment with a sought after physician. There are many great doctors who are skillful and caring. It is not uncommon to wait two to three months for an appointment. In the meantime, your condition worsens and you may have to be hospitalized.

One of the major failures of the present health care system is that the primary care physicians know about health problems, but they are not as knowledgeable about specific health issues as specialists are. The specialists only know their specific area-hip doctor, back doctor, vascular surgeon, oncologist, allergist, cardiologist, etc.

Therefore if you have one group of doctors that doesn't know enough about specific illnesses and specialists who only know their area, who is in charge of pulling all your health information together to determine what may be central to your health crisis that may include several illnesses? Too often the answer is no one and this is a huge incentive to manage your own health care.

Ways to Manage Your Own Health Care:

  • Write down questions you have for your physician before your appointment. Don't be afraid to give him a copy and read the list while he reads along with you. Take your time and write down the answers so you can ask follow-up questions.
  • Bring a trusted friend or partner with you to the doctor's appointment. It is important to have a second set of eyes and ears at this time because you may be too overwhelmed to ask pertinent questions and process information the doctor is sharing with you.
  • If the doctor refers you to a specialist, ask her if she will be communicating with the specialist and if the specialist doesn't find the cause of your health problem, what will the next step be?
  • If you have the sense that any of your doctors doesn't have your best interest at heart, request another physician. There is a great sense of feeling unsafe if you don't trust your doctor. If you feel unsafe, don't beat yourself up. There is probably good reason you don't feel comfortable with this doctor. Finding a physician with great skills and who makes the effort to listen to you is a reasonable goal.
  • If your doctor makes a diagnosis or recommends heavy medication or surgery, feel free to ask for a second opinion. This is standard patient practice and you shouldn't worry about hurting the doctor's feelings or fear that you are questioning his competence. It is not only your right to make this step; it will also either confirm or invalidate your doctor's assessment. If you get a totally different assessment, you may want to seek out a third opinion.
  • If your doctor says that your health condition is caused by stress, tell her that you know that stress can aggravate most medical conditions. Stress is also a normal reaction to having a health crisis. However, stress is not the cause of most health issues. Patients often feel that physicians state that stress is the cause for your physical disorder because the doctor doesn't really know what the cause of the health problem is. Insist upon a reason other than stress causing the health problem.
  • Reach out to your friends and other professionals in order to understand how to best access your health care system. Your friends may have experienced the problems of fragmentation and indifference from the health care industry. It does seem that every family has a horror story about this. They may have learned who and when to contact when you feel that your needs aren't being addressed.
  • If you feel that you need more testing to determine your diagnosis and you doctor disagrees, write him a letter and state, "I feel that I need an x-ray to discover why I am feeling this pain in my back. Please respond to me in writing why you feel that I don't need this x-ray. Thank you." The doctor then has the option of responding to you in writing why he doesn't believe you require an x-ray or he can call the radiology department and order this test.
  • If your doctor feels that you need medication, ask her about the side effects and what percentages of patients get the side effects. You can also ask if there any alternatives to medication such as supplements, exercise or relaxation exercise.
  • If you feel like your doctor is rushing you through the appointment, tell him that you have some questions that you would like him to answer before terminating the visit. It is common for physicians to have a set amount of time per patient visit. Don't be afraid to ask your doctor to spend as much time with you as needed.
  • If you are not clear about what your diagnosis and what the treatment plan is, keep contacting your doctor via phone, email or letter until you get the answers you deserve.
  • If your doctor originally states, for example, "I believe that your symptoms indicate that your heart arteries are blocked. I will have tests run to determine if that is correct." If all the tests come back negative, ask him what else could be causing your shortness of breath if your arteries are not blocked?
Bob Livingstone, LCSWBob Livingstone, LCSW, has been a psychotherapist in private practice for twenty-two years. He works with adults, teenagers and children who have experienced traumas such as family violence, neglect and divorce. He works with men around anger issues and with adults in recovery from child abuse. He is the author of two critically acclaimed books: Redemption of the Shattered: A Teenager's Healing Journey Through Sandtray Therapy and Body Mind Soul Solution: Healing Emotional Pain Through Exercise and his newly released book Unchain the Pain: How to be Your Own Therapist. For more information visit

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