TIPS for getting good quality health care before, during, and after a health care appointment
If you need help or advice right away, call the “nurse advice line” or “medical help line” at your health plan or doctor’s office. Get ready for your appointment by looking for information to help understand your health condition, symptoms, or treatment choices. Make a list of questions you want to ask and write down health information such as medications you are taking and allergies. Take these lists to your appointment. Consider asking a friend or family member to go with you to your appointment.
Ask plenty of questions – and if you don’t understand the answers, ask again. It can be hard to absorb what your health provider tells you, especially if the information is complicated or includes technical medical terms. To double check your understanding, it helps to repeat what you’ve heard using your own words. Take notes to help you remember what was said and what you need to do.
Whenever you start new medication or treatment, watch carefully for possible side effects or other problems. Find and use information to help understand your health condition and treatment. If you have a long-term health condition, learn ways to stay healthy with your condition and get the support you need.
Your Health: Fact Not Fiction How To Be A Smarter Patient And Live Longer
This information is meant help you become a smarter, more active patient. We hope it will help you understand when tests and treatments are necessary — and when they aren’t.
High value care: What is it? “High value care” describes health care in which the benefits outweigh the harms and costs. It is customized based on the values and concerns of each individual patient. It is not about rationing… it is about being rational. And, it can be different for every patient — there is no “recipe” book, when it comes to health care for all.
FACT: The United States spends more than
$700 billion every year on unnecessary tests and treatments.
FACT: In the United States, we use medical tests
more than other developed countries, but we are not healthier. We have a lower life expectancy than 21 other developed nations.
Why less might actually be more Some tests and treatments might have risks that outweigh their benefits including: • Pain
Medical tests and treatments are not perfect, and risks and expenses are often underestimated
• Radiation exposure • False positives* • Unnecessary treatment • Overdiagnosis** • Anxiety • Missed work
Medical technology should be used selectively on a patient-by-patient basis. More is NOT always better
• High costs • Complications * A "false positive" is when a test is wrong by saying that you have a disease you don’t have, which can lead to further invasive testing. ** "Overdiagnosis" is when a test gives you a diagnosis that is unlikely to ever affect your health, and it may be better not to have the test at all, particularly when it results in unnecessary treatment or testing.
High value care
Benefits Harms Waste
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Your Health: Fact Not Fiction How To Be A Smarter Patient And Live Longer
General Guidelines For High Value Care & Better Health To Do List
To Question List
Hypertension Screening Why: Treating hypertension has proven benefits for preventing strokes, heart disease and kidney disease.
Cholesterol Screening Why: This screening can help inform treatment plans for people who have risk factors for heart disease.
Colon Cancer Screening Why: Early detection helps decrease mortality from colon cancer.
Glucose Screening
? Imaging Tests for Nonspecific Low Back Pain Why: Test results will not change your course of care in the first 6 weeks. ? Imaging Tests for Headaches Why: Usually, information offered by the patient is enough to make a diagnosis. This test rarely provides useful information (less than 1% of the time); has a high false positive rate (20-30%); and if it is done via CT scan, results in radiation exposure. ? Antibiotics for Sinusitis Why: Most sinus infections are viral, which do not respond to antibiotics.
Why: Often in the early stages of diabetes, symptoms are not prominent, but early treatment leads to much better outcomes. Why: Early detection and treatment for HIV saves lives.
? Pre-Operation Chest X-Rays Why: For patients without breathing problems, the test does not improve surgical outcome or patient safety, and is an unnecessary radiation exposure.
Depression Screening
? Routine Electrocardiograms (for asymptomatic,
Universal HIV Screening (once)
low-risk people)
Why: Treatment can improve one’s quality of life.
Why: The chance of low-risk individuals having silent heart disease is tiny.
Screening for Smoking, Alcohol, Drug Use Why: These behaviors affect overall health and can lead to problems at work and at home.
IF you are male:
Flu Vaccine (yearly) Pertussis/Tetanus Vaccine (every 10 years) IF you are female:
? Prostate Specific Antigen Screening Why: There is controversy and conflicting data over whether the screening has an impact on saving lives.
Screening tests not recommended:
Pap Smear (every 3 years) Why: There is no benefit from annual pap smears. IF you were born is the U.S. between 1945-1965:
Hepatitis C Screening Why: Early detection and treatment of Hepatitis C saves lives.
✕ ✕ ✕ ✕
IF you are 65 years or older or smoke cigarettes, have chronic heart or lung disease, diabetes, alcoholism, cirrhosis or immune problems:
Pneumovax Vaccine
Total body scans Pelvic Ultrasound Ca 125 CEA
Everyone is different. The example guidelines here, as well as other tests and screenings, should ALWAYS be discussed with your healthcare providers.
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Your Health: Fact Not Fiction How To Be A Smarter Patient And Live Longer
Engaged Patient: What It Means Being an engaged patient means being an active and vocal partner in your health care. It means knowing your health history, values, and individual concerns, and discussing them with your doctors. It means knowing you have the right to ask questions, and not being afraid to ask them.
Why be an engaged patient?
Some key questions to ask about tests
• Better chance of receiving high value care
1. Is there a true benefit to doing this test?
• Less chance of being overdiagnosed
2. Will the results change my treatment? 3. Is there an effective and safe treatment for the disease?
How to be an engaged patient 1. Collaborate with your healthcare professionals
4. Do the benefits of finding and treating the disease outweigh the harms associated with testing and treatment?
2. Know your health history and medications
5. Would it be better to wait and see what happens?
3. Be prepared with your questions… and don’t be afraid to ask them!
Keys To Longer Life: How to Live Longer Those who live to be 100+ tend to live in larger households, live close to their children, eat lots of vegetables, be optimistic, educated, and married
Start with your diet
Be sure to exercise
✓ Eat more fruits and vegetables ✓ Eat more whole grains ✓ Eat more fish, less red meat ✓ Drink more water ✓ Include low-fat dairy in your diet
erobic activity A 30 minutes 5 days every week
uscle strengthening activity M 8-10 exercises 2 or more days every week
tretching & Flexibility S 10 minutes 2 or more days every week
Be sure to be engaged Connect, Communicate, Collaborate with your healthcare providers to: ✓ ensure you receive high value care ✓ avoid being over-tested, over-diagnosed, and over-treated
and most importantly… ✓ g et the best possible care for you and your loved ones!
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Your Health: Fact Not Fiction How To Be A Smarter Patient And Live Longer
Using This Information This information is provided for you to use in discussions with your health-care provider. The content is for educational use only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health-care provider about any medical condition. Never disregard, avoid, or delay in obtaining medical advice from a healthcare provider because of something you have read in this report. Use of this report is at your own risk. Consumer Reports, the American College of Physicians, Annals of Internal Medicine, and their distributors are not liable for any loss, injury, or other damage related to your use of this report. This report is intended solely for consumers’ personal, noncommercial use and may not be altered or modified in any way or used in advertising, for promotion, or for any other commercial purpose. Special permission is granted to organizations participating in the Consumer Reports health communication program to disseminate free copies of this information in print or PDF formats to individual patients, members, or employees. Learn more at ConsumerHealthChoices.org or send an e-mail to HealthImpact@cr.consumer.org. Published by Consumer Reports © 2013 Consumers Union of U.S., Inc., 101 Truman Avenue, Yonkers, NY 10703-1057. All rights reserved. Developed in cooperation with the American College of Physicians and Annals of Internal Medicine as part of the High Value Care patient education program. Portions of this report are derived from materials developed for the High Value, Cost-Conscious Care Initiative of the American College of Physicians and Annals of Internal Medicine and are used with permission. © 2013 American College of Physicians. Tips on diet on longevity from AARP New American Diet, used with permission of the author. Whyte, John (2012). AARP New American Diet: Lose Weight, Live Longer. Hoboken, New Jersey: John Wiley & Sons. ISBN 978-1118185117.
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5 QUESTIONS to ask your doctor
before you have any medical test or procedure. 1 Do I really need this test or procedure? Tests should help you and your doctor decide how to treat a problem, and procedures should help you live a longer, healthier life.
2 What are the downsides? Discuss the risks as well as the chance of inaccurate results or findings that will never cause symptoms but may require further testing.
3 Are there simpler, safer options? Sometimes lifestyle changes will provide all the relief you need.
4 What happens if I do nothing? Ask if your condition might worsen — or get better — if you don’t have the test or procedure now.
5 How much does it cost? Ask whether there are less expensive alternatives, or generic versions of brand-name drugs.
You can use the questions above to start a conversation with your doctor about the tests, treatments and procedures you need — and don’t need. Remember, overuse, or misuse, of medical tests and procedures provides little benefit, and in some cases can even cause harm. By talking to your doctor, you can improve the care you receive — and save yourself from the discomfort and expense of unnecessary tests or procedures.
✓
A talk with your doctor is the smart way to make sure you end up with the right amount of care: FOR MORE INFORMATION not too much, not too little.
Use your smartphone to access all of the lists of tests and procedures for you and your physicians to question as part of the Choosing Wisely® campaign.
http://consumerhealthchoices.org/campaigns/choosing-wisely/
Four things that would surprise you about health care Health care is anything but predictable. These four facts about your health and the care you receive may surprise you. 1. A long, caring and respectful relationship with your doctor is more beneficial to your health than you think. Forming a long-term relationship with your primary care physician is the most important thing you can do for your health, according to a Consumer Reports survey of 660 physicians. But having that strong relationship isn’t a guarantee. You’ll need to invest some energy—and make sure you find doctors who will do the same. Find out more about why the relationship with your physician is crucial in the article “What doctors wish their patients knew.” 2. Getting more health care won’t necessarily make you any healthier. Nearly half of primary care physicians say their own patients get too much medical care, according to a survey published in 2011 by researchers at Dartmouth College. And all that care is not helping people live better or longer. Researchers at Dartmouth found that “patients with serious conditions who are treated in regions that provide the most aggressive medical care—have the most tests and procedures, see the most specialists, and spend the most days in hospitals—don’t live longer or enjoy a better quality of life than those who receive more conservative treatment.” Read more about why getting more health care isn’t better. 3. One-third of all health care isn’t necessary. According to the Institute of Medicine, as much as 30 percent of health care in the U.S. is just not needed. There are several reasons why this happens. Doctors have little information on what constitutes the “right” amount of health care; most doctors are paid per test, visit or procedure; and … you, the patient, request it. Every unnecessary test or procedure is doing two things: exposing you to harmful side effects and racking up your medical bills. You can learn it’s okay to say “Whoa!” to your doctor whenever a recommended test or procedure feels unwarranted. 4. You’re paying different prices—for the same treatment. Not all health care is created equal—in dollars especially. There are significant price differences in the health care you receive. Consumer Reports writes, the “contracted prices that health plans negotiate with providers in their networks have little or nothing to do with the actual quality of services provided and everything to do with the relative bargaining power of the providers.” A little legwork can often go a long way. Read more about the cost differences and what you can do about them.
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Choosing Wisely Employer Toolkit
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Actionable Consumer Tools Referring to the six healthcare consumer segments, please check which segment you most identify with. Casual and Cautious Content & Compliant Online & Onboard Out & About Shop & Save As a patient/consumer, rank the following tools based on their value. Tool Value (Please check one)
Your Health: Fact Not Fiction
5 Questions to ask your doctor before you have any medical test or procedure.
Tips for getting good quality health care…
Four things that would surprise you about health care
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