Dr. Scott's Health Care Secrets
What is your doctor not telling you?
Learn insider information on things you need to know about doctors, hospitals and navigating the health care system. Get the most out of each doctor visit by understanding how doctors behave and how they determine your medical treatment. Health insurance and the health care system are confusing, and sometimes impossible to understand. Let Dr. Scott, a long-time practicing Emergency Medicine physician with training in Public Health, guide you through this complicated process. It's your money and your life.


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About Dr. Scott:
Dr. Scott, MD, MPH is a practicing Emergency Medicine physician with a Masters Degree in Public Health. His interests include Mind/Body medicine and holistic healing. As a past medical school clinical professor, he has authored several academic articles, lectured at national conferences and taught residents, interns and medical students.


Dr. Scott's Health Care Secrets^TM
Copyright 2006-2007 by Dr. Scott


Podcast 1: Your Money and Your Life
Are you interested in saving your money and your life? This Podcast will help you understand how much you might be wasting.


Podcast 2: One Problem at a Time
Physicians use pattern recognition to make a diagnosis. This Podcast discusses how the number of problems you review with your doctor can affect your diagnosis.


Podcast 3: Write It Down
Do you think that your memory is good enough? Has it ever been hard for you to remember an important detail? This Podcast discusses why you should not trust your health to your memory.

Information to write down:
Medical Problems
Past Surgeries
Medications
Allergies
Symptoms of current illness


Podcast 4: Symptoms
Do you know the 5 different aspects of pain that are critical in a correct diganosis? The Podcast discusses how to accurately describe your symptoms.

Symptom: Derived fro the Greek word meaning "something that has befallen one." A symptom is usually considered to be an abnormal sensation perceived by the patient. It is the way people experience an illness.

5 aspects of Pain:
What makes it better and what makes it worse.
Quality of pain.
Region of the body.
Severity of pain.
Temporal characteristics.


Podcast 5: History
Did you know that your job is part of your medical history? This Podcast will continue our mini medical school session on what your doctor needs to know from you.

Review of Systems: Review of different organ systems that may or may not be related to your current medical problem.

Past Medical History: Major medical problems under current treatment or were treated for in the past. This includes past surgeries.

Medications and Allergies: Name and dose of each medication. Name and reaction of each medication allergy.

Social History: Life style issues such as smoking, alcohol use, drug use, marital status, job and living situation.

Family Medical History: Important medical problems in your family tree that could have relevance to you.


Podcast 6: Talking to Your Doctor
Have you ever been confused talking with your doctor? This Podcast discusses how to begin to address this problem.

Doctors are not well trained in patient communicaiton.

Try to have a sense of humor if your doctor interrrupts you.

Always tell your physician what you believe is important, even if you are interrupted.

Ask about anything you don't understand or agree with. Your doctor will not know that you do not understand unless you ask.


Podcast 7: Things to Ask
Do you know the three most important things you need to ask your doctor at each visit? This Podcast discusses the things you must know at every doctor visit.

What your doctor tells you should seem logical, be clear and make sense. It is up to you to let your doctor know when you do not understand something.

Things to know at every visit:
Diagnosis and lab results: The name of your illness or medical problem. Do not leave the office without knowing if your labs or other tests are normal.

Treatment: There should be no uncertainty about what exactly you are supposed to do for your treatment.

Follow-up:
How long until you should feel better?
When should you see the doctor again?
How will you get the results of any tests not back yet?
How will you set up tests your doctor wants you to have?
What symptoms should cause you to see the doctor sooner than your scheduled follow-up?


Podcast 8: What Have I Done?
Do you want to hear a real ER story? This Podcast is titled, "What Have I Done?" A Dr. Scott Tale from the Pit.


Podcast 9: What To Bring
Did you know that what you need to bring to a doctor visit depends on the doctor's specialty? This Podcast will discuss what you need to bring when you see a doctor.

Information about current symptoms, medications, allergies and medical history as discussed in previous Podcasts.

Pertinent medical records including:
Lab results,
EKG's,
Xray readings or copies of xrays,
Biopsy, pathology or procedure reports,
Notes from other physicians,
Hospital discharge summaries,
Any other information that might be important.

If you are not sure what to bring, ask ahead of time.
Don't waste your time, come prepared.


10: Who To Go With
Did you know that who that who goes with you to the doctor can affect your care? This Podcast discusses when someone should go with you to the doctor.

Unless you really want to be alone or it is a minor problem, consider having a relative, friend or spouse go with you to a doctor visit, lab test or other procedure. Having someone with you provides moral support, helps with the waiting , can be very helpful in understanding your doctors advice and critical if you require an evaluation or treatment that could prevent you from being able to drive home. If you are not sure whether someone should go with you, call your doctor ahead of time and ask.


11: Surviving The ER, part 1
Are you prepared for an unexpected trip to the ER? This Podcast is part 1 of how to survive the emergency room.

You should go to the ER if you beleive you have a problem that can not wait to be treated by a doctor in an office. If you believe it is a life or limb threatening problem call 911. Other reasons to call 911 include serious problems such as stroke, incapacitating pain, or being ill to drive by private vehicle.

In general, it is best to go to the nearest ER that is covered by your insurance and is affiliated with your doctor or medical group. Exceptions to this guideline include needing to go to a closer ER because of your medical condition or a preferencfe or a non-covered ER.

Know where your local hospitals are. If you can't remember how to get to them, write down the directions and keep the information in your wallet or purse.


12: Surviving The ER, part 2
Are you prepared for an unexpected trip to the ER? This Podcast is part 2 of how to survive the emergency room.

The Podcast describes a typical ER experience.
The first rule to survive the ER is to accept the wait.
Be prepared to repeat your medical history to several staff members.
Emergency physicians will focus on the primary reason for your visit, other non-urgent problems should be followed-up by your regular doctor.
Try not to go alone.
Be prepared for a noisy and non-private enviroment .
Ask the doctor for your your diagnosis and treatment.
Make sure your primary care doctor has access to the ER evaluation or get copies of labs.
Unless otherwise directed, make a follow-up appointment with a primary care doctor.


13: The Urgent Care
Do you know the difference between an Urgent Care and an Emergency Room? This Podcast discusses what you need to know about Urgent Cares.

Urgent Cares are useful adjuncts to obtaining health care on a same day basis. The quality of Urgent Cares can vary widely from small independent offices to hospital affiliated centers. They offer much of the care that is provided at the ER for usually a lower cost and shorter wait. In general, however, they should not be used for life or limb threatening problems or any other medical problem that could require 911 (such as stroke or heart attack). The decision to use an UC over an ER should be based on your medical condition, health insurance and quality of the urgent care.


14: The Save
Do you want to hear a real ER story? This Podcast is titled, "The Save." A Dr. Scott Tale From The Pit.


15: Choosing A Doctor
Have you ever had a hard time finding a new doctor? This Podcast discusses how to choose a doctor.

Finding a new doctor is not easy and is ultimately a trial and error process. If possible, try not to rush your choice. Ask other health care professionals and friends for referrals and then do some research. Spending a little time up front, will increase the chance of finding a doctor that is a good match for you. If the doctor you choose does not work out, try another. A good long term relationship is worth the time it takes to find the right person. The internet is a good resource, but be careful about information overload and remember that not all of the information correlates with quality of care.


16: Second Opinion
Your doctor wants you to ahve a medical test that you don't think you need. So what should you do? This Podcast discusses getting a second opinion.

Consider getting a second opinion if your medical condition is not improving or you need to undergo complicated or serious treatment such as surgery or chemotherapy. You can get a referral from your physician or find another doctor on your own. Make sure you bring all relevant medical records to your appointment for the second opinion. Remember, health care is your money and your life, and getting a second opinion is sometimes your best use of both.


17: NPs and PAs
Have you ever been told that your health care provider will be a Mister? This Podcast discusses being cared for by Nurse Practitioners and Physician Assistants.

Nurse practitioners and physician assitants are specially trained health care providers. Their training ranges from primary care to specialties such as general surgery and gynecology. A good predictor of the quality of a NP or PA is the quality of the supervising doctor or medical group. If you do not feel comfortable being evaluated by one of these providers, you can request to see a physician. As with any doctor, your provider's diagnosis and treatment should be logical and make sense to you.


18. Internet Health Care
Did you know that using the internet for medical advice can be dangerous to your health? This Podcast discusses internet health care.

Using the internet to self-diagnose without a physician is a potentially dangerous practice and can result in incorrect treatment. Doing research, however, on previously diagnosed or evaluated problems can provide much useful information. Use only reputable sites such as academic universities, hospitals, medical associations or medical journals. Be careful about incorrect medical information. Use the internet safely.


19. Illness, Disease and Prevention, Part 1
Have you ever been sick and were told by a doctor that there's nothing wrong with you? This Podcast discusses the difference between disease and illness.

Illness: A person's perception of their physiological or psychological state, it is their constellation of symptoms and is defined by the individual.

Disease: A pathological state defined by health care professionals.

Illness can exist without identifiable disease and disease can exist without identifiable illness. The lack of an identifiable disease with a person’s illness can be a source of conflict between doctor and patient. If you are not given a diagnosis for your illness, make sure you understand your doctor’s explanation. You should have follow up evaluations until your problem has resolved and you should consider getting a second opinion if the problem persists despite your doctors best efforts.


20. Ilness, Disease and Prevention, Part 2
Did you know you can feel perfectly fine, but be in need of medical treatment? This Podcast discusses the early stages of disease.

The origins of disease are multifactorial. Pathological changes in our bodies can exist long before we perceive an illness or seek health care. Paying close attention to our bodies and the different aspects of our health and well being can bring awareness to the early stages of illness or disease.


21. Illness, Disease and Prevention, Part 3
Do you know what the long, short way is? This Podcast discusses preventive health care.

Many diseases start out slowly and silently. This means that there are multiple ways and opportunities for us to effect the development and progression of disease before the it becomes symptomatic or serious. To prevent disease or to catch it in the early stages we must be willing to set aside our natural inclination for the easy way out. And we must not be discouraged by the difficulty of taking action to improve our health. Our health tomorrow is determined by our actions today. And today is the day to take action.


22. Night Shift
Do you want to hear a real ER story? This Podcast is titled, "Night Shift," a Dr. Scott Tale From The Pit.


23. Sickness Care System
Did you know that clean water shaped oru current medical system? This Podcast discusses the development fo our Sickness Care System.

The development of medical care in the US was influenced by the changing disease patterns over time. Our current system was set up to intervene after someone becomes ill and was designed to be short term only. Chronic disease is treated as if it were a series of separate acute infections. Our system lacks a structure which takes into account a long-term understanding of health. True health is a state of wholenss comprised of interrelated components of physical, psychological and spiritual well being. We have the most advanced sickness care system in the world, but our ability to address the multi-layered issues of health is limited.


24. Health Insurance Introduction
Does your family own Walmart or is your name Bill Gates? If not, then you should listen to this Podcast.

Our modern health insurance industry began in the 1930's and rapidly expanded during WWII. Risk is the probability of loss and health insurance distributes the risks of financial loss from disease over large groups of people. Health insurance is the only practicle way to protect ourselves from potentially devastating financial loss. Managed care refers to restrictions placed on health insurance to control spending. The three basic types of health insurance are FFS (Fee-For-Service), HMOs (Health Maintenance Organizations) and PPOs (Preferred Provider Organizations). The newest feature of health insurance is Consumer Directed Healthcare.


25. Two Goals of Health Insurance
Do you know how health insurance differs from other insurance? This Podcast discusses the two main goals of health insurance.

The two main purposes of health insurance are to provide protection for medical bills and access to a network of providers and hospitals at discounted rates. Consider choosing the network of providers and hospitals you like best and then find a plan that will cover the providers and hospitals. Obtaining a plan with the providers of your choice may require you to obtain your insurance outside of work. With new insurance options, getting insurance outside of work is becoming easier for more and more people.


26. Health Care Revolution
Are you ready for the Health Care Revoltion? This Podcast discusses changes in health insurance that you should know about.

We are in a transition period of switching form employer based insurance to consumer directed health care. Recent legislation has created beneficial tax breaks, making it easier to obtain individual or family health insurance independent from work. Future legislation will probably continue i this direction. It may be a serious error to choose employer-sponsored health insurance without knowing all of your options.


27. Seven Things You Should Know
Do you know the 7 building blocks of health insurance? This Podcast discusses the 7 fundamental aspects of health insurance policies.

There are 7 basic terms or aspects of a health insurance policy. Understanding these terms is crucial to understanding and comparing health insurance policies. When analyzing or comparing policies, make a check list and write down these 7 features: Premium, Deductible, Out-of-pocket expenses, Co-payment/Co-insurance, Covered Expenses, Pre-existing conditions and Consumer Directed Health Care.