Category: Doctors & Hospitals

Having trouble finding reliable health information? Our medical professionals can do it for you.

By Nathan Blake | 11/14/18
Project Manager, HealthWeb Navigator

Readers sometimes ask what a typical day looks like here at HealthWeb Navigator.

Mostly we spend a lot of time browsing the web. Whether it’s groundbreaking medical research, user reviews of a diabetes smartphone app, or a new website that helps you understand your health insurance plan, we try to stay on top of everything health-related the internet has to offer.

Our tireless web browsing has helped us become one of the internet’s leading resources for finding and evaluating reliable healthcare websites. We are, to date, the only place that publishes in-depth reviews of health websites written by actual health experts. Yet we’re still on the lookout for innovative and helpful ways to meet your healthcare research needs.

That’s why we’re excited to announce a new service that gathers the web’s best health information specific to your needs or interests. Yep — we’ll check every nook and cranny to give you personalized resources from the internet’s most trusted sources. No more wondering if what you’re reading is credible. We pre-screen every resource for reliability and only send you the cream of the crop.

Start by shooting us an email at info@healthwebnav.org. Fill us in on the details — what topic you want to learn about, your preferred language and medium, the level of detail you’re comfortable with, etc. — and we’ll respond with relevant, trustworthy resources that specifically meet your preferences.

Maybe you want a Spanish-language video that introduces type 1 diabetes. Or perhaps you’re looking for clinical trials for new a Parkinson’s disease drug treatment. You might even like to know the side effects of your wife’s chemotherapy, or if there’s a support group for teens with cystic fibrosis, or where to download a podcast for caregivers. Whatever the case, we’ll see what’s out there.

We can’t guarantee that we’ll find something you haven’t seen already. And nothing we send you can substitute for medical advice. But no matter what, you’ll walk away with credible and up-to-date information that has been verified by at least one medical professional.

So what are you waiting for? Send us an email and get started today!

Free Health Research Worksheet for Patients

By Nathan Blake | 7/27/18
Project Manager, HealthWeb Navigator

Our team of medical reviewers talk with countless patients about health information on the internet. But many more patients don’t mention what they read online. Either they’re afraid the doctor will ignore them, or will think they’re being “difficult” for talking about what they learned, or they just don’t have time to bring it up.

Doctors and patients need to talk openly about what patients are reading. Browsing the web before and after a doctor’s appointment is something most of us do, as it lets us participate in healthcare decisions. But a doctor’s medical training can help us avoid dangerous or irrelevant advice. And if doctors refuse to listen to what patients have read, or if patients are afraid to speak up, then everyone misses out on valuable insights.

That’s why we’re providing this free resource to help you collect your thoughts before meeting with a healthcare professional. As you research health topics on the internet, use this worksheet to write down what you want to talk about with your doctor.

Make sure you’re clear from the start of your next appointment what you want to discuss and why it’s important to you. Then, let your doctor respond, and write down their thoughts too. Together, you can come to a decision about what to do next.

And don’t forget to browse our collection of reviews to find the most reliable health websites available today!

Download file: Health Research Worksheet

HealthWeb-Navigator-Health-Research-Worksheet

 

Why I Teach First-Year Medical Students

By Mark A. Kelley, MD |5/24/18
Founder, HealthWeb Navigator

I teach first-year medical students how to take a medical history and perform physical exams on patients.

These skills are the foundation of medicine. The health history and physical exam (plus a few basic tests) are time-tested methods for diagnosing disease. Using these tools, a skilled physician can reach an accurate diagnosis more often than not.

We humans share a standard range of symptoms. Pain, weight loss, fever, cough, abdominal complaints—are all examples of the body’s response to injury, infection, and inflammation. The range of diseases, while large, is still dominated by common conditions such as cancer, infections, heart and lung disease, etc. And how the human body reacts to these diseases has remained constant. A cough is still a cough—whether now or 4000 years ago.

As a former pulmonary and critical care physician, I treated patients with diseases ranging from common to exotic. No matter the scenario, the diagnosis becomes apparent if you are a good listener. As I tell students, if you ask patients the right questions, their answers will help solve the problem.

I teach first-year students because they have a refreshing perspective on medicine. They are eager to meet patients, who in turn seem to enjoy the experience.

Unfortunately, my students will likely spend more time with these patients now than when they are practicing physicians.

During their hospital rotations, students will quickly learn that time has become medicine’s coin of the realm. Filling out forms and clicking through computer billing systems devour time, leaving very little for a meaningful discussion with a patient, much less for developing a relationship.

Many dedicated physicians work within this time trap, and their patience is wearing thin. The warning signs are clear. More than 50% of physicians are experiencing burnout. Many respond by leaving clinical practice or retiring.

Is clinical practice becoming a sweatshop, where physicians are treated like assembly line workers and the only important metric is the bottom line?

Maybe—but only if we ignore human nature. When illness strikes, we all seek comfort from others. For millennia, our ancestors have received such help from trusted healers. I doubt that is going to change. One of life’s certainties is that we all become a patient eventually.

Medicine is having a Dickensian moment: we are now witnessing both the best and worst of times. We have a dysfunctional healthcare system complicated by high costs, mediocre quality, and chaotic public policy. Yet we are also on the verge of major scientific breakthroughs in basic science, information technology, and data analytics.

My bright first-year medical students understand this paradox and view it as an opportunity to improve healthcare. As I reflect on my own student days, I can remember feeling the same way. Throughout history, medicine has lived at the intersections of science, technology, social reform, and economics. Most problems have solutions, if we are bold enough to execute them.

Each new generation is equipped with the courage, creativity, and energy to create lasting change. As my students begin their careers, the most important lesson I can teach them is to make patient care their top priority. That happens only when the doctor-patient relationship is held sacred.

If students set their sights on this one goal, they, like countless students before them, can improve the lives of patients in ways we cannot imagine.

Hopefully I have gotten them off to a good start. After all, one of them may take care of me some day.

Hospitals Take Aim at Generic Drug Companies

By Mark A. Kelley, MD |1/22/18
Founder, HealthWeb Navigator

In a previous blog, I mentioned how the prices of many generic drugs have skyrocketed. In some cases the price of a single pill has increased over 500%.

But help may be on the way. Recently several large and respected non-profit hospital systems indicated that they will “fire a shot across the bow” of the generic drug business. That would be a game-changer.

Why has the price of generics skyrocketed?

Some large drug companies have purchased (or outcompeted) generic drug manufacturers. This has created a monopoly for some widely used and long-standing products, such as the EpiPen and the albuterol inhaler. In effect, the companies can set whatever price the market will bear. In many cases, the market (i.e patients) has no choice but to accept these prices since no one else makes the drugs.

As if that strategy were not enough, some analysts have suggested another motive. By raising the price of generics and controlling the supply, monopolies could also introduce new “copycat” drugs that resemble the generics and are protected by patents. Both of these maneuvers could improve the stock market value of these drug manufacturers.

The issue is that prescription drugs operate in a market that does not include the patient. Health insurance companies negotiate drug prices and then pass them on to employers and their employees. Compared to hospital costs, most generic drugs are minor costs for the employer. Furthermore, through deductibles, any new drug costs can be passed on to the patient.

Federal regulation might seem like be a good way to solve this problem. Most other developed countries set drug prices for their national health programs. However, Congress has historically forbidden the federal government to set drug prices for Medicare. Regulating the pharmaceutical industry seems unlikely.

What can a hospital consortium do? The hospital industry spends billions of dollars on drugs to treat patients in the hospital and in ambulatory practice. Most insurance plans pay hospitals a fixed price per hospital admission. If drug prices rise, either the insurance company must pay more or the hospital loses money. Lately the drug prices have jumped, especially for generics.

On the ambulatory side, the scenario is no different. Hospitals with outpatient practices are under increased pressure to reduce costs. Among the largest is prescribed drugs.

Another problem for hospitals is the shortage of many commonly used drugs whose patents have expired. Companies simply are not interested in keeping high inventories to meet the challenges of demand.

A nationwide hospital consortium could have tremendous market leverage since these facilities care for millions of patients. Currently, the consortium has enrolled 300 hospitals. That market power could be used to negotiate reasonable prices with the pharmaceutical industry. However, such a plan is complicated and might face legal and regulatory challenges.

The other option is for the consortium to create a nonprofit company that makes generic drugs and sets fair and reasonable prices. That is bold move that would create a true free market. Generic drugs account for almost 80% of all prescribed medications.

Rather than rely on for-profit manufacturers, hospital systems and their patients would have access to the same drugs at lower prices. In effect the providers would eliminate the middleman by controlling the supply of most drug products.

It is unclear how this proposal will evolve because it threatens the status quo. There is sure to be opposition—but not from patients. They will root for any plan that protects them from more out-of-pocket spending.

We need to reduce health care costs and, for once, here is an approach that offers an innovative and sensible solution for patients everywhere.

It’s an idea whose time has come.

Radiology Imaging Tests: The Basics

By Carla Dellaporta |12/8/17
Director of Education, NeedyMeds

You’re out walking your dog, enjoying the fresh air and holiday decorations, when suddenly — bam! Down you go on a patch of black ice. Standing, you realize you can’t put weight on your ankle.

The doctor says she’s not quite sure how bad the damage is. To get a better idea, she wants to schedule what she calls a “radiology imaging test.”

Say what now? Isn’t radiology like, nuclear?

Medical jargon gets thrown around left and right these days. Thankfully this one’s pretty simple. “Radiology” is the branch of medicine that relies on technology to diagnose or treat diseases. And “imaging” means the technology involved to take pictures inside your body.

So your doctor is saying she needs to get a better picture—literally—of what’s going on inside you.

There are many radiology tests out there. They differ in terms of the technologies used to produce images of your body. Some common radiology tests requested by doctors include:

X-ray: Uses a small dose of radiation.

CT scan: Combines multiple X-ray images.

Ultrasound: Uses high frequency sound waves.

MRI: Uses magnetic fields and radio waves.

From 2000-2010, imaging services and costs grew at twice the rate of other healthcare technologies. One reason why may be what’s called “defensive medicine.” This term refers to doctors prescribing or recommending unnecessary tests to protect themselves from potential malpractice lawsuits.

A recent study estimated that unnecessary medical tests cost the U.S. nearly $7 billion dollars annually. Overly cautious medicine is a common practice that, unfortunately, comes at the patient’s expense. Don’t rush to get a test without having a clear idea of what your options are and whether or not you can afford treatment.

Below, we’ll cover some questions to ask before scheduling your radiology imaging test. That way you’ll know you’re getting the best bang for your buck.

Questions to Ask Your Doctor Before Scheduling the Test

Do I need this test? You’ll want to understand why you need a scan and how the results will change your course of treatment. If the doctor can’t justify how the results of the test would change the treatment course, then you probably can do without it. No use in wasting time or money on unnecessary tests.

Are there safer alternatives? A CT scan exposes you to much more radiation than a standard X-ray. An MRI, on the other hand, doesn’t use radiation at all. Because radiation can potentially cause DNA damage, you want to limit your long-term exposure. Ask whether there are any lower-radiation but still effective options.

How much will this test cost? Imaging fees vary widely between hospitals, private facilities, geographic location, etc. Always ask for the bottom line cost before scheduling a test. Keep in mind, there’s something called a “global fee” you’ll want to be aware of. This fee charges for the test itself as well as the professional interpretation of the results. Being aware of the global fee ensures you won’t be blindsided when the bill arrives.

How long before I get the results? Radiology test results are generally read on-site by a trained radiologist. However, it’s the doctor who usually delivers those results to the patient, and a variety of factors will influence when you’ll receive them. Ease your mind by asking up front how long this process will take. Consider calling if you haven’t received your test results after five days.

Some Final Cost-Saving Tips

Confirm which location(s) your health insurer considers in-network and how much they cover. Few people know that most of the time, imaging tests cost more when performed at a hospital rather than private facility. Contact your health insurance company directly to find out which facilities they consider in-network. By staying in-network, you won’t have to pay the for the full price of care. There’s a reason you have health insurance—let your insurer help cover the costs!

Ask for a cash discount or sliding scale payment plan. Paying out-of-pocket doesn’t mean you’re doomed to pay up-front and in-full. Most healthcare centers will work with your financial situation, but first you have to ask. A payment plan is a much more reasonable choice compared to putting the total fee on a credit card. You wind up paying a lot more money in interest if you can’t pay off your credit card bill immediately.

Check the credentials of the imaging facility. You know you can trust a facility if it’s been accredited by the American College of Radiology. That means the center has undergone a rigorous evaluation process led by experts in the imaging field. Generally, accreditation can tell you if the center’s radiologists are experienced, and whether or not the center’s equipment and staff meet/exceed nationally accepted standards. Obviously you want the best care for your money.

To learn more about the field of radiology imaging, our reviewers recommend RadiologyInfo.org as a great introductory resource. This website explains the various forms of medical imaging including their indications, complications, and relevant tips for patients undergoing tests. Read our full review for more information.

Physician Burnout and the Battle for Time

By Mark A. Kelley, MD |11/10/17
Founder, HealthWeb Navigator

According to published reports, over 50% of doctors are burned out. The reason? They are overwhelmed by payment and quality rules as well as poor information technology.

It’s no secret that physicians spend long hours seeing patients. But as financial pressures have mounted within hospitals, doctors are forced to perform more administrative tasks. In fact, administrative tasks account for nearly a quarter of the average doctor’s schedule. That’s all time diverted away from patient care.

Many physicians feel a loss of autonomy, a major factor in burnout. The National Academy of Science now sees burnout as a major threat to maintaining our physician workforce.

The key issue is how we want healthcare professionals to spend their time. Instead of asking them to do more, we should ask, “Do more of what …and why?”

Our current system is based on assumptions and technologies that are outdated and interfere with the delivery of modern health care. Three problems are clear:

• Physicians in the United States must provide exhaustive documentation to justify their services. No other health system in the world imposes such onerous rules.

• Health IT systems are designed primarily to support tedious billing documentation rather than clinical care. For practicing physicians, this issue tops the list of frustrations.

• Payers and other advocates have promoted different measures and incentives, leaving both physicians and patients searching for a single, meaningful quality agenda. That goal remains elusive, trapping physicians in many time-consuming quality tasks of dubious value.

These three problems have forced physicians to perform more tasks that take time away from patient contact. The result is the “ten-minute patient encounter,” during which the physician spends most of the time on a computer to document and bill for the visit.

This contrasts with how other professionals spend their time. Imagine if we expected airline pilots to sell tickets, load the baggage, and fill the fuel tank before flying the plane!

Several innovations would help solve these problems.

1. Modernize healthcare transactions to be efficient and understandable. Documentation has devoured clinical practice. Originally designed to curb costs and prevent fraud, the current system is an obsolete instrument. In businesses such as the credit card industry, electronic algorithms and analytics detect fraudulent behavior. Such technology should replace arcane documentation rules and their toxic effects on clinical practice.

Beyond the documentation problem, the healthcare industry operates an economic system that bewilders patients, providers, and most business experts. Private insurance rules vary widely by plan, location, facility, and provider. If health care were a consumer-based business, it would have been “out of business” long ago.

2. Focus IT on healthcare analytics. The depth and breadth of medical information is growing exponentially. To serve their patients, physicians must process complex data and perform multiple tasks rapidly. Well-designed informatics can save time, reduce errors, and distill information. Sadly, we are far from reaching that goal.

The current health IT systems are heavy on billing and documentation, and light on usability and analytics. While medicine has aspirations for using “Big Data” in patient care, its information systems are poorly prepared to do anything more than print reports and bills. The healthcare industry needs “smart systems” that make medical practice highly reliable, safe, and more efficient.

Outside of health care, new IT solutions are thriving. Patients can purchase a $50 voice recognition device to browse the internet, play music or news, and perform calculations. However, their doctors and hospitals are stuck with expensive billing systems that are clumsy at retrieving and organizing patient information. That embarrassment would end if healthcare IT focused more on patient care instead of billing.

3. Prioritize national quality goals that matter. Our nation needs to justify the assignments it imposes on physicians. The major advances in healthcare quality have been successful because both patients and physicians understood their importance. These advances, such as cardiac prevention, were planned and tested to blend into practice. Physicians will support important quality programs that meet these standards…but not low-impact measures designed in a conference room.

Medicine is the ultimate human service, whose value to the patient is quality time—time spent with the physician. That bond should not be threatened by putting “business” processes ahead of patient care.

If we lose that battle, both patients and their physicians will be casualties in the war to save medical professionalism.

Quality Reports for Hospitals and Doctors: Interesting but Flawed

By Mark A. Kelley, MD |10/18/17
Founder, HealthWeb Navigator

Every patient eventually asks the same question: “How can I find the best hospitals and doctors?”

The solution might seem easy, since we live in world where information is readily available on the internet. In a few clicks we can shop for goods, review consumer products, market ourselves on social media, and complete financial transactions instantly. You would think that health care, which accounts for 17% of the GDP, would have all these same features.

Think again. Healthcare information for consumers is woefully unsophisticated compared to other industries. Ask anyone who has ever attempted to find prices for healthcare services, interpret a medical bill, or schedule an appointment online.

Healthcare information is primitive because it focuses on finances rather than customers—that is, the patients. As a result, hospital and physician offices are skilled at sending bills but often can’t help patients with much else.

Federal regulations have helped improve online medical records and lab results. But information about healthcare quality is still lacking. The lack of standardization about what is important, credible, and measurable leads to confusion.

HealthWeb Navigator lists the most common online hospital rating websites. Unfortunately for patients, there is no consistency among these many rating tools. Research shows that hospitals ranked highly in one system often score poorly in another…and vice versa.

The reason? These rating systems all use different measurement criteria, as well as different statistics to compute results. Some are heavily influenced by reputation rather than clinical outcomes. Even Medicare’s rating system—Hospital Compare—isn’t very helpful since it’s hard to navigate and most hospitals come out “OK”. Many patients choose not to use these “quality” tools due to the inconsistency among them.

Report cards about doctors are not much better. Medicare’s Physician Compare suffers from the same problems as its hospital-focused counterpart. The average visitor has difficulty sorting out the information most valuable to them. Some websites promote doctors who pay to be listed on the website. Others feature those doctors with regional and/or national reputation. This approach is common in regional publications magazines like Boston Magazine that list the “best” local specialists.

Finally, the newest “report card” for hospitals and doctors is the popular website Yelp. Reports featured on Yelp remain controversial, as they are based on consumer opinions rather than a more data-driven methodology. Despite the flaws, Yelp reviews are extremely popular among consumers.

In the midst of all this confusion, how can someone find a good hospital or doctor?

Most physicians, including me, think that the best source is still a recommendation from a trusted friend, preferably a health professional. Those in health care usually have a network of helpful contacts. Of course many other factors can influence patient choice. Most patients prefer medical care that is conveniently close to home. Others, especially those with complex conditions, may prefer to see a specialist in a large medical center far from home.

Once a hospital recommendation is made, the patient and their family can examine the hospital’s website to evaluate its staff and their credentials. Some hospitals publish their staff’s expertise and experience in certain specialties. Such voluntary public reporting is becoming more common among hospitals that perform at a high level. If a hospital does not list such metrics, it is worth asking for them.

As for doctors, you can check out their background on several websites featured in our “Physicians” section. Most hospitals list the educational credentials of their medical staff, including board certification.

Clinical experience is highly important when choosing a physician. That information may not be listed on a website, but every physician can and should be able to summarize their experience to interested patients. HealthWeb Navigator covers how to choose a doctor in more depth on a previous post.

In summary, publicly reported hospital and physician “scorecards” are interesting and sometimes helpful—but not necessarily authoritative. We have a long way to go before “public reporting” in health care represents an accurate reflection of clinical performance in ways that consumers can understand.

In the meantime, the best approach is to contact a trusted source, especially a physician or nurse. Ask them where or to whom they would send their loved ones in times of need. That recommendation is bound to be reliable.

How to Effectively Manage Appointments with Your Doctor

By Mark A. Kelley, MD |7/12/17

Everyone in health care is busy these days. Most doctors have full schedules and patients often can’t afford to take time off from work.

Neither patients nor doctors are satisfied with this situation. However, once you and your doctor get together, there are ways you can make the visit more valuable.

Doctor appointments fall into two different categories:

• Urgent visits: For true emergencies, you should seek immediate medical attention. For a problem that is not an emergency but worries you,  the best approach is to contact your doctor’s office. Your doctor may be able to solve the problem by phone or work you quickly into the office schedule.

• Routine planned visits: These visits are usually for a new consultation or a follow-up for a known condition. You can get more from these scheduled visits if you do some preparation.

The New Consultation

You can take a few steps to ensure a new consultation goes as smoothly as possible.

Educate yourself beforehand: Understand the reason for the consultation from your referring doctor. Have you read up on your particular problem? Have you checked the credentials and experience of the new doctor? Is this new doctor affiliated with a hospital that you like? Does the doctor accept your insurance?

Bring your medical records, drug list, and results of any lab/radiology studies: This step can make a major difference in your first visit. Medical records provide a clear picture of your health history. The doctor can read faster than you can talk, and this written information frees up time for the doctor to have a better conversation with you. The information may also reduce the need for more tests, allowing the doctor to focus on a diagnosis and treatment plan.

Prepare a list of questions in advance: Make a list that you can share with the doctor. This conversation will help you to understand the medical issues involved, as well as help the doctor understand your concerns.

Ask a close relative or friend to accompany you on the visit: This has several advantages. Your relative may remember something about your medical history that you forgot to mention. They may also be helpful in remembering specific details that the doctor mentions. Additionally, it is always comforting to have a close companion with you to provide support.

Ask the doctor to summarize their findings and recommendations for you: Then, in your own words, repeat the summary back to the doctor. This will help you remember details and ensure that you and your doctor are on the same page regarding your problem and action plan. Don’t be shy about asking questions. Doctors want their patients to be well informed.

Understand the plan and goals before the next visit: These may include any new medications, tests, procedures, or therapies. For each one, consider asking the following questions: How does this test or therapy work? Why do I need it? How long will I need it? What are its benefits? What are its risks? For a new medication, what side effects should I look for? Will it interfere with my current medication? If I have a problem, who should I contact?

Ask for a printout: Request hardcopies of any diagnosis, medications (especially new ones), or tests before you leave the office. You can also ask the doctor to send you a written summary of the visit for your records. By law, you are entitled to this information, and physicians are usually glad to provide it.

Learn more about your condition: Although you may have read about the subject beforehand, your doctor may direct you to other helpful resources. The information may come in the form of written materials or online resources. HealthWeb Navigator can direct you to the most trustworthy, independently reviewed health websites online today.

The Follow-Up

Follow-up visits are scheduled so that the doctor and patient can monitor progress together. You should expect to discuss the following issues with your doctor:

• Are you feeling better or worse?

• Are there any problems to report? If so, let the doctor know early in the visit. They can evaluate whether this issue is serious and/or related to other conditions.

• Are you taking your medicines as prescribed?

• Have you had any new tests or other doctor visits recently? The doctor may not have the results but should be able to get them quickly.

• Do you have any questions about your condition?

• Do you understand the treatment plan? Before you leave the appointment, be sure you receive written summaries and instructions.

Based on my decades of practice, this preparation makes the office visit more productive for doctor and patient alike.

Final Tip

Sometimes routine follow-up visits become “too routine.” Physicians know that patients spend a lot of time and money on medications and doctor visits. If you are doing well and everything has been under control, you may want to pose the following questions to your doctor:

• Can I cut back on any of my medicines (or even stop them)?

• Can I reduce the number of routine follow-up visits?

• Can some of these follow-ups be done by phone or email?

Physicians are modernizing their practices to suit your needs. I suspect that most are more than willing to discuss these requests.

When Your Doctor Doesn’t Accept Your Health Insurance Plan

By Nathan Blake | 1/17/17
Updated | 9/14/18

When I relocated from Massachusetts to Virginia, I was lucky to find a doctor I really liked. She was smart, sympathetic, had a sense of humor, and treated me like a person instead of a checklist.

But a few weeks following one of my routine checkups, I was shocked to find that the clinic had charged me nearly 3 times more than what they usually did for such a visit.

I called my insurer thinking there must have been some kind of billing error. Come to find out, that surprise bill was the result of a recent restructuring of my insurance plan. My doctor no longer worked with my employer-based health insurance and was now considered “out-of-network.” If I wanted to continue being her patient, I would have to pay the full cost for every visit out of my own pocket.

Health insurance is about as easy to grasp as quantum physics. Deductibles, out-of-pocket maximums, copayments, in-network coverage, co-insurance, accumulation periods — few people know how their health plan works, especially since plans change over time. But not knowing what your health insurance policy does — and doesn’t — cover can leave you exposed to unexpected medical costs down the road.

What do you do when your doctor doesn’t accept your health insurance? Keep reading for a few tips that might just keep you under your preferred doctor’s care no matter what your health insurance situation is.

What to Do When Your Doctor Doesn’t Accept Your Insurance

So your preferred doctor doesn’t accept your new health insurance, and you don’t want to find another provider. The first step you should take is an easy one: Ask your doctor what insurance carriers they DO accept.

Rather than finding a new doctor, you can switch to a different health insurance policy that you know your doctor will work with.

Unfortunately, Marketplace plans can only be changed during certain times of the year or for specific “special enrollment” scenarios like having a baby, getting married, losing a job, etc.

Check online to see if you qualify for special enrollment before you make any big decisions. If you’re eligible for special enrollment, this is by far the most painless solution.

But there are other options if you can’t afford the cost or hassle involved with switching policies. If you desperately want to keep your doctor, you can:

Ask your insurer to add an out-of-network doctor to their network. If your doctor isn’t in your insurer’s network, call the insurer directly to see if they’ll consider adding your doctor to their network of providers. If they refuse, ask for specific reasons why. You can also try convincing your doctor to join a particular insurer’s network. Sometimes just being determined is enough to do the trick. It may not work, but it can’t hurt to try!

•  Negotiate a discounted “cash price” with your doctor. It’s common for medical providers to limit the number of insurers they work with. The result is that patients insured through incompatible plans are forced to pay the price for medical services up-front. Thankfully some doctors will negotiate prices with patients on an individual basis, especially if there’s already a long-standing relationship. The key to these negotiations is knowing the fair price for a given health expense and working from there. Again, it costs nothing to ask, and the potential payoff is worth it.

•  Visit an urgent care center or walk-in facility. Urgent care centers and walk-in clinics are set up to treat patients with non-life-threatening illnesses and injuries like fevers or the flu, bleeding/cuts, sprains/strains, etc. They’re also good for immunizations and some diagnostic services such as X-rays and routine lab work. What’s great about these centers is that they are relatively inexpensive, don’t require appointments, and are often open seven days a week. If you can save money on “small” issues, then you may be able to afford seeing your doctor for the more serious issues that crop up from time to time.

•  Pay the difference out-of-pocket and seek reimbursement later. This one hurts. But if you have the financial resources to do so — and your doctor is too good to let go of — then you can pay for their services out of pocket and then submit insurance forms for reimbursement. It’s important to note that insurers will often apply reimbursements to your policy deductible (how much you’re expected to pay before the insurer picks up the bill) rather than give you the money outright. There’s also a good chance you will be reimbursed for only a portion of the original cost. Stay in touch with your insurer during the reimbursement process and make sure your voice is heard.

When It’s Time to Move On

Sometimes the cards just don’t play out the way you want them to. If you can’t afford to see your doctor without health insurance, and none of the above options works for you, then it might be easier to simply move on and find another doctor in your new network. Most health plans these days provide a list of physicians in their network. Call your plan directly for more information.

There are a lot of great websites out there to help you find the doctor of your dreams. Check out of collection of websites for finding a doctor in the Doctors & Hospitals category.

Being prepared for change and knowing what options are available is your best bet for making a smooth transition between providers. Comment below and let us know how your situation worked out!

Choosing Your Primary Care Physician

By Nathan Blake |12/19/16
Updated |7/3/17

When my partner and I moved from Virginia to Massachusetts, neither of us had any idea what we would do once we got here. Those days we were scraping by without: an apartment, jobs, state driver’s licenses, a local bank, and health insurance.

Fortunately we were able to cross off everything from that list within a month. But the last item — getting health insurance — was only the first step in health maintenance. I knew eventually I would want a medical professional I could trust to help me make my healthcare decisions, both big and small.

What I was needed was a primary care physician, or PCP.

What’s a Primary Care Physician?

Primary care physicians (also called “primary care doctors”) provide general medical services to specific patient populations.

A pediatrician manages the health of infants and children. Internists provide care to adults, diagnosing the nonsurgical treatment of diseases. A gynecologist specializes in pregnancy, childbirth, and the postpartum period. Each is a primary care physician, just with different specialties.

Why Are Primary Care Doctors Important?

PCPs, unlike many other health specialists, get to know their patients intimately and over a longer period of time. The ongoing nature of the PCP-patient relationship means the doctor can better assess what’s considered “normal” (and what isn’t) for each patient.

But those aren’t the only benefits of having a primary care physician.

The PCP often serves as a patient’s go-to medical resource. No more Dr. Google — with a primary care physician, you can talk about all of your health concerns with an expert you trust. It’s the primary care physician’s job to provide the patient with the very best care available, whether that care is in-house or through a referral to another specialist.

Primary care physicians and patients engage in what is called “continuity of care,” which means building a personal relationship that develops year after year. Keeping a close watch over a patient’s health allows PCPs to better intervene with disease prevention, patient education, health maintenance, and the diagnosis and treatment of both acute and chronic illnesses.

Lastly, the ease of access and communication involved with visiting a primary care physician is unrivaled. Longstanding doctor-patient relationships afford patients the opportunity to truly understand and participate in decisions that affect their health.

Once I settled down in Massachusetts, I knew I would need a primary care physician in my corner if I wanted to stay on top of my health. Turns out I had no idea how to actually go about choosing a primary care physician.

How Do I Choose a PCP?

Choosing a primary care physician is sort of like dating: there’s a large pool to choose from, and finding the right fit may take some trial and error.

Here are some tips I picked up that may help you find the doctor who best fits your personal needs. Let us know in the comments if they help!

Understand your insurance plan: Contact your health insurer or check your policy’s benefits to find out which doctors are considered “in-network.” Doctors in your insurers network will offer you discounted rates negotiated in advance by your health plan. Doctors considered “out-of-network,” on the other hand, often require patients to pay for their services up-front and in full.

It’s almost always a good idea to choose a PCP who is willing to work with your health insurance. We have an entire post focused on how to work with a doctor who doesn’t accept your health insurance.

Ask people you trustConsider asking for recommendations from friends, family, and coworkers. Most people feel more comfortable visiting doctors who have been recommended by someone they trust. Another benefit is that other people (or websites if you’re looking online) can help you pinpoint exactly what you want in a healthcare provider.

Are they male or female? Old or young? Laid-back or over-serious? The more you know about a doctor increases the chances that you’ll find one you like.

Keep an eye out for compatibilityMany patients schedule preliminary interviews with potential doctors to determine “fit.” Imagine the first visit as a trial run, and don’t rule out your gut-feeling.

Does the doctor explain things clearly? Do they listen without interrupting? Is the doctor relatable or more formal than your liking? Can you tell if the doctor prefers aggressive treatment or a more prolonged “wait-and-see” approach? All of these questions will help you in your search for a primary care physician.

Plan logisticallyIf you have a specific health condition like diabetes, you should choose a PCP who has specialized training or experience in endocrinology to receive the best care for your needs.

Other logistical considerations include the distance required to travel to the doctor’s office, schedule flexibility, and whether or not the doctor can understand you preferred language.

Make a list of your “wants” and “needs,” which you can then use to narrow down the list.

Know their availabilityNot all primary care physicians accept new patients. Even doctors with availability may have hours that conflict with your schedule. Some PCPs have dozens of patients, and those with more responsibilities require longer wait times to schedule an appointment.

Reach out to the doctor to get a better idea of their availability before you commit. You may be able to find someone who is a better fit for your schedule.

Check for qualifications:  A doctor is tasked with matters of literal life and death. Of course you’re not going to take advice from someone who isn’t qualified to give that advice. You want your health advisor to be an authority in their field, with an education and professional background that reflects expertise.

Check online or through the doctor’s office to see if the doctor is board-certified in the field(s) that you are visiting them for.

Are you ready to choose a primary care physician? Check out our “Doctors & Hospitals” category to browse resources we recommend for locating doctors online. Happy hunting!

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