by Rich Sagall, MD

You have an appointment to see your doctor about a health issue. It may be a new problem, a chronic issue, or an acute illness. No matter the reason, you are ready for a 10-minute visit filled with quick questions, a prescription or two, and some instructions. If you are lucky, some of your questions will be answered and you may remember a portion of what your doctor tells you.

It doesn’t have to be this way. There are steps you can take to have a more satisfying and productive visit. You may not be able to do all of these at every visit and some may make you feel a little uncomfortable, but they are worth trying.

  1. Expectations – Before scheduling an appointment, think about why you want to see the doctor and what you hope to get from the visit. For example, if you are seeing the doctor for new back pain, are you looking for an x-ray, do you want strong pain medicine or do you want reassurance it’s nothing serious? At some point you need to tell the doctor what you want. That’s not to say you will get it, but being forthright makes it easier for everyone.
  2. Take a friend or family member – Many studies have shown that patients remember little of what doctors tell them during a visit, and doctors generally overestimate how much patients remember. A second person in the room, someone who is not experiencing the stress of being a patient, can better remember what occurs and help you better follow the doctor’s instructions. Remember – this person may hear very personal and potentially embarrassing things about you.
  3. Bring a list of questions – Actually writing down what you want to ask the doctor serves many purposes and helps to make the visit more productive. First, it forces you to really think about what you want to learn and state it succinctly. Second, it helps your doctor know what you want to learn. Bring an extra copy of the questions and give it to your doctor. Third, the list provides a place for you (or your companion) to write down answers. This will help you better remember what transpired.
  4. Have a good history – Doctors depend heavily on the history of a problem to make the diagnosis. This has to come from you. Keeping a symptom diary is a great way to quantify problems. For example, if you are being seen for headaches, keep a diary for a few weeks. Enter the dates and times you have headaches, how long each headache lasts, what the headaches are like, what you are doing when the headache occurs, what helps lessen the pain and what doesn’t, etc. You get the idea. This information will help your doctor better understand what you are experiencing.
  5. Ask about tests – It’s easy to order tests and doctors tend to do it a lot. Many patients expect to have them. Before having any tests performed, you should ask, “How will the test results affect my treatment?” You’d be surprised how often the answer is it won’t. If the results won’t change anything, then a good question is why do the test?
  6. Get your test results – It’s important for you to receive a copy of every test result. Never accept the “no news is good news” response. No news may mean all is fine, but it can also mean many other things. Perhaps the doctor never received the results and didn’t know it. Perhaps the results came back and were filed without the doctor reviewing the results. Perhaps the doctor misread the results. Or perhaps the doctor saw an abnormal result, but the office staff forgot to call you. You have a legal right to demand the lab send you results, and you have a right to all results in your medical file.
  7. Ask for a copy of the doctor’s notes – You have a right to the contents of your medical record. The doctor may “own the paper”, but the information is yours. You want to make sure the doctor got it right and, perhaps more important, recording what happened correctly. Depending on your state, the doctor may be able to impose a reasonable charge, but it’s well worth it.You should understand what is recorded. If you don’t understand something, either give the doctor a call or ask at your next visit.Once something is recorded, it’s next to impossible to change or correct it. Doctors are told to never go back and change what’s in a patient’s record. It looks back if there’s ever a legal issue. However, doctors can and do include an addendum if something in the record is entered incorrectly. If you find a mistake or disagree with a statement, you should send your complaint in writing to your doctor. Ask that your statement become part of the official record.

I know some physicians will not agree with some of the above – or even all of it. When I was in practice, I followed many of these steps and encouraged my patients to bring lists, get copies of results, and become active participants in their healthcare. I encourage you to do the same.

Rich Sagall, MD, a retired family physician, is the president and founder of NeedyMeds, a national non-profit that has information on programs that help people in medical need. He is aslso the

Read more

Multiple Sclerosis is a chronic and often disabling disease that attacks the central nervous system. There are approximately 400,000 people living with the disease currently in the United States. According to the National Multiple Sclerosis Society: “Multiple Sclerosis (MS) involves an immune-mediated process in which an abnormal response of the body’s immune system is directed against the central nervous system (CNS), which is made up of the brain, spinal cord and optic nerves. The exact antigen — or target that the immune cells are sensitized to attack — remains unknown, which is why MS is considered by many experts to be ‘immune-mediated’ rather than ‘autoimmune.’”

Each person experiences MS differently, with unpredictable symptoms and severity of symptoms. “No two people have exactly the same symptoms, and each person’s symptoms can change or fluctuate over time. One person might experience only one or two of the possible symptoms while another person experiences many more.” Common

Read more

Rogue Internet drug sellers are widespread and the problem is growing.  The criminals that operate these illegal websites make millions of dollars each month peddling counterfeit and otherwise illegitimate medicine to unsuspecting patients. As a result, patients are just a click away from dangerous or even deadly consequences.

As the holiday season draws near, beware of what you buy online. “Too good to be true” prices and claims of legitimacy are usually ploys to lure you to buy. And when you do, you give your personal and financial information (credit cards, home address, etc.) to criminals, and put your health in their hands.

A Real Patient’s Story

According to the Partnership for Safe Medicines, Rachael Jablo, a San Francisco resident, reported her doctor at the University of California-San Francisco suggested she visit an online “Canadian pharmacy” to save money on an antibiotic that costs $1,000 for a two week cycle. Rachael represents just one patient who was misled. This particular online rogue drug seller was not a licensed pharmacy and it was operating from Canada.  It shipped medications

Read more

Treatment and other diabetes-related costs can be expensive.   According to the American Diabetes Association the total costs of diagnosed diabetes was  $245 billion in 2012, with $176 billion in direct medical costs.  “People with diagnosed diabetes incur average medical expenditures of about $13,700 per year, of which about $7,900 is attributed to diabetes. People with diagnosed diabetes, on average, have medical expenditures approximately 2.3 times higher than what expenditures would be in the absence of diabetes.”

Here are 5 ways available to find help with these costs on the NeedyMeds website.

1.     Apply for free or reduced prescription medications through a Patient Assistance Program (PAP).
How they work:

→ PAPs are run by pharmaceutical companies and provide free or discounted medicines to those who qualify.

→ Eligibility and application requirements vary from program to program, usually based on income and insurance.

How to find them:

→ To find out if there’s a PAP available for your medication, click on the Brand Name Drugs or Generic Name Drugs links and look up your medication alphabetically.

→ If you do find your medication, click on it and you will be able to look over any assistance programs that are available for that medication.

How to get enrolled:

→ Most PAPs require that you fill out an application,

Read more

Patient Assistance Program F.A.Q.

Here at NeedyMeds we are dedicated to providing information on how to save money on your medications and other health-related costs. One of our primary resources is our database of Patient Assistance Programs. Today we answer some of the most frequently asked questions about Patient Assistance Programs. If you have any questions that are not covered here please leave us a comment and we will get you an answer!

What is a PAP? – Patient Assistance Programs are usually run by pharmaceutical companies to help uninsured and underinsured patients get their medication at free or low-cost. For more information on applying to a PAP read our previous blog post Applying to a Patient Assistance Program.

What are the requirements for a PAP? – Every program is different but most require personal information including your full name, address, date of birth, and social security number. They also generally require information from your doctor including their contact information and a valid prescription. Some programs also require a diagnosis and information on household income. When using

Read more