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Health Care Decision Making

Chapter Thirteen

2013 McGraw-Hill Higher Education. All rights reserved.

HEALTH CARE DECISION MAKING

A hospital should also have a recovery room adjoining the cashiers office.
Francis O. Walsh

2013 McGraw-Hill Higher Education. All rights reserved.

Caring For Yourself


Medical self-care
Actions you take to optimize your health Self-treatment of common illness and injury

Signs and symptoms


Sign: result of an injury or illness and can be measured objectively by a health care provider
Symptom: the result of injury or illness that is subjectively perceived by the patient

2013 McGraw-Hill Higher Education. All rights reserved.

Medical Self-care Facts


Approximately 60% of emergency visits are clinically inappropriate. Approximately 30% of physician office visits are not clinically necessary. Approximately 25% of prescribed medications are not necessary. Only 45% of patients comply with the medical advice they receive. ~Larry Chapman, Wise Health/Sr VP WebMD
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2013 McGraw-Hill Higher Education. All rights reserved.

Caring For Yourself


Diagnosing common medical problems
Power of the Internet
www.familydoctor.org www.merck.com/mmhe/index.html http://familydoctor.org/online/famdocen/hom e/tools/symptom.html

2013 McGraw-Hill Higher Education. All rights reserved.

Caring For Yourself


Handling medical emergencies
9-1-1 Know where the nearest emergency room is? Doctors phone number accessible or programmed Know cardio pulmonary resuscitation (CPR) Automatic external defibrillator (AED) Caring for shock

2013 McGraw-Hill Higher Education. All rights reserved.

Caring For Yourself


OTC and Prescription medicines
Drugs (medicine or medication):
substances used in diagnosis, treatment, and prevention

Regulated by the food and drug administration (FDA) Over-the-counter drugs (OTC)
Purchased without a prescription

Prescription drugs (Rx)


Sold only by a pharmacist Authorized by written prescription from a medical practitioner

2013 McGraw-Hill Higher Education. All rights reserved.

Caring For Yourself


OTC and prescription medicines
Finding the right OTC medicines Pain and fever medicines Cold and allergy medicines Cough medications Upset stomach and constipation medications

2013 McGraw-Hill Higher Education. All rights reserved.

Caring For Yourself


OTC and prescription medicines
Tips for reducing medication mistakes
Keep medications in original containers Store as indicated Keep medicines separate Turn on the light when taking medicine Keep away from children Check expiration dates Dont take someone elses medication

Accessing information on OTC and prescription medicines


PDR health website: http://www.pdrhealth.com/drugs Physicians Desktop Reference (Book) PDR for Nonprescription Drugs NIH MedlinePlus: www.nlm.nih.gov/medlineplus/druginformation.html

2013 McGraw-Hill Higher Education. All rights reserved.

Body Art
Tattoo and Body Piercing Risks
Bloodborne diseases Skin infections Skin disorders such as scarring Allergic reactions Little is known about the toxicity of dyes

Reduce risks by going to licensed tattooing or piercing studio


2013 McGraw-Hill Higher Education. All rights reserved.

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End of Lecture

2013 McGraw-Hill Higher Education. All rights reserved.

Developing a Patient-Doctor Partnership


Finding the right doctor
Ask around
Is the doctor a good listener? Does the doctor answer questions in terms that are understood? Does the doctor ask for input? Is the doctor conservative in the use of medication? Is the doctor interested in you as a person? Will you get quality patient time? Are you comfortable talking to your doctor? Do you trust your doctor?

2013 McGraw-Hill Higher Education. All rights reserved.

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Developing A Patient-Doctor Partnership


Communication
Prepare for the visit
Symptoms Timeline OTC medications Prescription drugs, supplements Allergies, chronic conditions Important papers like Advance Directives

Communication goes both ways Take notes Ask someone to go with you and serve as advocate

2013 McGraw-Hill Higher Education. All rights reserved.

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Developing A Patient-Doctor Partnership


Tests and procedures
Standard test on blood and urine
Complete blood count (CBC)

Medical imaging
X rays, ultrasound Computed tomography (CT) Positron emission tomography (PET) Magnetic resonance imaging (MRI) Consumer questions about medical imaging and radiation therapies: www.radiologyinfo.org

2013 McGraw-Hill Higher Education. All rights reserved.

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Developing A Patient-Doctor Partnership


Hospital Admission; reducing medical errors
Read and understand all consent forms Ask WHY tests and treatments are performed Discuss test results with physician Know purpose and side effects of all medications (oral, injection, IV) Be sure all providers wash hands before physical contact Understand follow-up treatment plan when discharged Ask questions and understand your care
2013 McGraw-Hill Higher Education. All rights reserved.

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Developing A Patient-Doctor Partnership


Keeping medical records
Organizing paperwork into categories General information Specific medical conditions Drugs and dosage Insurance information Medical bills Electronic Health RecordsSingle, complete (electronic) record of a patients profile, diagnosis, allergies, and lab results that can be continually updated by all clinicians involved

2013 McGraw-Hill Higher Education. All rights reserved.

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Understanding Health Insurance


Terminology
Insurance carrier (the company that carries the insurance) Subscriber (the insured person) Premiums (the amount of money the subscriber pays for the policy) Deductibles (costs paid by the subscriber for medical service before insurance pays) Preexisting conditions (conditions that exist prior to obtaining insurance)

2013 McGraw-Hill Higher Education. All rights reserved.

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Understanding Health Insurance


Private health insurance:
Fee for service (traditional indemnity plans)
Greatest choice of medical care Greatest cost to the subscriber

Managed carePPOs, HMOlimit subscribers to specific networks of doctors and hospitals but at a lower cost
Preferred Provider Organization (PPO)
Health care providers that negotiate plans with insurance carriers

Health Maintenance Organization (HMO)


Plans that allow access to primary, secondary, and tertiary care within a health network.

2013 McGraw-Hill Higher Education. All rights reserved.

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Understanding Health Insurance

Private health insurance:


Health Maintenance Organization (HMO)
Allows access to primary, secondary, and tertiary care within a health network Types of HMOs
Staff model HMO Group model HMO Independent Practice Association (IPA) Point of Service (POS)

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Private Health Insurance

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Understanding Health Insurance


Public health insurance:
Medicare: insurance for the elderly / 65 and older Medicaid: low-income families and individuals living below poverty level

Choosing an appropriate plan


What is best depends on a number of factors
Choice of doctors Facilities Waiting periods Health screening Other features

2013 McGraw-Hill Higher Education. All rights reserved.

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Understanding Health Insurance


Healthcare Reform Patient Protection and Affordable Care Act (PPACA), 2010, President Obama
Reforms that increase the number of Americans that will have health insurance Provisions phase in over 10 year period Some provisions immediate
Keeping children on parents plans through age 26 Insurance available for pre-existing conditions Preventative services, such as vaccines and mammograms, must be covered

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Striving for Optimal Health


Staying Informed
Health Literacy; having the knowledge and skills to successfully access, analyze, and interpret relevant information to answer personal health questions
Self-directed learning Effective communication Critical thinking

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Striving for Optimal Health

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Can we now
Identify informed ways to provide self-care strategies? Identify effective ways of developing a patient-doctor Partnership? Explain the role of the primary care physician as it relates to diagnosis, treatment, screening, consultation, and prevention?

Understand Healthcare Reform?

Explain health insurance plans with details on deductibles, co-payments, fixed indemnity, and exclusions? Know where to find important self-care information?
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