Dr. Rx

11 Feb

Letterbalm StethoscopeDear LetterBalm: Many times you recommend that a spouse or significant other get their partner to a doctor. But laws protect doctor-patient confidentiality. How can caregivers and family members deal with this, especially if the patient is suffering from dementia, Alzheimer’s or psychological problems that prevent full understanding of their condition and capacity to care for themselves? How do you book a full workup, and, if you can schedule one, what should you do to be sure all your concerns are addressed?

–Need To Know

Doctor-patient confidentiality is cited in the Hippocratic Oath and is one of the longest-held ideals of the medical profession. But in today’s complex world, another law addresses the same issue and gives caregivers more latitude. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) allows that, where a patient is not present or incapacitated, a doctor or healthcare provider can share information with family, friends or others involved in the person’s care. (If it’s other than a family member or friend, the provider must be reasonably sure the patient asked the individual to be involved in the care.) Ms. L.B. offers suggestions to make the doctor visit the most productive:

  • When making the appointment, ask for the earliest timeslot for a “comprehensive examination” that will require time. If the doctor or appointment booker doesn’t know you, identify yourself and indicate precise reasons why you’re seeking a visit.
  • Prepare a written list of detailed symptoms/physical or mental changes/habit changes. Put the patient’s name and date in it. Give it to the doctor.
  • Have with you a list of the patient’s prescriptions and dosage.
  • Ask to accompany the patient in the examining room. If this is not possible, give the doctor your lists and meet with the doctor and patient in his office afterward. Bring a notebook and pen and take notes.
  • Ask smart questions:
    • What are the drug interactions for these new medications? What are the side effects?
    • What foods are recommended/not recommended?
    • Any physical activity not recommended?
    • Is there an appointment with a specialist we need to make (allergist, dermatologist, ophthalmologist, etc.)?
    • Does the patient need another test (X-ray, MRI, CAT scan, bone density, etc.)?
    • What changes in the patient’s care do you recommend?
    • Do you recommend the patient see a counselor specializing in his/her condition?
    • When should we arrange for a follow-up visit?
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