How Patients Can Advocate for Themselves at the Doctor’s Office

Dr. James Grant

| 3 min read

James D. Grant, M.D. is senior vice president and chief...

January is a great time to make a plan for staying healthy in the new year and focusing on preventive care. Preventive care aims to prevent health problems from occurring or worsening. It includes check-ups, screenings, tests and discussions with health professionals to assess an individual’s health status and risk of illness.
In fact, preventive care is so important to a person’s overall health that eligible preventive screenings, vaccines and exams are required to be covered in full by any health plan.
Equally important to one’s overall health is self-advocacy. Good health care should be a partnership between an individual and their care team that includes open communication and involves the individual in decision making. Individuals should be able to ask questions and share concerns with their care team. 

Take an active role

When individuals take a proactive approach in their own health care journey, they often have a more positive experience. They are able to provide valuable information and insights about their body that can help guide the care team’s recommendations.
By collaborating with the care team, individuals can make informed decisions about treatment options and therapies, as well as lifestyle changes that might prevent conditions from worsening.
Here are four ways to be a self-advocate at the doctor’s office:
  1. Prepare for every doctor’s visit. Before an appointment, write down any symptoms or new concerns. Make note of any health changes in family members, new medications from other doctors, any over-the-counter vitamins or medications, or any other factors that impact health. Bringing the list to the appointment will help guide the conversation with the doctor during the visit. 
  2. Ask questions. If what the doctor is saying doesn’t make sense, ask for clarification. It’s critical that individuals understand any test results, diagnoses or treatment and medication recommendations. Don’t be afraid to ask the doctor to explain the reasoning behind their recommendations, the risks and benefits, and any alternatives. 
  3. Ask for a referral. If there is an issue a primary care doctor cannot address, they may recommend a referral to a specialist for a particular issue. Specialists are doctors that have completed additional training in a specific area of care, like allergy or heart care or cancer. Primary care doctors can provide recommendations, but individuals can always find someone else. Individuals should check to see which specialists participate with their health plan. For individuals with HMO plans, their primary care doctor will probably need to send an official referral to the health plan for approval before the individual can see the specialist.
  4. Know what’s covered by health insurance. Individuals can guard against surprises by checking with their health insurance to make sure their doctor’s recommended course of action is covered. For most health plans, call the number on the back of the customer ID card.
The Affordable Care Act requires all health plans to cover 10 essential services. However, individuals may be responsible for a portion of the expense, depending on their plan:
  • Ambulatory care
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance abuse services
  • Prescription drugs
  • Rehabilitative services and devices
  • Laboratory services
  • Preventative and wellness services
  • Pediatric services
In this new year, individuals should take the initiative and advocate for their health. It’s empowering, and ultimately fosters a better care experience.
James D. Grant, M.D., is senior vice president and chief medical officer at Blue Cross Blue Shield of Michigan.
MI Blues Perspectives is sponsored by Blue Cross Blue Shield of Michigan, a nonprofit, independent licensee of the Blue Cross Blue Shield Association