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Your Doctor Doesn't Know Everything
When it comes to prescriptions, patients need to be part of the conversation

My father was from a generation that never questioned physicians. He put those who wore white coats on a pedestal, and was even reluctant to "bother" them with many medical issues. Above all, he always gave doctors the final word. Doctors knew best.

He would have been surprised by the idea that doctors actually have a lot to learn.

Don't get me wrong. The standards established through universities, medical schools and internships are extremely demanding. But in a recent presentation, Peterborough-based Dr. Jane Purvis stressed there are still gaps in how well physicians understand available medications and drug plans. There are simply limits to the time that can be devoted to gathering new information, reading journals and meeting pharmaceutical reps.

It's up to patients to offer research and insights of their own.

This hardly means that patients should begin diagnosing themselves, but those who take the time to understand the workings of a drug plan can pose some key questions that might otherwise be forgotten during a brief, seven-minute exam.

Asking whether a particular drug is covered might be one of the most important questions of all, and that can be determined by simply providing a medication's Drug Identification Number to an insurance carrier or pharmacist.

While an individual plan's formulary can include more than 8,000 options, every formulary is different. To compound matters, a doctor might simply default to prescribing a particular family of drugs based on experience with other patients. They may not check to see if a drug is listed in the formulary, if there are cost-effective generic or therapeutic alternatives, or whether the new prescription will have to be preauthorized by the insurer.

It is not the only advocacy role that patients can play in their own care.

Once drugs are prescribed, a few calls to insurers or benefit providers will ensure that forms are delivered to doctors in a timely matter. Then it is a matter of checking in with the doctor to ensure all the paperwork is submitted on time.

They seem like little steps, but they often determine which forms are pushed to the top of a doctor's inbox and identify any potential problems. The idea is to minimize delays in funding approved drugs and begin treatments as soon as possible.

There is never any time to waste, and there will always be questions to be answered.

Top Tips:

  • Supply your insurance carrier or pharmacist with a medication's Drug Identification Number to see if it will be covered by your drug plan.
  • Ask your doctor about cost-saving generic drugs and existing therapeutic alternatives.
  • Be an advocate in your healthcare, and check in with doctors to ensure that paperwork is completed in a timely manner.

May Everyone have a Happy and Healthy Holiday Season

If there is a topic that you would like me to write about,
please email me at billz@callerygroup.com.

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Benefits options for employers on a budget: smallbizadvisor

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