Five Ways to Get the Right Amount of Care
When it comes to health care, we all want and deserve quality. But just because something is called health care doesn't mean it's good for your health. Getting the right care when you need it - not too much or too little - is a big part of what makes up quality.
We all know that not getting enough of the right care can hurt your health. If you break a bone, you need to have it set. If you have acute appendicitis, you probably need surgery to remove your appendix. And if you're prescribed the appropriate medicine by your doctor, you should complete the entire prescription as directed. But did you know that more health care isn't always better? In fact, too much of the wrong care may do more harm than good and put your health at risk. It's important to focus on getting just the right amount of care.
What is the right amount of health care?
Getting the right amount of health care means you receive as much care as you need and avoid unnecessary care. Unnecessary care is care that you don't really need. Here are some examples:
- Getting lab tests or X-rays when you need them is the right amount of care. Repeating the same lab tests or X-rays when you see a different doctor - instead of just using the test results you already have - is unnecessary care.
- Receiving antibiotics for a bacterial infection that can be helped by antibiotics is the right amount of care. Getting antibiotics for a viral infection that cannot be helped by antibiotics - such as the common cold - is unnecessary care.
- Staying on schedule with preventive care (such as a general physical exam) and screening tests (such as a Pap test to screen for cervical cancer) recommended for your age, sex, family history, and health condition is the right amount of care. Having preventive care and screening tests more often than recommended, or that aren't appropriate for you, is unnecessary care.
Why is getting the right amount of health care so important?
Making sure you get the care you need is crucial for good health. If you can't or don't get as much care as you need, it can lead to more serious health conditions that are harder to treat successfully and may cost more to treat in the long run. But getting too much care also poses problems. Getting more care than you really need can be bad for your health, as well as unnecessarily expensive.
- Every drug or procedure has risks. For example, studies show that some surgery, such as spinal fusion (a surgical procedure to join together two or more vertebrae) for low back pain, may not be necessary or the best option. And with every surgery comes the risk of complications, including infection. Evidence from research on patientcare shows, for some conditions, treatments that are simpler and less risky than surgery may actually work better. So it's important to know all the potential benefits and risks of your options and make an informed decision.
- Some tests or procedures may actually cause risk in the future when they are not needed to improve your condition. For example, repeated exposure to radiation from advanced imaging like CT scans and X-rays has been shown to increase the risk of developing cancer years later.
Receiving care you don't need is costly.
- Whether the money comes out of your own pocket or is paid for by your health benefits, why spend money on care that you don't need? It's better to save your money for care you really need and for things that can help keep you healthy and vibrant, like gym memberships, nutritious food, or a bike with a helmet and lights.
- When employees are given care they don't need, the costs can add up quickly for the company that is paying for your health care insurance. This can lead to higher premiums, reductions in coverage, and higher out-of-pocket costs for you in the future.
What can you do to help make sure you are getting the right amount of care?
How can you know whether you and your family are getting the right amount of care - not too much and not too little? Here are some tips:
1. Talk to your primary care doctor.
Establishing a relationship with a primary care provider is key to getting the right health care. Knowing what you should do before you get sick can help you make the right decisions, as well as assist your doctor in helping you make the best decision for you and your loved ones. You can work with your primary care doctor to develop a care plan which will spell out what to do if you get sick, when to seek care, and where to go for that care.
If you're facing a health condition, such as asthma, depression, diabetes or heart disease, having a care plan in place is especially important. The planning process can help you learn when to seek care in your doctor's office and when you should go to an urgent care facility or emergency room.
2. You can call a nurse line for information and advice.
If you think you might need care but you are not sure, you can call the nurse line or medical help line available through your doctor's office or health plan. Talking with an advice nurse can help you decide whether you need to come in for care and if so, how soon you need to be seen and by whom. Sometimes you will need an appointment. Other times, it may work just as well or better to get advice over the phone on how to handle your problem and what symptoms to watch for that may mean it's time for an in-person appointment.
3. Ask questions.
When you have decisions to make about your care, or a doctor has recommended you get certain tests or treatments, asking questions is not only helpful but also your responsibility. That way you can be sure you understand why the care is needed, what it is supposed to do, and what the risks and benefits will be. It's your body. It's your time. It's your money. Ask questions until you get the answers you need.
4. Look for more information on your own.
When you have health concerns or decisions to make, finding reliable health information on your own can be helpful. You can use this information to help understand your health condition and treatment choices and know what questions to ask about your care. Be sure, though, to only seek information from reputable sources. There's a lot of material on the internet, for example, that is untrue. Refer to "How to Find Trustworthy Health Information on the Internet" available on the Own Your Health website at www.wacommunitycheckup.org/ownyourhealth
.5. If needed, get a second opinion from another doctor.
If you are facing a major decision about treatment and your doctor has made a recommendation, it may be wise to check with another doctor as well. Your doctor should not take it as a criticism or lack of confidence on your part. You'll want each doctor you see to clearly explain the risks and benefits associated with his or her recommendations.
You may get different recommendations and explanations from each doctor and have a decision to make. That's why you'll want to get the full picture and understand how all the pros and cons apply to you. Whenever you consult another doctor, make sure to get your records from the first doctor so that you don't get any unnecessary care, like repeats of tests.
You can also ask for decision support tools you can review before talking with your doctor. These tools, such as brochures or videos about a medical procedure (such as gastric bypass surgery or prostate removal surgery) enable you to have a better conversation with your doctor about your options.
Both undertreatment and overtreatment can hurt your health and leave you without the care you really need. Getting the right amount of care helps you stay as healthy as you can.
Our health care challenges and needs change over time. What is the right amount of care one day can be different the next. That's why it's important to use these tips on an ongoing basis and to tell your health care team that you want to get the right amount of care every time
Own Your Health is a campaign presented by the Puget Sound Health Alliance to empower consumers to become active participants in their own health and health care; Bureau of Minoirty Health; Mid-south Foundation; Louisiana Department of Health