How to Get Your Doctor to Help You in the Age of Obamacare, by Cynthia J. Koelker, MD

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Since I first wrote an article for SB on “How to Get Your Doctor to Help You Stockpile Medication” the situation has definitely deteriorated. With Uncle Sam peeping over your doctor’s shoulder, the challenge of medical prepping has greatly intensified. Whereas the general principles in that article remain true, your physician’s freedom to assist you is increasingly restricted.

In the past five years we’ve seen solo practitioners closing their offices to join group practices, community hospitals being gobbled up by larger conglomerates, independent pharmacies run out of business by the big box stores, and electronic health records being mandated by the most powerful player of all– the federal government.

Doctors must play by the rules, but it isn’t physicians making them. Obamacare and Medicare mandates filter down to every level of medical care, leaving fewer and fewer decisions in the hands of your doctor. Does your personal physician work for you or someone else? The shingle out front may not paint the true picture. Unfortunately, when your doctor is an employee, his or her first allegiance is to the employer, not to the patient. Whereas an individual physician may be concerned about your disaster preparedness, a larger entity will be focused on statistical measurements of care according to computerized databases rather than your personal satisfaction with assuring your health both now and in times of crisis.

So as patients become mere numbers, you must become even more proactive to protect yourself and your family against future uncertainties. Regarding medical preparedness, below are suggestions to help you rely on yourself more and your doctor less.

  1. If you have the freedom to do so, choose a middle-aged or older like-minded solo practitioner who still uses paper charting, and thus is not yet entangled in the web of electronic medical records, which are under ever-increasing government surveillance. If you see your doctor glued to his computer, you should know that his first priority is to comply with the growing burden of E.H.R. mandates and not necessarily what’s best for you personally. Older physicians with a record room full of paper charts are more likely to remain self-employed and less likely to make the transition to electronic charting. Such a physician maintains a much greater degree of independence and lack of outside interference from entities such as insurance companies, Medicare, practice managers, and hospital employers.
  2. Build a relationship with your physician. Trust remains the key to getting your doctor to help with medical prepping. This is the one area from my earlier article that I am re-iterating. Honesty, mutual respect, and understanding form the backbone of any relationship. Once your doctor gets to know you as a reasonable person (as opposed to a crazy prepper), he or she is more likely to listen to your opinions and honor your requests. It also helps if your doctor likes you; Christmas cookies are definitely appreciated. Having a trusting relationship with your doctor is the primary ingredient in having him or her comply with your request for additional refills or antibiotics. It’s not unreasonable to have at least a few months of medication on hand, just in case, though you may have to pay for it on your own.
  3. When you visit your physician, change your approach. Don’t ask how he or she can fix a problem for you. Ask your doctor’s advice on how you can remedy the situation yourself. This may take a longer office visit, costing more in the short run, but increasing your self-reliance in the longer term. If you think you’ll require a longer visit with your doctor, please let the scheduler know ahead of time. Otherwise, your doctor won’t have time to answer your questions and/or it will make him run late the rest of the day. Learn the right questions to ask, how to handle your problem under various circumstances, what alternatives exist, when to expect improvement, and what the dangers are of non-treatment and how to recognize them. Take advantage of online resources from respected institutions, such as the Mayo Clinic or the American Academy of Family Physicians. In many cases, it is possible to learn how to manage your chronic conditions, such as high blood pressure or diabetes on your own. You may even want to consider ordering your own labs. Though insurance won’t cover the cost, it is possible to order your own labs online and receive the results yourself.
  4. Whenever you see your doctor for a medical problem, ask about over-the-counter alternatives to prescription medicine. A great number of conditions may be treated with OTC drugs, many of which were by prescription in recent years. Armed with appropriate knowledge, you can treat a multitude of conditions on your own, including arthritis, gout, vertigo, nausea, motion sickness, acid reflux, headaches, migraines, hives, diarrhea, constipation, back pain, yeast infections, dermatitis, fungal infections, warts, nasal and eye allergies, acne, swimmer’s ear, poison ivy, athlete’s foot, even some instances of diabetes, asthma, and hypertension. Just understand that not all doctors approve of this approach; after all, they need to see patients to stay in business, and some doctors believe medical treatment should be left to professionals. If you fear you might offend with such questions, use phrasing such as, “What should I do if this ever happens on vacation?”
  5. Tithe your medication. Many studies have shown that patients are non-compliant with medication, commonly skipping at least one tenth of their recommended doses. In decades of experience I have rarely seen missing an occasional dose to be a problem. You might ask your doctor if skipping a dose would hurt you. If you hold back 1/10 of your medicine, with time you’ll build up a supply to use in case of future crisis. Make sure to order refills on a timely basis even when you have medication remaining (which is the point, after all), and to rotate your supplies so you use the oldest medicine first. For those who use inhalers, refill these whenever a refill is due, even if you have medication remaining. You may also want to experiment to see whether one inhalation is as effective as two. This can usually be assessed with a peak flow meter, by your own symptoms, and/or whether you require any visits for emergency care, which you definitely want to prevent. For the serious asthmatic or COPD patient, you should consult your doctor about the best approach.
  6. Along the same lines, tithe your antibiotics as well. For many illnesses three to five days of antibiotics is as good as seven to ten days. Patients do this all the time anyway, stopping the medication once they’re feeling better. Usually this causes no problem. Once your immune system has geared up to fight an infection, antibiotics are not as vital in combating the illness as they are earlier in the course of disease. For a serious situation, however, you should consult your doctor before taking this advice. When your doctor prescribes an antibiotic is also a great time to ask how long you really need to take the medicine. This is a legitimate question, since many people try to limit their use of antibiotics for a variety of reasons (secondary yeast infections, bacterial resistance, cost, et cetera).
  7. Think outside the box. Medication that is by prescription in the United States may be over the counter in other countries, such as our neighbor to the south, or overseas. Ask your doctor about alternative treatments; for example, peppermint tea may help irritable bowel syndrome equally as well as Rx drugs. If you have hypothyroidism and slaughter your own cattle, learn how to make your own thyroid jerky. Now is the time to consider how you would handle a situation if no doctor were around. Whatever conditions you may have or anticipate, investigate ways to free yourself of reliance on medical professionals.

In summary, it’s up to you to protect your loved ones and yourself in times of crisis, as I teach in my Survival Medicine classes (see www.armageddonmedicine.net). This situation is unlikely to improve as our country embraces a future of socialized medicine.

About the Author: Dr. Cynthia Koelker serves as Medical Editor for SurvivalBlog, and hosts the survival medicine web site www.armageddonmedicine.net. She is the author of the book Armageddon Medicine and is the chief instructor for the Survival Medicine Workshops.

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