HIGH-QUALITY MEDICAL CARE FOR OLDER PEOPLE: SELECTING A NEW DOCTOR
Changing doctors is an unpleasant task that many older people face, not just the few who awaken to the fact that their trusted family physicians are less than competent. You may have moved after retirement. Or you and your doctor may have grown old together. One year he decides to retire. It is hard to start again from scratch after losing a relationship that may have spanned much of your adult life. You may feel no one will know your body in the same way. Never again will you get the same special attention or care.
These fears are natural. Anyone we have such an intimate relationship with for so long is bound to seem irreplaceable. The truth is that transference is transferable. Provided you make a determined search, you can find a doctor you will eventually feel just as enthusiastic about. But you must choose wisely. Make selecting a replacement a special project. What other investment of time is more important? (Once again, it may be helpful to enlist another person in following the next suggestions, a competent “buddy” who can work with you – or even take over the job – in making this project succeed.)
Develop a list of names. Question friends and relatives, but give most weight to recommendations by doctors or other health-care professionals. They will be better able to evaluate candidates’ skills. You can feel more confident that someone they suggest is competent, not just affable.
Check the credentials of each person on your list. What training and education does the doctor have? Does he or she have an academic appointment at a medical school? What hospital is the physician affiliated with, and what is its reputation? To get these facts, either call the doctor’s office directly or ask your county medical society.
Expense. Find out the doctor’s fees and when payments are due. If your financial situation is tight, would it be possible to arrange a special payment schedule to fit your budget? Find out if the doctor accepts Medicare (or if you are eligible, Medicaid), and if so, for what services. Will the office bill Medicare and your insurance carrier directly?
Medicare will pay only for the services of licensed physicians. Your doctor may bill Medicare directly, or you may pay and then be reimbursed by Medicare. Whatever arrangement you have with your doctor, after you pay the yearly deductible, Medicare pays 80 percent of what it deems the “reasonable charge,” and you pay the other 20 percent. If your doctor charges more than the “reasonable charge,” you are responsible for the additional amount.
If feasible, choose a doctor who takes what is called “Medicare assignment.” This means that even if his normal fee is higher, he agrees not to charge you more than Medicare will cover. Those who accept Medicare assignment also submit claim forms directly to Medicare, which will save you time. Unfortunately, however, it is increasingly hard to find a doctor who does accept assignment. Because of Medicare’s stingy reimbursement rates, nationwide 72 percent do not.
*140/159/5*
HEART SAVING TIPS: EXERCISE IS VITAL
We all know that exercise is good for us, but you may not know just how much it can save your life. If someone could bottle the positive effects exercise has on our bodies and sell it as a drug, they would make a fortune because we’d all be taking it! Interestingly enough there was a weight loss supplement on the American market called “Exercise in a Bottle”; the US Federal Trade Commission has permanently banned the manufacturer of this supplement from marketing products for weight loss because of false and unsubstantiated claims made about this supplement. There’s nothing like the real thing!
Exercise has the following benefits for your heart:
• It makes your heart muscle stronger, so that it can pump more blood with less effort.
It helps you maintain a healthy weight by speeding up your metabolism and increasing your muscle mass.
• Reduces your chance of having high blood pressure.
• Strengthens your immune system and improves your ability to fight off infections.
• Exercise reduces LDL “bad” cholesterol and triglycerides, and is one of the few ways you can increase your HDL “good” cholesterol.
• It improves glucose tolerance, thus reduces your chance of developing Syndrome X and diabetes.
• Exercise helps you cope with stress and reduces anxiety and depression. It reduces tension, anger and fatigue, and helps to lift your spirits.
• Exercise improves your self esteem and makes you more motivated to eat well and look after yourself well.
• It causes your artery walls to release nitric oxide, which dilates your blood vessels, improving blood flow; reducing inflammation of the artery walls and reducing the tendency of blood clots to form in the arteries.
• Exercise makes you smarter! Yes it’s true; studies have shown that exercise helps thinking and decision making abilities, and speeds up brain activity.
• It helps you to live longer.
Clearly exercise is one of the easiest, least expensive things you can do to reduce your risk of heart disease. An ideal amount of exercise would be 30 to 60 minutes most days of the week. If you can’t fit it all in one go, you can split this into two or three sessions. For example, two fifteen minute walks would be just as good. If you don’t have time for formal exercise, you can still stay active by gardening, doing vigorous housework, walking to the shops instead of driving, taking the stairs instead of the lift, going out dancing, or having energetic sex. Find some way to be more active; it will be well worth it.
If you have diagnosed heart disease it is vital that you check with your doctor before starting an exercise program.
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