Who’s in charge of your healthcare?

Depending upon how you view things like patient rights and autonomy, asking who’s in charge of your healthcare may seem like a silly question.

After all, lots of folks are quite accustomed to turning over the wheel of their healthcare needs to the providers who care for them.

But there are others who are determined to maintain as much autonomy as possible.

And I’m one of them.

With all the changes in healthcare technology that have taken place over the last decade or so, there’s much greater access to the information we need to help inform our healthcare decisions and empower us in our care.

Additionally, the somewhat-recent shift in payment models from a fee-for-service framework to value-based care means that patient needs are increasingly being honored at the center of care—which is exactly where they should be.

Patients as Consumers

Back in 2014, when I was working as the senior content editor for a digital health company, I co-wrote a piece entitled, “The Democratization of Medicine and the Two-Party System.”

Discussing the results of a survey in which both patients and providers were asked about how much access patients should have to their healthcare information, I proposed that patients should be given options that align with their individual needs. Here are a few excerpts:

“I have to say that I’m a stubborn and independent consumer of healthcare. My nursing background and experience have a lot to do with that—both in terms of how I view patient autonomy, as well as my comfort level in dealing with healthcare information. It also fuels my empathy for the concerns that providers express. …

There will always be patients who need more support than others and are happy to be governed by the paternalism of our healthcare system. But, there are many who prefer a more independent approach. I believe we need to attend to the needs of both. …

…We need to sort out who-needs-what and match it to who-gets-what in terms of access and empowerment. For the patients who want to take responsibility for that which they already own—let them. For those who don’t—give them the level of support they desire.”

Avoiding the Healthcare System

I remember standing at a desk in a clinic beside Mom as we dealt with some frustrating issue related to her care and thinking that where my own needs were concerned, I’d do all I could to avoid the healthcare system.

And largely, I did, until 2017, when I started having some issues with my health.

Honoring my promise to myself, I put off going to the doctor as I researched and tried to diagnose things on my own.

But eventually, I ended up going to my primary care physician, having some testing and being referred for specialty care—which lead to surgery and everything went well.

Now let me stop there to say that I’m grateful for every healthcare expert I encountered on that journey, because it was overwhelming at times and I was quite willing to follow their guidance.

But as I look back (yes, that retrospective perspective is always most keen), I’m surprised that I was as passive as I was and didn’t ask more questions than I did.

Mostly, that relates to procedures and tests that I’m not sure were necessary—and the related physical stress and costs of having them.

However, I know that becoming an overwhelmed-and-passive patient is something that happens a lot—especially if questioning our healthcare providers isn’t something we’re accustomed to.

Embracing a New Model for Care

In light of all that, the fact that I actually enjoyed the recent visit to see my new primary care provider might sound like a contradiction.

It was a delightful experience and renewed my hope that patients can get the individualized and respectful care they deserve.

For context as to why this was such a positive experience, I’ll first say that I really liked my last primary care provider and appreciated her care.

However, the office policy at the time (perhaps it’s changed to meet pandemic needs) meant that anytime I needed to get my results for any type of test, I had to go through the incovenience and expense of an in-person visit.

And what I encountered with my primary care provider before her were visits held at an “efficient” pace, which was likely due to the need to meet a certain visit quota in a designated period of time.

Of course, COVID-19 has turned healthcare on its head, so things are little different now with so many relying on telehealth.

But still, you get my point.

In the context of my past experiences, imagine my delight this week when my new primary care provider sat down and spent a leisurely hour with me and then followed up with both a call and several texts.

Although it may not be the same across the board, the model she works within is referred to as “direct primary care,” in which patients pay a membership fee for unlimited access to care. No insurance is involved, although having it is still recommended for specialty and hospitalization needs.

I was familiar with the model and heard about this specific practice several years ago on a local Christian radio station. During the clip, the founders described their vision for providing primary care in a holistic way that gives patients more access and control.

What they described sounded fabulous to me and I tucked the information away with plans to check them out in the future.

When the health sharing ministry we belong to recently added benefits for using direct care models, I knew it was time to sign up.

And I’m sure glad I did.

Because while I know that I need healthcare experts to guide my care as I age, I also want caring providers who see me as a collaborative partner in the process—rather than a patient who’s just being told what to do.

So, regardless of the healthcare paradigm you embrace, this is just a reminder that you should be treated with the respect you deserve to ensure your individual needs are met in a way that works best for you.

This post is adapted from Sue’s Perspectives column in the latest edition of The Empowered Traveler™ Newsletter. If you’re not already a subscriber, you can do that here: Subscribe to Sue’s newsletter.

Sue Montgomery is a Christian writer/content creator who's also been a hospice nurse, family caregiver, health coach, and professional organizer. Now she's helping Baby Boomers like herself embrace the Boomer Continuum™ of agile caregiving, graceful aging, and peaceful dying—with Christian faith and simplicity to focus on what matters most.
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