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Healthcare: A Hot Bed of Controversy

Healthcare QuestionsHealthcare…a real hot bed of controversy. How important is it? I don’t think there is a debate here. It is significantly important. I think we can all agree on that. Right? However, what we find ourselves in conflict about runs the gamut from patient quality care, patient safety, medical billing errors, insurance denials, healthcare provider mistakes, and now, the Affordable Care Act or “Obama Care.” Most of us are no stranger to healthcare conflict and the exorbitant costs.

Healthcare laws, policies, healthcare insurance contracts and billing statements are often conflicting causing confusion, frustration and downright emotional breakdowns.  There are numerous examples…Money is taken out of you salary for healthcare benefits but your unsure of what they are. You have a doctor’s visit with a specialist; and you do not understand why your health insurance will not cover it. Or, maybe there has been a medical treatment error or you question the perceived mistreatment of a family member in a hospital or nursing home by a medical care provider. It could just be a misunderstanding but allowing this misunderstanding to go unresolved or clarified only leads to escalated conflict. And what you need most right now is good communication between you and your healthcare professional. Here are a few tips to better help you improve communication with your healthcare provider.

  1. Bring a friend or family member. Dealing with complex medical issues can be confusing, emotionally draining and difficult to make decisions. Having a friend or family member as you visit your healthcare provider gives you the extra support you need to listen, ask questions or hear a different perspective.
  2. Ask questions. Your health insurance and healthcare providers are responsible for answering your questions and helping you understand your medical situation. Ultimately, you are responsible for the decisions you make but it needs to be based on solid information.
  3. Seek clarification. It is often hard to take it all in at the doctor’s visit. Maybe you forgot or misinterpreted something your healthcare provider said. Don’t be afraid to reach out to your healthcare provider or their assistants for further clarification.
  4. Take notes. Whether it is a pen and pad or your tablet, bring it with you to take notes. This well help you remember any questions or comments you would like to make regarding future and presence issues of healthcare.

Many of us have faced or are facing these healthcare issues or know someone who is. These situations can quickly escalate and become emotionally-charged, potentially dangerous and life threatening, and possibly result in threats of lawsuits with drawn-out and expensive litigation. Going to court may be the best decision for you depending on your legal rights, your interests and the law. However, court does not have to be your ONLY option for hopes of resolving, understanding and coming to an agreement. What are your other choices? Let’s See!

Alternative Choices for Resolving Healthcare Conflict Early On!

  1. Patient Advocate. This person can be a family member, close friend, social worker or anyone you trust that can speak on your behalf, who can communicate and work well with others.
  2. Ombudsman. An ombuds who specializes in the healthcare industry can assist patients and their family’s healthcare providers and/or the hospital’s organization in resolving conflict that involves quality of care or patient safety.
  3. Mediation. The mediation process utilizes a third-party neutral to help you and your healthcare provider, engage in a constructive dialogue and possibly come to fair agreement.
  4. Arbitration is a legal proceeding utilizing an arbitrator who makes a binding decision based on the facts presented in the case and the policies and laws governing the medical situation.

The Texas Conflict Coach will host a Health Care and Conflict series starting Tuesday, February 4, 2014. Listen and learn from experts in the healthcare industry their best tips and strategies for managing healthcare conflict.

By Tierra Henry, Graduate Student, University of Baltimore Dispute Resolution Program

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