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Tips on Dealing with your Doctor

  • Many HMOs require you to choose a primary care physician. A primary care physician is the doctor that will be your main contact with the HMO when it comes to medical matters. Make sure you find one you will get along with. Sometimes you will simply pick a name off a list, or the HMO will assign a primary care physician to you. Get to know that doctor over a couple of visits. If you like him or her, fine. If you don't, talk to people who are in the same HMO, or the same medical group as you to see if they can recommend a doctor they might know about. See if someone at the HMO or medical group can suggest someone.
  • Make sure that you spend enough time with your doctor to discuss all of your concerns.
  • Have your concerns written down. What are your symptoms, what are your worries, what are your expectations? Ask all the questions that are important to you, and be honest and open with your doctor if he or she has questions for you. Don't be rushed if there's something that is on your mind that you haven't gotten to.
  • If you think you need to see a specialist, discuss this concern with your primary care physician. Most HMOs require the primary care physician to approve appointments with specialists.
  • If you are not sure your doctor is right about a diagnosis or course of treatment, especially if it involves a major procedure like surgery, ask for a second opinion. You have the right to see another doctor for a second opinion. In many cases, the HMO will pay for the second opinion. A second opinion might confirm what your first doctor said, but in some cases the second doctor sees something the first doctor missed, or knows something the first doctor doesn't.
  • If your health plan does not allow you to get a second opinion, ask for an explanation and ask them to put it in writing.
  • Be familiar with your plan's grievance process. If you do not agree with any medical decision, the plan's grievance process is designed as the first step in resolving the problem.

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