Lessons From The Front Line: Common Health Care Questions and Answers

Studies regarding job satisfaction have demonstrated that beyond basic financial security, it is things like autonomy, working with people you respect and feeling that your labors are meaningful/making the world better, that contribute to happiness at work: “A job is usually more than just a means to a paycheck. It’s a source of purpose and meaning, a place in the world.”

In my case, there were many times while working in varied corporate roles when I wondered if what I had done all day had any real value. Today, by contrast, I am happy to say that I feel extremely fortunate — I LOVE what I do at Healthassist!

Sharing my insider knowledge of how the healthcare system works with clients — many of whom feel frustrated and overwhelmed — and helping them to achieve a sense of mastery and control, is incredibly gratifying and keeps me working very hard on their behalf every day.

Recently, after receiving many requests (often in social situations) for some “on the spot advice” about a healthcare or insurance situation, I decided to make this a standard offering: Clients simply register online for a one-hour, as needed phone consultation at their convenience.

I’ve done many of these now and have found that certain topics come up again and again, including:

Doctor-Patient Relationships

If you have a primary care physician or specialist with whom you don’t feel completely satisfied, rest assured that you are not alone. I hear this one frequently!

Clients report that while they may have regard for the physician and his/her competence, they describe interactions they perceive to be one-sided; they just don’t feel listened to and/or heard.

In these circumstances, my advice is to always assume the physician is also motivated to have a mutually satisfying interaction. The first action, therefore, is to address the topic of “our relationship / communication,” and to include it on your agenda for the next scheduled meeting.

Here is what you can say when you sit down together:

“Our mutual relationship is of great value to me and I’d like to expend some effort on enhancing it. I’d like to discuss how we communicate and what works best for both of us.”

From there, you can discuss past interactions (how they left you feeling and how you would have preferred them) as well as what you would like to see going forward (e.g., sharing your agenda at the beginning of a meeting, sending an email in advance, your preferences regarding phone conversations).

Most physicians tell me they are grateful when a patient brings up this topic, especially when a patient feels unsettled. They recognize that methods of communication need to be customized to each patient and are eager for the opportunity to improve.

Medicare: When to enroll? How to enroll? What to choose? Help!

There are many options regarding when, how and at what level to enroll. These variations are necessarily specific to each individual and my work with clients focuses on sorting all of this out and creating a customized game plan.

One area that people find particularly confusing is the difference between Original Medicare and a Medicare Advantage Plan.

Original Medicare, including Part A and Part B, pays for approximately 80% of health care costs. If you add a Medigap/supplemental plan, it can cover all your healthcare costs and result in little out-of-pocket expenses. I call this a “pay up-front” plan and it generally costs more than the option below.

A Medicare Advantage Plan, on the other hand, functions like an HMO or PPO plan obtained through employers. It may or may not have an additional premium and deductible associated with it and always has additional out-of-pocket expenses for co-pays and co-insurance amounts. I call this a “pay as you go” plan, and while it may appear to be less expensive, the devil is in the details of how, where and when you access care.

A careful analysis of an individual situation, taking into account preferences for coverage, other family members that must have health insurance, where you live and your income from the two years prior to reverting to Medicare, all must be considered.

Working with my Insurance Company

Questions in this area tend to focus on understanding the various components of insurance and coverage, as well as how to file claims for things like long-term-care insurance policies.

One topic that nearly always arises has to do with the difference between an HMO (Health Maintenance Organization) and a PPO (Preferred Provider Organization).

An HMO is the more restrictive of the two. You must identify a primary-care physician, you must obtain referrals from her/him to see specialists and you must stay within a network of doctors and hospitals.

A PPO has fewer restrictions. It does not always require you to have a primary care physician or to obtain referrals. Also, financial coverage is greater if you stay within the network of doctors and hospitals. If you go outside the network, you still have some financial coverage.


I have the incredible privilege of waking up every day knowing that I love what I’m going to be doing. Having a fabulous team of highly skilled professionals to work with contributes to that feeling.

But mostly, it’s the clients I love — the ability to enter their lives at what often are very vulnerable times, to develop a relationship with them, and to share some of my insider knowledge in the hope of making their lives just a little bit easier. To me, that is simply the best!