Doctor listening to patient's heart with a stethoscope in doctor's office

With health insurance premiums rising, insurers and doctors want to balance costs while keeping health care effective and accessible for everyone. But patients play a role in keeping a lid on expenses. It starts with being proactive, offering honest information, and asking your doctor the right questions. Raki Pai, executive medical director at Regence, shared some strategies for how to be your own advocate and get the best care. 


How can you minimize costs before your appointment?

Cost is obviously a huge concern. One of the simplest ways to tackle this issue is by ensuring your doctor is in-network, meaning they have contracted with your insurance company to offer care at a lower rate. You should verify whether your doctor is in-network before your appointment. Just call your doctor's office, contact us or sign in and use Find a doctor.
If you're receiving more complex treatment like, say, a hip replacement, be sure to ask your doctor whether other people in your care team, for example anesthesiologists and assistant surgeons, are also in-network. This simple step can help you avoid surprise costs. The exception is in an emergency room situation; emergency services are generally considered in-network.

When should you ask for a second opinion? How can you start that conversation?

Any time you feel uncertain or uncomfortable with your options, seek out a second opinion. If your doctor is offended, then he or she is probably not the right doctor for you. It's really as simple as speaking up if you aren't 100 percent comfortable with your care plan. You must be your own care advocate.

But for some people, the doctor's office can be an intimidating place...

Absolutely. In that case, bring someone with you to your appointment. Medical conversations can be stressful for a number of reasons. The last thing you want to do is miss an important detail or not speak up during a conversation with your doctor. Bringing a family member or friend may help keep you honest. You are more likely to share all of your symptoms, ask all of your questions and not withhold valuable information if you have a loved one by your side. So when in doubt, bring someone you trust.

What other advice would you give patients?

This may seem obvious, but for specialized treatments or surgeries, find a specialist who has done a significant number of the procedures you are seeking. And, when possible, try to find patient reviews or talk to other patients who have received treatment from that doctor. Referral patterns tend to be very local and based on relationships. A hospital system may be great at many things—but for the care you are seeking, there may be a better option that is still in-network but outside of the typical referral patterns.
Also, take advantage of preventive screenings. Go get your annual exam, especially if chronic health issues run in your family.

What questions should you ask about prescription drugs?

As we all know, drug costs contribute substantially to overall medical spending. There are some basic things you can do to ensure you're getting a safe and effective treatment for a fair price. Ask if there is a generic version of your prescription available. Question your doctor about potential side effects. Additionally, opioid addiction has been in the headlines of late, so before you take one of these drugs to manage your pain, see if there is a safer alternative. Also, know your family history and if you have a higher risk of addiction. '

Be your own health advocate.