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What to Expect

The medical profession in the U.S. is held up to high government standards. In order to legitimately carry the designation of MD (medical doctor) after his or her name, a physician must have undergone a prescribed course of study, including four years of pre med and four years of medical school, as well as an internship at a hospital, and must be licensed by the medical board of the state in which he or she practices. To pursue a special field of medicine, additional study is required. Any doctor one consults should have the designation of MD.


Typically, a doctor will have a registered nurse (RN) working with him, who will perform minor procedures such as recording weight, taking one's temperature, or drawing blood. Some medical practices, particularly group practices where several doctors share the same staff and suite of offices, may also involve a nurse practitioner who is licensed to perform tasks not permitted of an RN. These may include simple diagnoses and the writing of some prescriptions. Nurse practitioners provide a valuable service, are highly skilled and can alleviate some of a physician's workload. However, if you feel that a nurse or nurse practitioner has not met your needs, do not hesitate to insist on seeing the doctor, or speaking with him if you are making inquires over the phone.

Doctoring in the U.S. has become very departmentalized. Although family doctors, or general practitioners, still exist, many patients eschew these in favor of a more specialized physician. For example, if you have problems with your skin, you can consult a dermatologist; if your feet ache, a podiatrist is what you want. Women go to gynecologists, children to pediatricians, and so on. As a medical condition becomes more specific or serious, a referral from a primary care physician, such as an internist (internal medicine) to a more specialized one (i.e. an otorhinolaryngolist, or "ear, nose and throat doctor") is likely to be required, especially by some Insurance plans. But for check ups or "well visits," or basic, localized problems, you must select a doctor on your own.

It is important to note that not all doctors accept new patients; some simply have too much of an existing work load. If a doctor is accepting new patients, he or she may require a thorough examination as a pre-requisite, and should definitely include an interview to discuss with the patient his or her general health, and any related problems. The patient's medical history will be inquired about, including a family history of disease or health problems. Accordingly, most doctors charge a higher fee for first time visits. Also, many doctors are "booked" weeks in advance. Unless a significant problem is involved where immediate attention is necessary, don't expect to be able to see the doctor in a day or two. For this reason, it is always a good idea to line up a doctor you feel comfortable with well in advance of an emergency situation. And finally, many doctors run behind schedule, so do be prepared to wait to be seen.

When visiting a doctor, you will always be asked if you have Insurance and who your carrier is. Chances are, the doctor's office staff will file the Insurance claim for you; your Insurance agent can supply you with information on how to proceed if you are responsible for filing claims yourself. It is important to note that most tests are billed separately and the doctor's staff or your Insurance agent can guide you on filing for these payments. Occasionally, an Insurance plan will refuse to pay for a test that your doctor has recommended, in which case, you will be responsible for covering the cost of that procedure. It is usually possible to contest such decisions by the Insurance company, and your doctor can be helpful with this. If you do not have Insurance, you will be responsible for payment to the doctor, and for that of any tests or procedures. Most doctors' offices want payment at the time of the visit, but occasionally they will be willing to bill you through the mail. All tests will be billed, by the laboratories that perform them, through the mail. If your bills are high, perhaps do to ongoing care or a lengthy or expensive therapy, most doctors and laboratories will be willing to work out a payment plan with you. The same is true if you incur the services of a hospital. All such facilities accept major credit cards and most will accept personal checks.



 
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