Ep. 167: Healthcare, It Gets Messy

In this continuation episode, we discuss common barriers to healthcare, including transportation challenges, the cost of medications, and healthcare expenses overall. We also share practical ways to overcome these obstacles, highlighting transparency with providers and helpful resources such as GoodRx and the Patient Advocate Foundation. Lastly, we talk about how patients can make sure their concerns are addressed during healthcare visits, especially when appointments feel rushed.

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Transcript

SPEAKER_02 0:04

You're now listening to a potent dose of three with your hosts Linda, Jasmine, and Kathy. And we're here to bring you your weekly dose. Hey guys, welcome back. This is a continuation of last week's episode.

SPEAKER_01 0:29

Same Linda. I remember when I started working at the clinic, I they they were telling us all the resources they provided, and I was like, wow, I would have never known a clinic offered all these resources. And so eat that's I want to reiterate reiterate what Kathy said is I know it can be hard sometimes to open up about your personal life, but um a lot of times these clinics do have resources and they wouldn't know to offer them to you because they they can't just offer all the resources, right? Um, because there's a lot of resources, so they can't just offer you or assume that you need the resources. So sometimes um being a little open about your situation or like Linda said, asking what um services are offered. The clinic that I worked at, um, they actually offered medication for free. Um, if we had the medication, they could and they were prescribed it, they can get it at our clinic and they wouldn't have to go to a different clinic. One, that's a transportation cost right there, and two, that's a cost ish um cost for the medication. And so that, you know, you wouldn't know if you don't ask. Um, and then also like I know the clinic I um I worked at, they also gave like good RX coupons, and so then that would also cover their medication. Um, so there's a lot of resources out there. You just have to ask for them or kind of be open about your situation, which is um, you know, would help alleviate a lot of the cost that a patient with multiple chronic conditions, you know, would be facing.

SPEAKER_02 1:58

To add on to what Jasmine is saying, you know, I I know our conversations be going everywhere, but we're we're making some good points. Jasmine mentioned something about medication. So one thing that I've noticed this year, because of the whole healthcare administrative station, a lot of things changed in healthcare that's not for the good for the patients. They just healthcare is just screwed up right now. Um, so a lot of patients lost insurance, had difficult time re-signing up for insurance. So, because of that, they didn't have their medications for a month or just something regarding medications where they were not able to take it. Yes, good health rx, health rx, whatever it's called, the prescription thing. Walmart also, if you go to Walmart.com, they have a prescription section where they you can get pills, medications for under $10. So if you go to your to your provider and you have to pay out of pocket, because that's another thing. We'll do, I'm forgetting like the medical or the terminology for these things, but say you go to your visit and you don't have health care insurance, they'll give you like a base rate of maybe like $25 for that visit, but then you still need to pay for your your medication out of pocket. So we'll recommend going to Walmart to pick up your medication. You need blood pressure medication. They have like a torturin for um for like five dollars. Um, I said a toro sadin. Oh my god, it's been a long day. My point is um I my point being is that uh I lost my train of thought. She got ADHD too, guys. So I think so. Because I went uh because I I set the wrong medication and that just threw me off. I was gonna say something, because you had mentioned something about medication. Oh, yes, medication. So if you ever run out of medication and you don't have health care insurance or it's difficult for you to get into your get in contact with your provider, but you it's a very important medication that you need, go to the emergency department. The emergency department is required to treat you even if you don't have health care insurance, and they usually will give you like a month's supply of medication until you're able to see your provider. So that's one way for you to get certain medication that you need, maybe for like your blood pressure, until you're able to um see your provider. So that's an option as well.

SPEAKER_00 4:31

Also, as Linda mentioned, because of everything that's happening right now and healthcare is being kind of messy. Um one thing that I've been running uh to a lot with patients is that their medications are not being covered. So they just like, and I get it, it's it's kind of because uh me as a patient when and as a parent, it's kind of hard to navigate the healthcare system. They make it really difficult. So, for example, uh when they tell you, like, oh, this medication, yeah, we we will not cover. So you as a patient, because I've done it, I'm like, okay, then fine and I'm not gonna take it. Like, how am I gonna afford the medication, right? But what you could do, then I found out because there was some medication that it wasn't being covered for me. I don't, I think it was my birth control, something like that. And then I talked to the pharma, I was like, I'm gonna call pharmacy. Call pharmacy. And then he's like, Oh, you just need to call your insurance and see which uh no, I called the insurance, and the insurance was like, you just need to call the pharmacy to see which um medication they could cover or something. But like, because you know, there's generic name and then there's brand name. Preferred alternative, yeah. Brand alternative. Yes. So then um I was like, oh, okay. So I did that, and then they're like, oh, they just need to change to the generic name. And I was like, oh, okay. Right when the uh doctor like they changed the prescription to the generic name, it was covered. And that's a lot that's happening right now with a lot of my patients that uh they they get discouraged and they're older, and then sometimes they don't know how to navigate their phone, or sometimes I had a patient that was blind. I didn't know until I called her, and then she's like, I'm blind, honey. But and I'm like, you know what? I'll make the club for you. That's why I'm your nurse. Let me make the club for you. I got you. And then yeah, like they don't know about this type of like alternatives, so it's good to do not give up, just ask questions, or call your clinic. They we're we're there to help you, and then that way we can know that maybe they just need to change the prescription and then you'll get them the medication, and then you'll be fine.

SPEAKER_02 6:34

Yeah, I just want to make a quick comment because it's gonna bother me because I was talking too fast, and that's the reason why I lost my train of thought. Because I said be blood pressure med and I said a torovastin. It threw me off because I know dang on well a torovastatin's not for blood pressure, it's for cholesterol. I meant to say uh a medication like m lodipine or something. A torturin, guys, is not for blood pressure, it's for um cholesterol. I just have to clear that up so you won't be questioning these people that's speaking right now. I swear I got my degree. I swear. Don't worry, we know you know, we know you know your stuff. Don't worry. Yeah, I swear I do, I swear.

SPEAKER_01 7:14

Um, I wanted to add on to something that uh Kathy was saying when your insurance isn't covered, and then you try to do the preferred alternative, so the um the non-name brand, right? And it's and then that sometimes that's not even covered. And so I was doing research. Yes, I was doing research, and you can also ask your doctor to submit to do a treatment authorization request. Um, so your doctor will have to submit a request, and this should allow the um Medi-Cal to cover the financial cost of that medication. So that's another option as well.

SPEAKER_02 7:48

Yep, yep. Those PAs, prior authorization, those come in clutch um when you're they're having a hard time trying to cover your medication. They the pharmacy will usually send it back to your provider. The medical assistants at our clinic, they usually do it. They just put some information down and sometimes they get covered.

SPEAKER_01 8:07

Also, um I found like a lot of other like different foundations that they can help, you know, with your co-pays, help pay your co-pays and um help, you know, there's just so much there's a lot. You just have to really look for it. Um, but uh some other things I found was patient advocated advocate foundation. It's a nationwide program um that helps, you know, deal with like insurance issues. Um, they offer one-on-one case management, and they do the copay relief. Um, they also have like small grants and um help you, you know, like they give anywhere from $300 to thousand dollars to help with uh expenses like transportation, lodging, um, utilities and food. So there's things out there you just have to look. I know it's very difficult, you know, when you're dealing with the situations, but um it's just you you literally have to look. They're scattered everywhere. You just have to look and ask.

SPEAKER_02 9:11

Ask questions, use your phone for the the the computer savvy people, um, and for the older folks, ask your ax your your nieces, nephews, grandkids, someone because it there's um resources out there you just have to to look for it. If you don't look or it's difficult for you to look like Jasmine said, just ask someone. And I'm gonna go circle back around with the whole health care insurance thing. If you don't have health care insurance, that doesn't mean you can't be seen. You can go to the emergency department, and then also a lot of times there's clinics that will go based off of your income. So if you don't make that much money, your payment for that visit will be about $25 to be seen. But when you go to those visits, make sure you let them know that because you're paying out of pocket, you want to address this. Though you have a long health history that us providers, it's like your blood pressure is not doing too good, but still let them know that you want to focus on this because you're paying to be seen for this. Um, but yeah, we'll go, we'll go based off of your income and you can pay out of pocket very little, very little amount.

SPEAKER_01 10:20

Yeah, um, yeah, like a lot of the nonprofits do that, I believe. And then um I didn't look too much into this. And if you know about this, uh Linda and Kathy, let me know. But I heard that sometimes you can ask to just pay out of pocket because a lot of times that might be cheaper um for certain things um than going through your insurance, but I don't know. I heard that, but I'm not sure.

SPEAKER_02 10:42

I I did hear that too, but I don't know how that works like legally. How does that work? Because I heard a story like that. A man he was saying that he was basically with insurance, he was paying way more, and then when he said that he didn't have insurance, he wasn't barely paying like anything. But I don't know how that works if you actually have insurance. I don't know if you can eventually you have insurance and you're saying you don't have insurance. I think there's something around those lines that you because I feel like everybody would do that if they had insurance, but they want to pay a lower price if they say they don't have insurance. So don't listen to us regarding that. You have to look that up. We'll have to look into that future episode. Exactly. You have to look that up too, because I don't know.

SPEAKER_01 11:30

So yeah, there are definitely options, um, and we just have to look for them.

SPEAKER_02 11:37

Yeah, and I think for us, for me, for us, um I think that's too even more so why I like being a provider is because I'm I've seen the other side of where patients have not been giving the best the best the best of care. So when I when I have my patients' visits, I let them let tell me their concerns. And I'm like, I'm open. Like I I don't just I'm not like I'm open to where whatever they what they're what they they're saying.

SPEAKER_01 12:17

When I when they were training, or I guess I'm still training, right? But when they were training me, they taught me that when a patient comes in. Obviously, like obviously we look at their chart and we see if there's any major issues, if they have any um any like any care in certain areas that that that hasn't been done, right? Like, have they had a PAP smear? Um, have they those healthcare maintenance?

SPEAKER_02 12:43

Yeah, healthcare maintenance. Yes, healthcare maintenance. We we they're strict or at my clinic, they're like, make sure you're just the healthcare maintenance, make sure you're just the health. I was like, okay, I get you want me to address the healthcare maintenance, your PAP smear mirrors, colonoscopy, prostates, uh, PSA, mammograms. Um, if you're in a uh triple A, like, oh, there's a whole list of healthcare maintenance. Depending on your age, you should be getting.

SPEAKER_01 13:08

Right. So we do that, we look at that on top of like, you know, their chronic conditions and see like what was the last thing needed. And then obviously, so you'll as a provider you'll have I don't want to say an agenda, but you'll have an idea of an agenda that you want. But a lot of times the patient will come in with concerns, and obviously, a lot of times these conditions are things that need to be addressed. And so, yes, you know, our job is to listen to patient concerns, and the the provider does not run the the the visit, the patient does because the concerns are what need to be addressed, and so again, patients, if or you know, if you have a problem, that's what your visit is for. And so our job is to listen to you. So don't be afraid to talk about your concerns. That's what the visit is for.

SPEAKER_02 14:01

Yes, and like I said in the beginning of the episode for providers, future providers who are in practice, planning to be in practice in school, like Jasmine, already practicing. I think it's a good, it's good to adapt the three, the three rule, the three rule thing, like you know, um, address one thing that you as a provider want to address with your patient, and then allow your patient to also bring up two things. It's be good if they only have one, but a lot of the times with the population that I have, they have a long list of concerns. So I said, just give me two and I'll do one, and then we'll just keep following up from here. But at least, you know, you address your concern and let allow the patient to bring up two concerns of their own.

SPEAKER_01 14:46

Yeah, and and like we said, obviously, a lot of times these visits are not long. And so if you as a patient have, you know, a lot of concerns, don't please don't feel dismissed if the the provider says we don't have time for that today, but you can always make a follow-up visit to address those other concerns as well.

SPEAKER_00 15:06

So yeah, and that's happened to me because basically in my clinic we do something that is called like a co-visit. So I go as a nurse and then the provider comes like five minutes. Like I just I the patient will spend more time with me and then I go and present, and then provider will listen and they're like, okay, we're gonna do this, this, this, this, this. And then they go in, they say hi to the patient, they give them that. And then if the pro the patient has another concern, they had to tell me so I could say while I'm presenting the patient that way. If the provider forgets, because it's happened to me, it happened to me like last week. Uh patient came in, I was with her, and I was like, okay, I'm gonna go talk to the provider. Do you have anything else? No, no, no, no, no. And I was like, Are you sure? Yeah, no, and I'm like, okay, so you are aware that this patient, let's say, is for hypertension, high blood pressure. Um, yeah, yeah. And I'm like, okay, go tell the provider everything, present everything, we come back in, and then uh provider's like, okay, she was there for like a minute. What and the the patient like lost it? Like, why am I here for so long? Like, you you're only here for one minute, and then and then I have more concerns, and then the die the provider was like in a rush because it was one of those days that it was just it was one of those days, you guys know. So then um, she's like, Can you explain to her, like, how is does this visit work? Like, or is it something concerning that she said to you? And I'm like, no, like I don't know what concerns she has. Like, she didn't tell me this. And then so eventually she stepped out and I talked to the patient and I was like, What are your concerns? Like, we could make a follow-up appointment for this, like we could make it in two weeks, four weeks, like just talk to me, you know. Oh no, I just wanted to tell her that thanks to her, like I'm feeling much better. I don't have no pain. And I'm like, Oh, but do you have any serious cause? She's like, No, I just wanted to. I'm just like, Okay, ma'am.

SPEAKER_02 17:08

Oh, patience, patience, patience, patience.

SPEAKER_01 17:13

She just wanted to be heard. She just wanted to be heard.

SPEAKER_00 17:17

Yeah. So then I'm like, you know what? If you have like it sounds like you're still struggling with this, let me just make you like a like a 13-minute appointment with her, and then she's like, okay, thank you, honey. Like, I appreciate it. And I was like, Yeah, I'm sorry about the rush, but this is how these appointments kind of work. If you want a little bit more time with uh your provider, we could do like a follow-up, just you and the provider, and don't make it like a covet zit, because in a covet zit, you're gonna spend more time with me. Just like, oh, okay, okay, but yeah, that was that was my experience last week.

SPEAKER_02 17:48

Yes. Um, and to bring the episode full circle, um, uh there's some things I just want to circle back around on is you know, advocate for yourself. It's okay to say I don't understand. Can you explain it in a different way? Um, I thought I think it's also important to, you know, people freeze during visits. Come in with a script, you know. This is my concern today. I want to really address this before I leave, or can we talk through all of my options, not just this one? Um, what happens if I don't understand or this treatment plan doesn't work, or I still feel like something is wrong, what else could it be? Last one, can you document that in my chart if it's been dismissed? So say you're you're bringing up a concern to your provider and they're saying, no, no, no, no, nothing's nothing's wrong. This, this, and that. You let them know that you would like to for them to document that in their chart. Um, so something to happen later on, you can like, oh, this should have been documented. Um, especially if it's something that was dismissed. Uh, so those are my my little uh advice that I'm gonna give before ending the closing the episode of certain questions or uh statements that you can use for your visits and to re to emphasize what Jasmine and Kathy said, bring a friend, get on FaceTime, write out your concerns prior to the visit visit, use Chat GBT to help um help you go in what direction you want to address during your visit. So I hope this episode was helpful. Um, I'm hoping this episode was helpful. If there's any other concerns or any other questions that you would like for us to answer, please let us know. You can DM us, DM us, DM, we haven't said that in so long. Do you realize that? You can DM us at a potent dose of three on Instagram or email us at a potentose of three at gmail.com. Thank you for listening. Bye. Bye. Bye.

SPEAKER_00 20:02

Thanks for listening to this episode of PD3 with your hosts Linda, Jasmine, and Kathy. Make sure you like, comment, and subscribe at a potent dose of three so that you never miss an episode and your weekly dose.