Choosing Your Physician And Healthcare Team
WHETHER OR NOT your choice of physician is restricted by your health plan, the most important factors in your selection should be (1) your comfort level in working and communicating with this doctor, and (2) the physician's knowledge and experience in MS. Centers that specialize in MS care are often in a position to offer a wider range of medical and psychosocial interventions. However, even the most sophisticated MS center will not meet your needs if you do not feel able to communicate and work comfortably with the healthcare team.
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| Multiple Sclerosis Clinics |
If your healthcare plan requires you to select a primary care physician (most likely an internist, or a general or family practitioner) to act as gatekeeper for your medical care, look for a physician who currently treats other MS patients and is familiar with the complexities of the disease. He or she should be willing and able to help you manage your symptoms and knowledgeable about existing treatment options. The primary care physician should also be willing and able to refer you to a specialist when the need arises. If you are unable to find a physician within your network who is experienced in the care of MS patients, your next best option may be to find one who is willing to learn.
Staying Informed
PEOPLE WITH MS and their family members need to educate themselves about the disease and existing treatment options. In particular, those patients whose care is provided by non-MS specialists need to take responsibility for staying informed and up-to-date about MS management. This is the most effective way to ensure that you are receiving optimal care. Today, more than ever, there are numerous avenues for obtaining this kind of information, including books, newsletters, information lines sponsored by pharmaceutical companies, the Internet, and the vast array of publications offered by the MS societies. Keep in mind, however, that some sources are more authoritative than others, and that you cannot believe everything you hear. This educational process will enable you to be an active and informed participant in your own care.
TIPS FOR MAKING THE MOST OF DOCTOR VISITS
- Make a list of questions and concerns before the visit.
- Prioritize the list and discuss your most important issues first.
- Make sure that your doctor has a complete list of all the medications you are taking, including any that have been prescribed by another physician for non-MS-related conditions, and any over-the-counter drugs or supplements.
- Bring up all your concerns - even the ones that may be difficult to talk about (e.g., bladder and bowel problems, sexual changes, cognitive changes).
- Discuss any medication side effects you are experiencing.
- Ask for a referral if' you would like a second opinion on any aspect of your disease or its management.
- Consider bringing a family member or friend to your visit if you feel the need for a "second pair of ears"; consider tape recording the visit for later review.
- Ask for more time or another appointment if you have not addressed your issues fully.
THE DOCTOR-PATIENT collaboration is at its most active during the office visit. This is the time to give your physician the information he or she needs in order to help you manage your MS. Be prepared for your visits.
Because most people find it difficult to remember all the things they want to talk about, particularly when they are trying to listen to what the doctor is saying, it is a good idea to bring a list of topics and questions. Let the doctor know how current medications are working for you and what, if any, problems or side effects you are having with them. This is particularly true in relation to the approved immune-modulating therapies - the interferons (Avonex, Betaseron, and Rebif), glatiramer acetate (Copaxone), and mitoxantrone (Novantrone).
An effective collaboration between you and your healthcare team will help to ensure that you initiate treatment at the time that you and they feel is most appropriate, and that you can continue comfortably with the treatment for the foreseeable future.
Describe your symptoms, taking care to let the doctor know which of them are causing you the greatest difficulty. Patients are sometimes hesitant to bring up certain issues that they find embarrassing. Unfortunately, some physicians may be reluctant to bring up the very same topics. People living with MS need to know that bladder and bowel symptoms, sexual difficulties, and cognitive and emotional changes can all be significant problems related to their disease. Do not hesitate to talk about them, and do not hesitate to think about looking for another physician if you feel that you are not getting adequate help with these important problems. To find out more, you can check out Multiple Sclerosis Clinics.