in El Paso,” Andrade says.
Andrade received radiation
treatments at Anderson and
receives follow-up care at a
clinic near his home.
Some patients are reluctant to travel for fear of offending their doctors. While
that’s understandable, it’s
important to remember that
your doctor’s ego will recover, while you may not. And
though most doctors have
their patients’ best interest
at heart, other agendas—
such as reluctance to part
with a challenging case—
can occasionally taint their
advice. The message: If the
facts point toward better
care elsewhere, don’t stay
home just to be nice.
Stuart Freedman, 58, a
health insurance executive in Seattle, ran into resistance from one of the
neurosurgeons he met with
after he was diagnosed with
a large benign brain tumor.
That doctor tried to talk him
out of undergoing a novel
procedure devised by Amin
Kassam, chair of neurosurgery at University of
Pittsburgh Medical Center.
In certain patients, Freedman had learned, Kassam
removes brain tumors via
the nose instead of through
a hole in the skull. One
advantage of this treatment,
according to Kassam, is
a reduced risk of serious
TK CREDI T
Freedman talked to
Kassam and looked at the
data from his procedure.
He then compared that
with the treatment offered
by local neurosurgeons,
studying the risks of death,
paralysis, and brain dam-
age from each of them.
Freedman wanted the
treatment, but his insur- ance company initally denied his request, without giving a reason. They even- tually agreed to the Pitts- burgh option after Kassam sent them a letter outlining the likelihood of a faster re- covery and a shorter—and cheaper—hospital stay. Freedman’s treatment was a success, and it rein- forces one of the most im- portant aspects of choosing a hospital: while your doc- tor’s guidance is important, this shouldn’t be the only measure. Follow Freed- man’s example and ask each doctor you’re considering for hard numbers on suc- cess and complication rates on the treatment he or she is proposing. Also look at the hospitals’ statistics-based ratings on sites such as Hos- pital Compare. As Robert Krughoff, president of CC, points out, a small differ- ence in mortality rates can mean a big difference in the total number of cases. “Two percent sounds like a small number, but if you told me that two out of one hundred people who stayed at a cer- tain hotel died, I wouldn’t go to that hotel.” If all this sounds daunt- ing, that’s because it can be. Remember that it’s a fluid process; you can change your mind. And no one can make the decision bet- ter than you can, once you are armed with the facts. When it comes to choosing a hospital, there is no right answer for everyone, only a right answer for you. ;
Sandra G. Boodman writes
about health for The
CAN YOU AFFORD TO TRAVEL?
INSURANCE COMPANIES frequently approve—or even recommend—
out-of-town travel for difficult cases. After all,
it’s less expensive to treat a serious illness right the first time than to have it
linger. But understand your coverage
before you go, to avoid any surprises.
DIFFEREN T PLANS HAVE different requirements, says Erin Moaratty, chief
special-projects officer at the Virginia-based Patient Advocate Foundation.
For example, you might need to prove
that your condition can’t be treated
within your insurer’s network before it’ll
agree to pay for out-of-town care. Also,
check with the hospital’s billing office
to make sure it accepts your coverage.
IF YOUR INSURER DENIES your request
to travel and you are convinced that you
can’t get the care you need at home,
you can appeal the decision to an external review board. This process varies by
state, but your insurer’s customer-service reps can tell you where to begin.
EVEN IF INSURANCE will cover your hospital stay, out-of-town travel—airfares,
hotels, car rental—can be expensive. But
if you ask the right people, you can often
get help. Many hospitals have admissions professionals, resource specialists,
or social workers to help visiting patients
handle logistics and sometimes find
ways to help pay expenses. Peter Coleman, a medical social worker at the Mayo
Clinic in Rochester, Minnesota, has led
patients to foundation grants, hospitality programs, and religious groups willing
to help with lodging. Many hotels near
hospitals offer lower rates for patients.
ONE UNDERUTILIZED source of help:
friends. They can lift the burden at
home, whether it’s by walking the dog or
taking the kids for a week. Social workers say most people want to help—if
only they are asked. —Alissa Ponchione