FIVE GOLDEN LENSES

                                    I

                                 VE

                               BEEN

                         THINKING
                   AND IT MIGHT
               SAVE YOUR LIFE
                     (AND VISION)

Frank J. Weinstock: M.D., F.A.C. S.

When you go shopping you always buy the right pair of shoes that are the perfect fit. Going to buy a suit, dress or even a coat you want to make sure that the cut and color are perfect. Asking questions of the sales person and making sure that the size is right, the material does not itch and you will look great wearing it. Asking questions is vital not just when it comes to fashion but when it comes to taking care of yourself and dealing with your health. This outstanding resource will help clarify and lift the veil so that you, the patient will learn more about how to choose the right physician, ask the right questions, come away from a visit more informed and learn what the proper office protocols are when things go wrong. In chapter one the author defines the many different kinds of providers that patients come in contact with during a visit, on the phone or when preparing for a visit. There are many routines tests that patients will encounter when going for an ophthalmology office as the author relates since this is his area of expertise. But, in some offices he expands that there are mid-level provides like physician assistants and nurse practitioners that take patient histories and even do the exam and prescribe treatment. Learning more about the different staff in your doctor’s office is vital. When in a hospital this could be more complicated as there are more staff members and different shifts causing the patient to deal with many different people and many different personalities. I am someone who asks questions as the author states when someone comes into your exam room you have the right to ask who they are, their title and what they are going to do to you. If you are going for surgery you need to ask who will perform it, your doctor or a hospitalist who are based within a hospital. You need to ask many more questions about the surgery, the doctor, the recovery time and more, as you will learn after reading part one of this book. Next the author explains in detail how to find good medical care. Believe it or not this is not an easy task. First it depends on the availability of the care and second on the affordability of care. Quality care is paramount and it takes time, questioning and work to make sure that you choose the correct physician that is the perfect fit for you. The best doctors he states have great communication skills. Dealing with a doctor during an emergency situation would be one primary test of how much he/she cares about their patients and how well he communicates and understands your needs. Next, recommendations are great but I would still check out the person on my own to make sure that they are board certified in the area that they are practicing and they have no sanctions against them. Hospitals and medical societies have reference services. Another way to determine whether this person is qualified is by calling the office and asking the person taking the call the following: Is the doctor board certified, which hospitals is the doctor affiliated with. Another vital point is how the office staff responds to patient requests and questions on the phone. Always make sure you know the name of the person you spoke to. Chapter three focuses on the Chaos and Confusion in the Practice of Medicine where the author highlights the many different personalities of doctors, how they diagnose and manage patients and fees. He continues to explain how doctors get paid. Next, choosing a doctor. Read chapter four followed by Emergency Departments in chapters five and six.

What questions should you ask and what is the reason why many of us complain about the doctors we see? Poor communication from the doctor and his staff can create some unrealistic expectations from the patients. As he stated in a previous chapter recommendations are great and be careful when checking out ads or web sites. What should you expect? A caring doctor and staff, polite and courteous staff, answers to your questions and concerns and notification of test results in a timely fashion and manner. These are all discussed and elaborated upon within Chapter 7. Most important is what insurance the doctor accepts and what out of pocket if any costs will you incur? Within pages 32-35 the author lists questions that you should copy into a file, notebook or pad and put in a safe place in order to be prepared for doctor’s visits, questions you should and must ask and dealing with any procedures that you might need and understanding the reasons why/why not they should be performed. But, not everything will go according to what you might or should expect of a doctor so the author continues with how to deal with a doctor that does not call with results, does not return calls or impolite staff. Equally vital are the explanations you need for medications, side effects, how often to take them and what is the prognosis. Read the remainder of Chapter 8 to learn more and then chapter 9 which focuses on Medicine an ART OR SCIENCE followed by something all seniors encounter they tell me: Medicare can be a muddle. This chapter is enlightening, quite clear in its explanations and will unmuddle the reader as you learn more about Medicare Parts A and B, what they are for, why you need to have a supplementary insurance to cover what Medicare does not and the different kinds of plans. He continues with the rules for emergency room care, what are HMO’s and PPO’s and the definition of Original Medicare and other health plans. Learn what Medigap means too and the medical costs that you will incur if you have no insurance, private, Medicare or Medicaid. Chapter 12 is really important as he explains the costs, whether you are paying too much and why providers bill for services the way they do. You need to learn why doctors charge huge fees to insurance companies and the rationale behind it. What the word CODE has to do with doctors getting paid, what happens when Medicare cuts payments to hospitals and doctors and understanding the different pay plans? Chapter 13 deals with different preventions and tests that we need to know about and who performs them. In Chapter 14 the reason why problems arise when a doctor’s handwriting is illegible and why some have taken to using a scribe to enter the information for them during and before the exam. The full details are on pages 76-77.

The most frustrating thing is trying to talk to a doctor who does not want to answer your questions or take the time to talk to you. This person should care because you do. Read Chapter 15 to learn the sources of patient dissatisfaction and what happens when a patient is hard of hearing, cannot speak, speaks another language, had a stroke or cannot speak after surgery. How do you prevent miscommunication and what preventions and aids need to be put in place? The final chapters in part one focus on asking questions, quality care and what do you do when you are unhappy with your doctor?

How would you feel if your doctor operated on you from a remote location? What is Telemedicine you just won’t believe what new technology is out there until you read Chapter 23. How would you feel if your eye test results were sent to an ophthalmologist who may be miles away? How would you feel if this person made recommendations for your treatment? Find out more when you read this chapter and the next one.

Part two focuses on what tests you need as a patient, what is routine how diabetes and high blood pressure affects your eyes. An eye exam can detect many other illnesses including Thyroid Disease and strokes even before the patient is aware of them. What happens like a kid that does not listen to his parents or refuses to follow his teacher’s directions you, the patient skip appointments, do not make your meds and ignore your doctor’s advice? Whose fault is it if you get worse and your health takes a deep decline? Added in the author lists the fact that patients might have heart problems, diabetes and some overweight, which makes things worse. What about smoking and drinking? What should you do? Try listening to the doctor and follow his advice. Try asking questions when you do not understand. Write down complicated instructions, take your meds and keep appointments.

The author now focuses on his area of expertise: Our precious eyes. He begins with explaining in detail the definitions of those that practice medicine dealing with our eyes: Ophthalmologist, Optometrist, and Optician as well as the definition of a physician. Within Chapter 27 you will learn the differences and their definitions and then he focuses on crossed eyes, near-sightedness, contact lenses and how they can help with near-sightedness plus within pages 150-151 you will learn when glasses are needed and why. Next, contacts or glasses chapter 31 and trouble with your glasses or contacts and why followed by a chapter that I read several times: Chapter 33 how often should you get your glasses changed and why? The next chapter adds more about contacts but what some might really want to learn about is how and when Botox will help your eyes and other conditions.

For those who have diabetes chapter 37 will explain why you need to monitor your condition, why you need frequent eye exams, what tests you need and in various chapters he explains Glaucoma and the test involved to determine any problems. Cataracts take up the next few chapters and the doctor includes his own experience with Cataract surgery in chapter 39, Poor vision due to cataracts, glaucoma and diabetes are discussed and how simple tests can save your sight. Chapters 41 and 42 deal with second opinions, which I did go for before my recent surgery. What happens when the surgery that is performed is on the wrong part of the body? Find out how this could happen and what Dr. Weinstock and others do to prevent mistakes. Eye emergencies, eye exams and what to expect, aging and your eyes, falling, night driving troubles and vision screening and much more fill the final chapters of this outstanding resource. The final ones deal with Aids, Herpes and the doctor’s legal obligations to patients and understanding the procedures and getting the answers you need to your questions beforehand. Dealing with scheduling, counselors and more is discussed in Chapters 54 then problems that seniors might have. Part three deals with cataract surgery and the matter of new lenses and different eye diseases that cause loss of sight and what are floaters. There is much more to learn but as in a good mystery the rest you will find out when you read the book for yourself. As with shoes, a coat or even a pair of gloves do your homework find the right doctor that is the right FIT for you! This is one resource that everyone including doctors should have on their bookshelf.

Fran Lewis: Reviewer