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With soaring prices, supply shortages and growing wait lists for most goods and services — not to mention a virus that continues to disrupt the workforce — it’s tough to be a consumer right now, including a health care consumer.
Back in September, the AARP Bulletin published a package of stories called “Beat the System” that detailed how to get the best possible customer service. Readers told us they found the advice collection hugely helpful. So in that spirit, we’re back with a new edition of “Beat the System,” this time focusing on how to find the health experts and health services you need in these challenging times.
Our team of reporters interviewed dozens of insiders about how to separate the best from the rest, and their advice follows. But the experts also noted that certain approaches are timeless and universal — meaning they still apply right now. So to start, here are the universal rules for finding the best in health care (and anything, really), 2022 style.
Rule 1: Take appropriate time
Yes, when competition is hot, you want to be flexible and move quickly when quality products or services come available. Even so, “big decisions shouldn’t be fast decisions,” says Terrance Odean, a professor at the University of California, Berkeley’s Haas School of Business and an expert in behavioral finance. Do the due diligence required and take the time to verify you are getting a real deal. And absolutely “no decisions at 3 a.m.,” he says.
Rule 2: Research is free
Take advantage of the vast amount of free information available on the internet, social media and beyond to investigate the experts or services you are interested in. Start with price and reputation, of course, then get into the weeds, like efficiency ratings, certifications and areas of expertise. But put little stock in user ratings. Online reviews are increasingly bought, and there’s no way to verify their authenticity. If you wish to scan, look for specific anecdotes and a personal writing style that a paid reviewer (or computer program) couldn’t generate.
Rule 3: Set priorities
Great decision-making lies in the art of filtering. That requires knowing what features or skills are most important to you; use that to pare down your choices, says Katy Milkman, author of How to Change: The Science of Getting From Where You Are to Where You Want to Be.
Rule 4: Pretend you’re making a mistake
Many of us are overconfident about how a choice will turn out, Milkman says. For a reality check, she suggests envisioning what could go wrong with your choice. Better to think about this now rather than later in order to help you prepare for — and possibly prevent — things that could go awry.
Rule 5: Involve other humans
A productive half hour on the internet can make you feel smart. Perhaps too smart. The golden rule: Always find a responsible friend, family member or adviser — “preferably someone who is as good or even better at decisions as you,” says Odean — and get into the habit of asking for his or her feedback before making a big decision.
Finding the best hospital
There’s no way to sugarcoat it: Our hospitals are in crisis. Yes, many have responded to COVID by upgrading their ventilation systems and adding new protocols that may reduce the risk of airborne illnesses, but that can’t overcome the human cost: Eighty-seven percent of nurses surveyed recently reported they were burned out, and last September the American Nurses Association sent a letter to the U.S. Department of Health and Human Services urging the government to declare the current nursing shortage a national crisis. We don’t always get to choose which hospital we’re treated in, but when we do, it’s more important than ever to match up our particular needs with a facility that’s set up to manage them.
Read the right rankings. Numerous organizations rank hospitals, but a 2019 report in the New England Journal of Medicine rated the raters — and deemed U.S. News & World Report its top choice. Next in line was the Centers for Medicare and Medicaid Services’ star ratings program.
Apply the insurance filter. Once you know the best hospitals in your area, check with your insurance provider to make sure it covers services within that facility (if you’re a Medicare Advantage patient, confirm that the facility falls within your plan’s umbrella).
Know your options in advance. Just like doctors, hospitals offer different specialties. Some have psychiatric services, others have specialties in bone health, oncology, drug abuse treatment, etc. An overwhelmed hospital might struggle to manage a problem that’s outside its expertise, so become familiar with the options in your area. If that broken arm is a result of osteoporosis, it may make sense to travel a bit farther to a hospital with a bone center. If it’s a grandchild who took a spill, make sure you know which hospital has a pediatric ER. “Going online and seeing what services they have available is really helpful in terms of some of the subspecialty services,” says Marianne Gausche-Hill, M.D., president of the American Board of Emergency Medicine.
Check for a GEDA. That stands for Geriatric Emergency Department Accreditation, and it means the hospital has an ER that meets a higher standard of care for older Americans, according to a set of criteria established by the American College of Emergency Physicians.
And check the H-caps. Each year, more than 3 million patients from more than 4,000 hospitals complete an HCAHPS (pronounced “H-caps”) hospital survey on everything from cleanliness to the responsiveness of the staff. Go to the Medicare website and conduct a search to see how hospitals scored.
Check accreditation status. Make sure your hospital is accredited by an accrediting agency approved by the Centers for Medicare and Medicaid Services. The largest is the Joint Commission, a nonprofit that accredits more than 22,000 U.S. health care organizations and programs that meet its quality and care standards. Not all hospitals are accredited — and some may be on probation — so it’s an important indicator of quality, Gausche-Hill says. Visit qualitycheck.org to see if your hospital has met the Joint Commission standards, or call the hospital to verify its status with other accreditation agencies.
Finding the best surgeon
Someone is going to reach an instrument, or maybe even their hands, into your body. In a recent poll, 69 percent of surgeons say they feel overwhelmed, so having someone who’s experienced and cool under pressure is paramount. Before signing up for any surgery, take these steps:
Get the hard numbers. Go to the American College of Surgeons NSQIP Surgical Risk Calculator. You’ll be able to plug in your age, sex, weight, chronic and acute health issues, and other prevailing factors, and get a no-nonsense statistical assessment of the surgery’s possible downsides and chances of success for someone who fits your physical profile. This is great information to have as you start your research journey.
Research your condition. You can’t easily assess a surgeon if you don’t have some grasp of the ailment or injury they are trying to remedy. So start by conducting research on reputable sites (think cancer.org, run by the American Cancer Society, or orthoinfo.org, the American Academy of Orthopaedic Surgeons’ site). Remember, disinformation is rampant on the web, so look at a few different sites, focusing on those representing accredited medical institutions or government agencies, not just individual doctors or media companies. Armed with a reasonable knowledge of the ailment and the surgery, you can ask more specific questions and understand the answers, says Mark Glover, M.D., a general surgeon with Austin Surgeons in Austin, Texas.
Assemble the candidates. Your primary care physician is the best source for a referral, but don’t just stop with her or his recommendations. Search your insurance provider’s website for a list of surgeons it covers and consider them, too.