Navigating the System



Before illness strikes, people should know about the medical care systems so they can work within it most effectively. Choose your system of care: —an HMO system like Kaiser, private practice that can be an HMO, or PPO or a variation of one of these types of insurance, or Medicare or as needed Medicaid. Then, choose and then know your insurance policy. Eventually, when care is needed, people are in one of three groups. One group consist of those getting routine follow up after having had an illness; they have little or no new anxieties (except the night before follow up for a serious illness). A second group are those in whom the doctor or patient have a new and real concern for serious illness. A third group consists of those in the middle of a workup or therapy for a serious illness such as cancer.

Your PCP (primary care physician), especially if you have had a long-standing relationship, can help you get the best workup, the proper consultants for you to determine the workup and care, and handle other medical problems and psychosocial issues as they arise. You serve yourself best by understanding what’s going on. But have others help you if possible. For example, have others with you especially for important meetings. If you have cancer, develop relationships with other health care professionals such as the nurses or radiation therapists who are involved should you be getting chemotherapy or radiation. Develop a relationship with the social workers or navigators who should be available through the hospital or the system you’re in.

Some individuals are readily available as part of the team that is caring for you. If more help is needed to understand your insurance coverage and your share of cost, ask for that help from the physicians, nurses or personnel at the infusion center. Medical systems offer lots of help from qualified professionals but you will need to ask. You may want another opinion to confirm a diagnosis or suggest other possible therapies. Don’t be afraid to ask for help for fear you’ll offend or in some way push your physicians away. Your PCP or RNs on your team can help get other physicians identified for a second opinion, hear your concerns, be a good listener and offer advice and in other ways help you. You can also ask that your problem be discussed at Tumor Board. Hospitals have periodic meetings among experts in cancer care with different expertise to discuss individual problems. Such discussions can either validate the present course of care being pursued or suggest alternatives or both. These meetings are free to you and can be very helpful.

Dr. Mark I. Singer
California Pacific Medical Center
2340 Clay St., 2nd Fl.
San Francisco, CA 94115
(415) 600-3800
Mark I. Singer, M.D., FACS is board certified in otolaryngology (ENT) at California Pacific Medical Center. He got his M.D. from Columbia Univ. College of Physicians & Surgeons, did his internship at Rush-Presbyterian-St. Luke's Medical Center, his residency at Northwestern Memorial Hospital and fellowship at Northwestern Memorial Hospital. Dr. Singer's professional interests are laryngectomy rehabilitation and reconstruction surgery of the head & neck.
Dr. Robert Rodvien
California Pacific Medical Center
2100 Webster St.
San Francisco, CA 94115
(415) 717-7044
Dr. Robert Rodvien graduated from Columbia University's Physicians and Surgeons' medical school, and then did his internship, medical residency and hematology fellowship at Tufts. He continued his training at MIT in molecular biology followed by a year at Harvard Medical School and the Beth Israel Hospital in biomaterials. At present, he is at California Pacific Medical Center in San Francisco.

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