Health Care 1.0 in 2025

Since moving to another state, I have become acutely aware of the current problems in our health care system. Moving 200 miles away from doctors, hospitals, and labs, we knew and trusted, has made me realize that I had to be responsible for informing each of our new providers of our health history, and that I had to track it all down (what I didn’t already have), and make it as easy as possible for the new provider to get up to date on our current and past medical issues.

That is not an easy task! Think about it, especially for senior citizens. It is vital to have one’s medical history, including past illnesses or medical events, and the results of routine tests.

For example, when was your last mammogram? Did you require special imaging? When will your insurance pay for the next one? I traveled four hours to Baltimore, my old “home,” and decided to get my annual mammogram while there, only to find out that I was 2 days early, so it wasn’t covered by insurance. I took all of my records (including the CDs so the new center could see the images, not just the report) and found a new facility to do it.

And what about DEXA scans? They can only be done (Medicare guidelines) every two years and a day after the last UNLESS you are on a new or different bone fortifying medication, (to see if it is helping) and then it can be one (1) year and one day. However, a little-known fact is that to get an accurate comparison to previous scans, DEXA scans MUST be performed on the same machine each time, otherwise it is like comparing apples and oranges.

If you see a cardiologist, the new doctor will want to see the actual report of your stress test, not just the report. When was your last colonoscopy? You need to be able to share the findings. When are you due for the next one? Do they have images of your intestines? Biopsy reports?

And the internist, the supposed keeper of all the records? Legally, they can only send you their records, not any notes they received from specialists. Do you recall all the specialists you have seen? And by the way, just because the specialist (ie cardiologist, surgeon) sent the report to your doctor does not mean they read it, or even received it.  It is up to you to discuss all specialist visits with your internist.

I obtained our medical records from our internist, all 155 pages (for both of us), many duplicates, but most importantly, I had our immunization records. Who remembers when they are due for a tetanus shot? Did you get all of your pneumonia vaccinations?

Moving and reviewing the records opened my eyes to what needed to be done: I went through every page, and gave our new internist a 3-page summary for each of us, including our shot records, preventative screening, lab studies, etc, and our problem lists, with explanations. She was very grateful. When I asked Dr. N if she would have spent the time to review our records as sent from our old providers, she rolled her eyes and thanked me for my summaries. We did the same for our specialists.

Health care is becoming increasingly challenging for the provider, health insurance companies, and most importantly, for us, the patient. There is no more Marcus Welby, MD, no family doctors. Our doctors don’t know us well, and often they don’t remind us of follow-up exams. Once again, it’s up to us, the patient.

I am very knowledgeable about the healthcare system. I can’t imagine what it is like for those who still have “faith” in a system that is changing rapidly, and, in my opinion, unsuitable for anyone.

Take the time to organize your records, and see what tests you should be getting at your age. Current guidelines don’t recommend a PSA (for prostate cancer) for men once they are 70. Is that okay? Look at President Biden; his doctors followed the guidelines, and he wasn’t tested until he was found to have late-stage prostate cancer. It is not recommended that we have colonoscopies after the age of 75. But what if your last one was at 66? Do you do one more? We must be aware of this and talk to our providers about our individual needs. And look at your family history. If your dad and another close paternal relative developed early-onset prostate cancer, you may need to be tested starting at 40, not 50.

As overwhelming as this may seem, it is vital to take action as we age. Don’t face a grave illness because of something you didn’t do—whether it be a test screening not done, or a new provider overlooking a past medical condition. Ask for help; call a Patient Advocate to get you started. An advocate will help you assemble your history, review your history with you, and ensure you are on track for all medical screenings. An advocate will also prepare you for every medical visit. Best advice: find one who is medically trained. It may be the best money you have ever spent.