Medical Practice in the U.S.
Many individuals from other countries are unaccustomed to the particular practices of, and requests made by, American physician and other health care providers. For example, because privacy is very important, health care providers assume that you will want to be seen alone. If you want someone to be with you during an appointment, be sure to tell both the receptionist and your physician.
At HUHS and in other physician's offices each physician has a private room in which he or she sees patients. A health assistant will usually bring the patient to the physician's exam room, ask the patient some preliminary questions and may check the patient's temperature or blood pressure. It is not unusual for patients to be asked to undress and put on a gown provided for them before they are examined. Be sure to ask the health assistant and your physician to explain or repeat instructions that are unclear.
Choosing a Physician
It is advisable to choose a physician before you or a family member becomes ill. Some factors to consider in choosing a personal physician are the cost, the office hours, whether you would prefer a male or female physician, how questions are handled outside of office hours or when the physician is away, the possibility of consulting with the physician by phone, and the physician's response time in an emergency. When choosing a pediatrician you should be sure that the physician will visit your newborn in the hospital, that you will be able to call him or her frequently when the baby first goes home, that you share the same opinions on issues such as breast versus bottle feeding, and medications for babies and children, and whether the doctor prescribes medication at the first sign of illness or wait to see what develops.
If you have not enrolled in a health insurance plan and do not have a personal physician in the area, you should telephone or visit the Outpatient Department of the nearest hospital for information about the health care services it provides. You should not use the hospital's emergency room for non-emergency care, since emergency rooms handle only serious problems. In addition, being treated in the emergency room is much more costly than being treated in an office visit.
Communicating with a Physician
Since it is important that your personal physician knows about your individual health history, you should feel comfortable discussing any of your needs and/or concerns with him or her. Be prepared to tell the doctor or nurse practitioner about your medical history, all medications and any other kinds of treatment or remedies you are using. Also be sure to tell your physician about any medication allergies you have.
If you are concerned about using English to discuss such important medical information, prepare a list of your questions and concerns before you go to your appointment. Bring along someone who can translate for you, or ask if there is a physician or translator who speaks a language you are more comfortable using. If you ever have difficulty understanding your physician, you should feel free to ask him or her to repeat, talk more slowly, or explain more carefully.
Physicians expect you to have questions regarding your health, diagnosis, treatment, or medications. This kind of dialogue between a patient and a physician is a common feature of U.S. health care that may be different from what you may be accustomed to at home. Ask your physician to write down any instructions that you should follow, and tell him or her if you still have questions or need more information. State what information you need, and ask if you should schedule another appointment. Your physician may suggest other resources for answering these questions or meeting other needs. If you have more questions or problems after you leave the clinic, telephone your physician for advice or another appointment.
Physicians and nurses rarely make home visits in the United States. Usually you must call for an appointment and visit the physician's office. If you are covered by a health plan, it is usually necessary for you to visit one of the health plan's physicians in order to avoid paying extra fees. For example, Harvard students and affiliates enrolled in the Harvard University Student Health Plan must use HUHS facilities in order to avoid having to pay an office fee.
The U.S. Government regulates the sale and distribution of medications in the United States. Many medications such as antibiotics, strong pain relievers, birth control pills, and drugs for respiratory and heart conditions are available only with a written prescription. Prescriptions, written and signed by a certified physician, are given to patients during an appointment or after a phone consult. The medications ordered in a prescription may only be obtained at a pharmacy or drug store. A pharmacist will package your medication and provide written and verbal instructions on how and when it should be used. Your health plan may or may not cover the cost of medications.
HUHS operates its own pharmacy located in the Smith Campus Center near the main entrance to HUHS. This pharmacy is open to anyone with a Harvard ID, but fills prescriptions written by HUHS physicians only. If you need to fill a prescription when the HUHS pharmacy is closed, take your prescriptions to a local drug store like CVS or Walgreens to be filled.
If your physician prescribes medications, be sure to get complete information regarding the medication i.e. where to get it, how to take it, potential side effects, and special instructions such as whether it should be taken with food or whether you should avoid alcohol while you are taking it. Ask your physician if you should finish the prescription completely, or use it only until your symptoms disappear. Inquire also if it is available generically, that is, by the name of the chemical formula rather than the brand name, since generic prescriptions are usually less expensive.