Weight loss and diet plan for a healthy lifestyle.

Here’s how I envision the way health care provision will change and how it will affect the first group:

The first group, the purchasers of health care, will expect to be able to choose their doctors, either in an HMO or outside. A health care purchaser who agrees to pay for the deluxe version of traditional, conventional indemnity insurance, will be able to pick any health care provider he wants. But this will be the exception. The majority of health care consumers will participate in an HMO or other group practice plan. The employers and governments that pay for the plan will want to make sure that the doctors, hospitals, and ancillary services provide quality health care. They might also want a plan with an HMO or group practice that emphasizes child care and prenatal and obstetrical care if they have a lot of employees with families. On the other hand, if the company is in an industry that’s particularly stressful, it will want to make sure the plan provides psychological care benefits. The plan the purchaser ultimately selects will depend on cost, quality of care, and availability of service.

The aim here is to assign each patient in the HMO to one primary care physician—who is usually a generalist, a primary care internist, a family practitioner, a primary care pediatrician for those with children, and an OB/GYN for women, which some insurance plans will cover. This physician will serve as the captain of the patient’s health care, and the patient will see this physician before any testing or further specialists are ordered. The purpose is to establish a close relationship between the physician and the patient and to use only tests and/or specialists that are absolutely necessary, which will help to eliminate duplicate and unnecessary tests. This will help save money for the purchasers of health care—both the employer and the insurance company. In turn, the primary care physician will be monitored by the insurance company to make sure she is providing good care at a reasonable price. The insurance company may also look, for instance, at the number of patients in the HMO who have diabetes and suggest that this group be referred for nutritional counseling or perhaps for eye exams. This will cut down on future medical costs and also maintain current expense levels.

With this new model, the primary care physician will be paid less for the services he provides for each patient, as compared to his old fee-for-service days. But the advantage of this plan is that the doctor serves as the gatekeeper, which ensures improved care, and that medical costs across the board are controlled. Quality is also maintained because the insurance company may institute a plan in which it will issue a periodic report card for each health care provider that will show how each professional in the group is performing.

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To help your doctor diagnose your illness, you should also try to be as specific about your symptoms as you can. The phrase “I just don’t feel well” can be frustrating for your doctor to hear, because it doesn’t tell him anything. A few ways in which you can be more specific about your symptoms is to ask yourself the following questions:

• Have I recently lost or gained weight?

• Do I feel more tired than usual?

• Do I feel a pain somewhere in my body? Is it sharp or dull? Is it constant, or does it appear after a particular activity?

• Is my temperature over normal?

• Has my appetite changed?

• Do I feel short of breath?

• Have I noticed a change in my personal hygiene?

The amount of time you’ve had your symptoms is also important. If you have had a number of different symptoms for more than a few days, you should be sure to tell your doctor how many days, weeks, months, or years you’ve had that particular symptom. And if you’re trying to read the Body Signals of a family member or close friend, ask him or her these same questions as they pertain to his or her condition.

Remember, relying on the doctor inside you will speed up your own

physician’s diagnosis and treatment plan and ultimately your own recovery as well.

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