What’s Up, Doc?
Under the Weather
Aaah-choo! Oh, boy, that stuffy nose you’ve had all week is getting worse. You’re sneezing, you have a headache, you’re achy all over, and your throat is sore. These symptoms can mean only one thing: time to head to the doctor. But who? For most common problems like colds and flu, a general practitioner should be your first choice. These doctors are also called family doctors because they treat patients of all ages, and they take care of most common illnesses. For some more serious problems, the GP may suggest that you see a specialist. The GP will be able to make a recommendation, and she will provide a referral if your health insurance plan requires one.
But if you’re new in the neighborhood, you may not know what general practitioner to call. Sometimes the best way to find a doctor is to ask someone you trust. Ask a neighbor or a friend at work. Your employer will help you find a list of doctors who participate in your health plan.
ALAN: Hi, Lia. I haven’t seen you for a few days. Where have you been?
LIA: I haven’t been hiding. I haven’t been feeling well for a couple of days, so I’ve been trying to get lots of rest. I don’t think it’s working because I still feel sick.
ALAN: Wow, maybe you should get checked out by a doctor.
LIA: I think so, too, but I don’t have a family doctor yet. Can you recommend someone?
ALAN: We love our GP. She’s very patient, and she’ll answer every question you ask. She doesn’t rush you. You should call for an appointment. In fact, if you’re really sick, she’ll squeeze you in right away, even without an appointment.
LIA: But what if it’s not a cold? What if it’s serious? What if I need to see a specialist? What if I need a hospital?
ALAN: Calm down. It’s probably just the flu. Call Dr. Patelli. I’m sure you’ll feel better after you talk to her.
Tip 1: Many doctors have this sign at the reception desk: “Payment must be made at time of service.” If you can’t pay, the doctor will help you with a payment plan.
Tip 2: Bring something to read! Sometimes there is a long wait at the doctor’s office. There are usually magazines in the office, but they could be old or boring. Plus, sick people have been touching them!
VOCABULARY
achy (also ache): a dull body pain (an achy feeling is different from a sharp pain)
checked out: examined, looked at
employer: the person or company you work for; the boss
flu: an illness that makes you sneezy and just feel really bad and achy all over
general practitioner: a type of doctor who sees people with the most common illnesses
GP: short name for a General Practitioner
health plan: an insurance benefit provided by some employers for employees (and sometimes their family members) who become ill
patient: someone who is receiving health care
reception desk: the counter or window where you sign in to see the doctor
recommendation: a suggestion
referral: a doctor’s recommendation of another doctor
rush: hurry
sneezing: aaah-choo!
sore: hurting
squeeze someone in: make time to see someone, even if they don’t have an appointment
stuffy nose: a feeling that you can’t take in air through your nose
symptoms: signs of illness
Health Insurance: What’s Up with That?
Although every country tries to find the best way to provide health care for its citizens, it seems there is no one system that is perfect for everyone. In the United States, health insurance is a huge issue. How can we be sure everyone has access to excellent health care? How can we help people pay for doctors and expensive treatments? What will a family do if someone becomes seriously ill and needs hospitalization? Medical care in the United States can be very expensive, and no one wants people to suffer because they can’t pay.
Most large companies and some small businesses offer health insurance benefits to their employees. This means that they participate in a health insurance plan and cover some of the costs. Other costs for the plan will be deducted from the employee’s paycheck. This is usually the best option for employees, but there are many plans and many rules, so it’s important to get all the information from the human resources department at your job or from your employer. A very important thing to remember is that, if you have health insurance through your job, you usually must use a doctor in the insurance network. Many insurance companies have arrangements with certain doctors to charge only a certain amount for care. In most cases, your insurance will only pay for doctors in the network. If you choose a doctor who is not in the plan, you will have to pay most of the costs for service yourself.
Many health insurance plans say that you must choose a primary care physician. This is the doctor that you will see first whenever you have a problem. If the doctor feels that you need more specialized care, the health insurer may require a referral to the specialist. This isn’t as complicated as it sounds. Most doctors are very knowledgeable about insurance rules. Doctors often have a staff member whose only job is to deal with the insurance companies.
Once you see the doctor, it’s possible that she may prescribe a medication for your condition. She will write the name of the medicine and the dose on a special form. Take the prescription to the drugstore. The pharmacist will ask for your insurance card and fill the prescription. He may substitute a generic drug unless your physician specifically requests a name brand. If you have prescription coverage in your health plan, you’ll only need to pay a co-pay. The insurance will pay the rest of the cost. Insurance plans are complicated, but it’s worth taking time to figure them out!
LIA: Hi. My name is Lia. I called a little while ago. My neighbor recommended that I come in to see Dr. Patelli.
RECEPTIONIST: Yes, of course. First, I’ll need you to fill out this form with your health history. It’s for your chart. While you’re doing that, I’ll make a copy of your insurance information.
LIA: Oh, no! I didn’t bring any information with me! What do you need? Do I need to call my job?
RECEPTIONIST: No, it’s okay. You don’t have to call them now. But didn’t you get an insurance card with your group number?
LIA: Oh! I think I have a little card that has my name and a bunch of numbers on it. Is that what you mean?
RECEPTIONIST: Exactly! That’s all the information I need. We’ll process all the insurance claims for you if we have those numbers.
LIA: Whew! I think worrying about this insurance was making me sicker than my illness! Will it take a long time for me to see the doctor?
RECEPTIONIST: Well, we know patients sometimes have to wait a long time for lots of doctors. Dr. Patelli tries to be respectful of her patients. She won’t make you wait unless there’s an emergency and she has to squeeze someone in. The nurse will take you in and take your vital signs, and then Dr. Patelli will come in to examine you. After she makes her diagnosis, she’ll write a prescription if you need one. But she will always leave time for you to ask questions. She wants you to understand exactly why she thinks a certain medicine will help.
LIA: I think I like this doctor already!
Tip 3: Once you’ve received your prescription, you can drop it off at the drive-thru and pick up the medicine later. Yes, many pharmacies have a drive-thru. But you won’t be getting a cheeseburger at this drive-thru!
Tip 4: Hundreds of specialists deal with only one kind of problem. Here is a list of some of them:
- cardiologist: heart problems
- dermatologist: skin problems
- OB/GYN (obstetrician/gynecologist): pregnancy, childbirth, and women’s health-care issues
- oncologist: cancer treatment
- orthopedist: bone-related problems
- pediatrician: children’s illnesses
- plastic surgeon (also called a cosmetic surgeon): improving the appearance of the body
- psychiatrist: mental concerns or illnesses
GRAMMAR REMINDER: Modals Review
Here are those modals again! See how useful they are?
Check in this unit for all of these examples:
- should for giving advice
- must to show a strong obligation
- could for possibility
Fun Fact!
English has lots of health-based sayings. Here are two common ones:
- Early to bed, early to rise, makes a man healthy, wealthy, and wise.
- An apple a day keeps the doctor away.
So, eat lots of apples and get lots of sleep. Just don’t eat the apples while you sleep!
MORE FUN WITH IDIOMATIC EXPRESSIONS: Health
be/feel under the weather: feel a little sick
→ He woke up with a sneeze and felt under the weather.
take a turn for the worse: have an illness that gets more serious
→ Later that day, he took a turn for the worse, so he called the doctor.
in bad shape: in very bad health
→ The doctor said that he was in such bad shape that he should go straight to bed.
clean bill of health: information that one’s health is excellent
→ He took some medicine and got lots of rest. After a few days, the doctor gave him a clean bill of health.
the picture of health: in excellent health
→ Now he looks well rested and the picture of health.
VOCABULARY
access: ability to use
benefits: something special the employer offers
chart: your health record and diagnosis
condition: illness
co-pay: the amount you must pay before the insurance company pays the rest of the cost
cover: pay for
deal with: handle all the communication with
deducted: taken out of
diagnosis: the decision about what your illness is
dose: the amount of medicine you must take and how often you take it
employee: the worker
generic drug: medicine that has the same formula as a name-brand drug, but it is made at a smaller company
group number: identification of your company so the insurance company knows exactly what to pay
health history: a list of any illnesses you’ve had in the past, which helps the doctor understand your problem
health insurance: a plan that will pay for your medical bills
hospitalization: being placed into a hospital for treatment
human resources department (also called personnel): the department that deals with the workers
ill: sick
insurance claim: a form that tells the insurance company what your illness is and how much they should pay the doctor for your costs
knowledgeable: knowing a lot about something
little while: a short amount of time
medication (also called medicine or drug): something that will help you get well
name brand: made by a well-known company
network: a group
pharmacist: specially trained professional who will prepare your medicine according to the doctor’s prescription
prescribe: write a note for a medicine
prescription: a special form with your name and the dose of the medicine you must take
primary care physician: the doctor, usually a GP, whom you will see first for any illness
specialized: dealing with only one kind of problem
specifically: specially
staff member: office worker
substitute: use to take the place of
treatment: care
vital signs: usually your height, weight, blood pressure, and heart rate (These are usually checked at each visit.)
