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Navigating The Health Care Maze

Spokane Public Radio presented this forum at the Spokane City Council Chambers, Wednesday evening, March 12, 2003.

Hear the audio from each hour below.

Forum panelists
If you suspected you might have a medical problem, who would you talk to? Friends? Family? Search the internet? Would you even feel comfortable talking to your doctor or visiting a medical clinic?

Spokane County estimates that in 2000, more than 45,000 people in the county didn’t have medical insurance. Many of those who did have insurance would have to be dragged to their doctor’s office. Among the excuses of “What I don’t know can’t hurt me,” and “They’ll just charge me for saying there’s nothing wrong with me anyway,” are serious questions about how the health care system works.

“We’re doing this to empower people to be good health care consumers,” says SPR’s Doug Nadvornick, who will moderate the panel discussions. “We want people to understand their rights and responsibilities as patients. And we’re trying to give people the tools they need to do their own research. In this information age, where can people go, who can they trust to find accurate and pertinent information? And how does that information affect the job doctors are doing?”

The first hour of the forum featured the doctor/patient/administrative relationship. Many people feel uncomfortable describing their complaints, either feeling intimidated or embarrassed in front of their doctor. Others can’t remember all their symptoms, or answer questions such as when problems started. Yet the more information doctors have, the better the chance of diagnosis. On the other hand, doctors can’t usually answer questions about what’s covered by a patient’s insurance plan. For many people, the most frustrating part of medical care is coping with paperwork and billing afterwards.

 The second hour focused on finding reliable information outside of the doctor’s office. Even those who do go to their family physician are expected to participate in decisions about health care, and many want to know if there are options the doctor or specialist hasn’t explored, including alternative and complementary medicine. Many without insurance are checking medical symptoms with internet sites, or other free sources including public radio programs Dr. Zorba Paster’s On Your Health and People’s Pharmacy. Prescription drug companies are advertising their products on television and radio.

“This is part of our lives, both in the doctors’ office and in the hospital,” panelist Schaaf says, recalling a patient who recently brought web sites on her laptop to talk about treatments. “I regularly talk with patients about how to weed out the nonsense from the useful information. There are clues to whether it’s a valid site, someone with an odd perspective, or a site trying to sell you something.”

Forum Panelists

Linda Garrelts MacLean is a pharmacist and certified diabetes educator. She is currently a Clinical Assistant Professor in the Department of Pharmacotherapy with Washington State University where she teaches the Nonprescription/Herbal course, focusing on the pharmacist's role in advising and counseling patients with regard to proper over-the-counter medication usage. As the past co-owner of Jones Pharmacy in Spokane, Washington she is vitally interested in community pharmacy. She has developed and implemented niches to better serve patients, such as rapid step testing, smoking cessation, diabetes self management, wellness education, immunizations, specialty compounding, emergency contraception, collaborative prescriptive protocols, and lipid management.

Mary Mitiguy Miller has experienced and navigated the health-care maze from both inside and outside. As a Physician Assistant in family medicine, she practiced and taught at Dartmouth Medical School, the University of Washington, and the University of Utah. She cared for patients in sites ranging from overcrowded inner-city hospital clinics to Harvard teaching hospitals.
Her second career has been in journalism, working for the Spokesman-Review and KPBX, and then for Group Health Cooperative in both media relations and as medical editor of Group Health’s patient magazine. Most recently, she wrote an intranet magazine for the American Red Cross, which included researching healthcare issues on the Web.
Her latest, and perhaps most challenging “career,” has been helping friends and family cope with terminal illness, chronic diseases, and acute medical emergencies.

Marilyn Ream, MD earned her medical degree at UC San Francisco and did her residency training in Family Medicine at UW She was a family physician at Group Health Cooperative in Spokane from 1987 until 2002. She is now in recovery from ovarian cancer and is working part-time in an administrative position at Group Health and starting her own consultative practice out of her office in her home. She has always had an interest in a more holistic approach to health and has taught a stress reduction course called Skills for Mindful Living since 1996. She is certified in interactive guided imagery and has studied herbal medicine as well. She has also been training in 5 Element acupuncture since 1998. She has volunteered abroad a number of times, including working with traditional healers in Peru and most recently working at the hospital built in Bangladesh by Dr. George Bagby, a retired orthopedic physician from Spokane.

Tom Schaaf, MD, clinical director for Hospitalist Services at Group Health Cooperative has spearheaded the region's first hospitalist program since its inception in October 1999. Group Health hospitalists work with family doctors, hospital staff and other specialists to ensure patients receive the best possible hospital care. Dr. Schaaf, a family practice specialist, has lived in Spokane and has practiced medicine with Group Health for the past 10 years.

Jim Shaw is the Medical Director of the Providence Center for Faith and Healing at Sacred Heart Medical Center, which seeks to integrate spiritual care into health care. He is also an ethics consultant for Sacred Heart and Providence Services, and is active in both the Spokane End of Life Coalition and the National Catholic Initiative “Supportive Care of the Dying” Coalition. A certified family practitioner, Jim practiced with Group Heath for 22 years.

Randall Stamper is principal partner of Stamper, Rubens, Stocker, & Smith P.S. His practice emphasizes health care law, focusing on representation of hospitals, physicians, and HMOs. Having represented hospitals and physicians for over 30 years, Stamper has dealt extensively with patient rights issues including consent forms, directives, patient confidentiality, patient coverage and reimbursement issues. A Spokane native, he received his law degree from the University of Notre Dame in 1972 and was admitted to the Washington State Bar that year.