By: ARIEL J. WARDEN-JARRETT, MD, FAAFP

Have you ever felt that a provider did not listen to you or take your concerns seriously? Chances are, we have ALL felt that way at some point. But I have realized that communication gaps are often the roots of these frustrations. Allow me to explain.

Through the years, I have treated hundreds of women going through menopause who came to me because they didn’t think their gynecologist “cared… or they would have ordered the hormone levels.” I used to get so frustrated when patients came to me, and I had to clean up the “misunderstanding created by a specialist.” Some patients were even prepared to find a new gynecologist because the last one “did not order hormone levels…” Some women had tears in their eyes, and I could sense their pain.

I acknowledged the pain, then shared the current guidelines of hormone testing in their age group. Once this was done, I added that in their case, their gynecologist had simply followed the guidelines, and what they were feeling was part of a normal process. They thanked me for taking the time to explain, then looked me in the eyes to ask why the specialist had not explained it “the way I did…”

Now doing that set me back with scheduling each time, but it was an investment worth making, as I am a doctor for the people! However, I realize that many patients do not ask questions when they matter the most during office visits.

Here are my tips to foster stronger communication skills during your visits. Don’t shut down, stand your ground.

1. Plan our questions ahead of time and write them down. Keep in mind that your provider typically only has 15 min to address your concerns. Don’t be offended if your provider requests a follow-up visit to provide adequate time to address your needs.
2. Find out your provider’s preference for more complicated questions. Perhaps they may prefer a message in the portal ahead of the visit so they have time to do research or they may want to do the research after the visit…
3. Don’t be so quick to switch providers or offices after a single issue. If you don’t understand, or feel unheard, don’t shut down, but rather try to redirect and share how you are feeling in that moment. If the provider dismisses you, THEN look for another provider that you can better connect with.

If you don’t remember anything, remember this, don’t shut down and stand your ground.

By: ARIEL J. WARDEN-JARRETT, MD, FAAFP

Many Americans are working hard to manage their weight and have set goals to lower their body mass index (BMI)  to under 25. While this is a worthy goal, it can often feel like a challenging and sometimes frustrating journey. But the good news is that there are more resources and options available today than ever before to help patients achieve their weight management goals. 

However, navigating the world of insurance coverage can add complexity to the process. Many patients experience disappointment when they go to the pharmacy to pick up a prescribed medication and discover that it is not covered or isn’t listed on their insurance’s drug formulary. They are often advised to contact their doctor’s office to request a prior authorization or a tier exemption. While it sounds simple, these processes can sometimes be more time-consuming and challenging than anticipated. 

In each of our offices there are dedicated individuals working behind the scenes to get your medications covered. Sometimes each prior authorization may take significant time to complete and we appreciate your patience as we manage these requests. 

It’s also important to understand that your employer plays a significant role in selecting your insurance benefits and choosing which medications are covered. Many patients may not realize this. 

If a medication like Mounjaro or Ozempic, which is often prescribed for diabetes, isn’t covered for someone who isn’t diabetic, this is typically due to how the insurance policy is structured. If the medication doesn’t align with the required coverage criteria, even with a prior authorization, it may not be approved.

Additionally, starting in January 2025, some insurance plans will no longer cover medications like Zepbound or Wegovy for obesity alone, making it more challenging to get these treatments covered under certain plans.

So, what can you do if you’re facing these challenges?

1. Talk to your employer: If you find that your medication is no longer covered or the coverage is limited, it may be helpful to ask your employer about the available options or if there’s anything that can be done to improve coverage.
2. Work with your healthcare provider: Your doctor or healthcare team can help explore alternative treatment options and lifestyle modifications that may be beneficial in reaching your weight management goals. Together, you can find a plan that works for you.
3. Check for manufacturer assistance programs: Many pharmaceutical companies offer discount programs or coupons to help offset the cost of medications. If you’re able to pay out-of-pocket, it might be worth exploring the cost of the medication without insurance, though be aware that these payments won’t apply toward your deductible.
4. Advocate for change: If you’re facing difficulties with your insurance coverage, consider reaching out to your congressperson or state representatives to share your concerns. They are there to represent you, and they may be able to assist in advocating for changes or improvements in the system.

Remember, you’re not alone in this process, and we are all working together to find the best solutions for your health and well-being. Don’t get discouraged – there are resources available to help, and your healthcare team is here to support you every step of the way.