Tag Archives: Pharmacy

Types of Providers

Types of Providers

If you have complicated health issues or your doctor has called another doctor an industry term you’ve never heard before, you may be left wondering what all these health care names really mean. We can help you make sense of the different types of providers.

Your Doctors

Primary Care Provider (PCP)

A primary care provider, or PCP, is your main doctor. It’s who you visit for routine checkups, preventive care, and general health problems. Each person in your family can have a PCP, or you can all see the same one.

If you’re on an HMO or POS plan, you have to choose an in-network PCP who will oversee your care and refer you to specialists. If you’re on a PPO plan, you don’t have to choose a PCP to get referrals, but you can to get personalized care and savings.

And if you’re a woman, you can set a doctor as your PCP or choose another in-network doctor, like an OB-GYN, to oversee free preventive care, your yearly well-woman visit, or a pregnancy.

Setting and changing your PCP is easy. Just log in to Your Health Alliance to update your PCP.

Specialist

A specialist is a doctor who provides health care services for a specific disease or part of the body, like dermatologists, who focus on skin care.

Usually, you’ll be referred to a specialist when your personal doctor wants you to check on specific issues or problems. You’ll also be sent to a specialist when you’re diagnosed with something serious, like a heart condition or cancer, or if you find out you’re pregnant. 

Surgeon 

A surgeon is a doctor who is qualified to perform surgery, and they have their own specialties. If you have a heart attack and need surgery, your surgeon will be an expert in heart surgery.

If you’re sent to the ER because of an emergency or diagnosed with a condition or disease, you might be sent into surgery. But if you need a minor procedure, like having your wisdom teeth out, you’re seeing a surgeon too. 

Hospitalist

A hospitalist is a dedicated, in-patient doctor who works only in a hospital or network of hospitals. If you’re taken to the hospital in an emergency or accident, you might be treated by a hospitalist.

Help with Your Care

Care Coordinator

Care coordinators help you figure out your health care in lots of ways, especially after a hospital stay, diagnosis, or if you have a chronic or complex condition.

They can help provide you with resources, educational materials, and self-care techniques, help you understand your doctor’s instructions, connect you to resources in your community, and help you plan for the future.

Health Coach

Health coaches can help you or your family plan for better health. Our health coaches can help you get the best care possible from your healthcare team and get the most from your coverage.

They’ll partner with you to help in areas like nutrition, weight and stress management, and preventive screenings and immunizations.

Nurse Navigators

You might get help handling your care from a nurse navigator when you’re discharged from the hospital if you get a serious diagnosis. For example, a cardiac nurse navigator will help patients with a primary diagnosis of heart failure or myocardial infarction.

They will usually start the process by visiting you before you leave the hospital, then they’ll stay in-touch to walk you through the first 30 days after discharge. 

Nurse navigators can help you organize your appointments, connect you to education on your diagnosis, medications, exercise, diet, therapies, and when to call the doctor. And they might host support groups that can help people like you.

Other Kinds of Care

Home Health Care

Home health care is medical care, treatment, or skilled care you can get in your home. You doctor might recommend this in situations where care in your own home will be easier for your case and condition.

Skilled Nursing Facility

You doctor might order medical care that must be given or supervised by a licensed health care professional in a skilled nursing facility. This type of care could include:

  • X-rays and other radiology services
  • Physical, occupational, and speech therapy
  • Storage and administration of blood
  • Use of appliances, like wheelchairs
  • Meals, including special diets
  • A semiprivate room or private room if medically necessary

Hospice Care

Hospice care is special care for people who are terminally ill, including medical and physical care and help with social, emotional, and spiritual needs. It also provides support for family and caregivers.

Other Help

Pharmacist

Pharmacists are healthcare professionals who practice pharmacy, which focuses on safe and effective medication use. You might not think about your pharmacist’s skillset when you pick up your drugs at the pharmacy, but they’re trained to know how drugs work.

They know which drugs can interact to protect you from dangerous drug combinations, they can explain the side effects of your drug to you, and they make sure you’re getting the right dosage of your drugs on the right schedule.

Social Worker

Social workers are there to help you with social problems that can affect your quality of life and health care. They can help you and connect you to resources for domestic violence, sexual assault, abuse and neglect, housing and food insecurity, home-delivered meals, substance abuse, mental health issues, advance directives, and more.

Other Providers

Medical Director

A medical director is a leader who recruits and manages doctors, nurses, and other personnel. They also examine and coordinate processes within their organizations to improve and guarantee the medical quality of the facility. 

 

If you need to find covered providers, use our Find a Doctor or Hospital tool to search for covered doctors, hospitals, and more.

World Antibiotic Awareness Week

World Antibiotic Awareness Week

It’s World Antibiotic Awareness Week. Why should you care about antibiotic resistance?

Why It Matters

 

Reasons for the world antibiotic resistance crisis include:

  • Patients not finishing their full course of antibiotics

What You Can Do as a Patient

 

  • Health workers over-prescribing antibiotics

What You Can Do as a Health Worker

 

  • The overuse of antibiotics in livestock and fish farming

What You Can Do as a Part of Agriculture

 

  • Poor infection control in hospitals and clinics

How Antibiotic Resistance Spreads

 

  • Lack of hygiene and poor sanitation

What You Can Do as a Policy Maker

 

  • Lack of new antibiotics being developed

WHO_HWC_ 6x infographics_22.10.15

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Cleaning Meds Out of the Cabinet

Long View: Leave Prescribing to the Pros – Don’t Mix Your Meds!

I used to visit my aunt and uncle in Missouri whenever I got the chance. They were older but still lived on their own. My uncle Bill took a lot of medicine, as is often the case with a 90-year-old. The problem was my aunt, his caregiver, felt she knew better than his doctor.

She would cut his pills in half because she thought they were making him “groggy.” She also would “prescribe” outdated meds. I found my aunt’s secret stash in a shoe box in the closet.

Both of them also took over-the-counter meds … to keep their joints limber, eyesight sharp and other things she was sure would enhance their golden years. Her approach was dangerous, but I could only help while I was there.

So, what can a caregiver do?

Brad Berberet, acting director of the Health Alliance Pharmacy Department, shared this advice.

“Many people know different drugs can interact with each other, causing unexpected side effects,” he said. “However, most people forget that interactions can occur between prescribed medications and over-the-counter (OTC) medications and herbal supplements.  Patients should let their doctor and their pharmacist know about all OTC and herbal supplements they are taking, especially when they start a new medicine.”

Our chief medical officer, Dr. Robert Parker, shared similar advice.

“When you take medication exactly as prescribed, your doctor can better monitor you for side effects,” he said. “It’s important to be honest with your doctor to assure you have the best chance of a positive, not harmful, impact to yourself or those you love.”

You can help your loved ones get rid of old medicine. Don’t just flush them. Check for places that dispose of drugs safely, like your pharmacy or hospital. Your local senior center may have suggestions.

My PCP does a medicine review every time I have an appointment. Just keeping a list of how much medicine you take and when helps your doctor. You can ask your doctor to make changes to your list so it stays current.

While I’m sure my aunt had the best intentions, her approach to medicine was dangerous. Be sure to talk with your doctor or pharmacist before taking any new medicine, prescription or over-the-counter. Not only will you avoid harmful interactions, but you will probably feel better, too.

Pharmacy Pro Protecting You

Pharmacy Pro Helps Members Make Smart Choices

Tamara Migut has spent the last 14 years in pharmacy helping people understand their prescription drugs and how to take them safely. She now works closely with the Health Alliance drug formulary, so she’s able to explain it in simple terms.

“The formulary lists common covered generic and brand-name prescription drugs. It’s not a complete list,” she says. “It helps you and your doctor choose the best drug for your health needs, first, as well as your budget.”

Tamara spends a lot of time doing research to help members and doctors with their prescription questions. After reading health lingo all day, she likes to unwind (when time allows, she’s a mother of three!) with a science fiction book.

Maybe that’s because she’s married to a science teacher. Her husband has taught chemistry at Urbana High School for 12 years.

Tamara also helps members save money by telling them about cost-saving pharmacy programs like Rxtra.

“You can save based on where you have your prescriptions filled,” she says.

She also tells people about generic drugs, which work just as well as brand-name ones but cost a lot less.