像老板家长一样驾驭医疗保健系统的5种方法

从感冒到COVID，很难预测这个季节会给你带来什么。但你能知道的是如何准备。把这当作你在美国复杂的医疗保健系统中导航的备忘单。

1. Pick the Right Doc

找儿科医生，与其说是为了找到世界上绝对最好的，不如说是为了找到一个适合自己家庭的人。例如，对一些人来说，这可能意味着一名拉丁裔医生，因此，他更熟悉拉丁裔社区普遍存在的健康问题，如哮喘，与他建立信任可能更容易。西班牙裔健康全国联盟主席简德尔加多博士说，感到舒适是获得最佳护理的关键。事实上，研究表明，看同一种族或种族背景医生的人更有可能在预约时敞开心扉。"如果你在儿科医生的办公室里感觉不到完全的欢迎，那就不要回去，"德尔加多博士说。

对于那些喜欢彩色儿科医生的人，不要羞于向朋友、父母同事和同事寻求建议。HUEDco.com是一个在你所在地区寻找有色人种医生的免费工具，AyaNATHERATION.com也提供类似的服务来寻找有执照的心理健康治疗师。

在你承诺之前，亲自或虚拟地安排一次与医生的见面会总是一个好主意。问问题3360你看到多少有色人种的病人？你对多代同堂的家庭有什么体验？你学过第二语言吗？这些问题没有正确的答案，但如果医生不予理会，那就是另寻他处的危险信号。相信你的直觉。

RELATED:如何选择儿科医生

2. Manage Medical Costs

Do shop around.

当你的一年级学生鼻子里塞了一颗豆子时，你可能不会花时间比较价格来取出它。但是对于一些程序——比如核磁共振成像、语音评估或过敏小组——提前询问价格是有好处的，因为价格可能会有很大差异。ClearHealthCosts.com让你看到价格，狭窄

ed down by both location and procedure, while Guroo.com compiles millions of insurance claims to show the average costs for certain exams at the national, state, and local levels.

Don't avoid the doctor to save money. 

After all, pediatricians are trained to catch and diagnose conditions early, says Silvia Pereira-Smith, M.D., a Venezuelan mom and assistant professor of behavioral pediatrics at the Medical University of South Carolina.

Do speak up.

Personal finances can feel taboo to bring up at the pediatrician’s office. But in reality, your child’s doctor may have a wealth of resources at their fingertips, from abundant samples (formula, bandages, nasal saline, hand sanitizer…) to simple cost-cutting strategies, such as prescribing medications in bulk. They’ll also know that it’s important to confirm that tests or procedures are necessary (rather than routine) and covered by insurance.

Don't fill scripts on autopilot.

Studies show that generic medications typically cost 80 to 85 percent less than brand-name equivalents. Be picky about filling prescriptions too. Some insurance companies reward members with lower prices for using preferred pharmacies. Price-comparison tools like GoodRx.com and LowestMed.com make it easy to search for deals. Sometimes it’s smartest to get your meds without going through insurance. At stores like Costco and Walmart, you’ll see up-front prices that can sometimes, depending on your coverage, beat your prescription co-pay. Also check out the Partnership for Prescription Assistance (MAT.org) as well as Needymeds.org.

• RELATED: 9 Things a Pediatrician Wishes You'd Stop Doing

3. Plan for the E.R.

Taking a family member, especially a child or aging parent, to the emergency room is never going to be stress-free. But doing a little homework in advance can help things go a lot more smoothly. 

Figure out your route.

The nearest E.R. may not always be your best option. For instance, children’s hospitals often have pint-size equipment and staff that are more experienced in treating kids. Ask your family’s doctors to see whether they have recommendations about where to go. And check with your insurance company to see if they have a preferred location (which can save you money).

Load your wallet.

You’ve probably already got a photo ID and credit card. But double-check that your insurance card is up-to-date and safely stashed in there as well. Tucking $10 in cash into an out-of-sight pocket will ensure you can buy water in the waiting room. And since there’s always a chance that you won’t be able to accompany an elderly parent into the E.R., prepare their wallet as well. If you’re worried language will be an issue, include a letter explaining that they speak Spanish or another language and will need an interpreter, along with your contact info.

Get records in order.

Electronic health files are increasingly common, and your kid’s pediatrician may already have a patient portal and can give you access. You can also create your own on an app like Apple Health. Or go old-school with a notebook or binder. Just be sure to jot down any previous illnesses, surgeries, immunizations, allergies, chronic conditions, prescriptions and dosages, regular supplements, and OTC meds. Keep these physical records in a tote bag with other essentials (extra phone charger, a stuffed animal or game for your kid, snacks) that you can easily grab in case of emergency.

sick girl receiving a hug and kiss from mom Credit: Priscilla Gragg

4. Consider Telehealth

In-person appointments are crucial for well visits and to diagnose certain conditions (hello, strep!). But there are plenty of times—follow-ups, checkups for chronic illness, therapy—when connecting by screen will do the trick, says Aura Obando, M.D., a Colombian mom and pediatrician at Boston Health Care for Homeless Program.

To get the most out of any virtual visit, talk to the doctor in a private, well-lit area so you’re comfortable chatting freely about symptoms and they can easily see your kiddo, Dr. Pereira-Smith suggests. Set up your laptop or mobile phone on a table so there’s less distracting movement during the session, and write down a few notes beforehand about the symptoms or questions you want to ask so you won’t feel too rushed or miss anything. “And, just like an in-person visit, it can be helpful to give your child a small toy or something to entertain them while you talk,” Dr. Pereira-Smith says.

• RELATED: A Parents Guide to Telemedicine: Everything You Need to Know About Remote Healthcare For Your Family

5. Boost Your Family’s Immune System

These small, daily habits can help rev up infection-fighting defenses.

Embrace bedtime.

The pandemic has upended many of our normal routines, especially if family members are working or learning remotely from home. But “children who are well rested have stronger immune systems,” says Kimberly Montez, M.D., a Mexican-American mom and assistant professor of pediatrics at Brenner Children’s Hospital, part of Wake Forest Baptist Health in Winston-Salem, North Carolina.

Cook the rainbow.

You know fruits and veggies are packed with vitamins, minerals, and antioxidants—all of which play a crucial role in keeping your kid’s immune system humming, Dr. Montez says. But people tend to eat less produce in the winter. Beat the trend this year by embracing more cold-weather fruits and veggies, such as citrus, squash, sweet potatoes, cabbage, and persimmons. If your kids aren’t keen on five servings a day, aim to bump up their intake by just one serving a week. Small improvements add up over time.

Get active.

There’s strong scientific evidence that regular exercise can reduce the number of times someone catches the cold or flu in a year, possibly because it helps the circulation of infection-fighting cells. To make daily activity a habit, build it into the schedule (say, a post-nap walk around the block or a predinner scooter session), and don’t let low temps trap you indoors. Sledding, snowman building, nature scavenger hunts, and snow tubing are all great ways to build a sweat—and memories.

Bring on the sunshine.

Soaking up some time in the sun has been linked to everything from improved mood and sleep to—yes—stronger immune function. Scientists think that it might be thanks to vitamin D, aka the sunshine vitamin. A 2020 study suggests that increased vitamin D could help boost the expression of hundreds of genes that are thought to play a role in immune function. Just be sure to wear sunscreen, even in winter, Dr. Montez advises.

Don't Forget The Flu Shot!

Influenza vaccines aren’t 100 percent fail-proof, but they’re a safe way to decrease the odds that your child will get seriously sick. “That’s especially important this winter because coronavirus and flu will coexist,” says Nancy Silva, M.D., a Brazilian-Portuguese mom and pediatrician in Wesley Chapel, Florida. “Some kids may contract both, and it’s much harder to fight two potentially deadly infections instead of one alone.”

Particularly for multigenerational households, she stresses the need for everyone to get a flu shot, from your kid to Grandma. You can get vaccinated “even into January or later,” according to the CDC. And many pharmacies offer on-site flu shots without requiring an appointment, though ask about age restrictions before heading over.

• RELATED: The Most Important Vaccines for Children: An A-Z List for Parents

Containing COVID-19

Even when your family is doing their best to wear masks, wash hands, and practice social distancing, someone may still come in contact with the virus. Just because one person tests positive doesn’t mean everyone will inevitably get sick. In fact, though the research is still emerging, early studies show that within-household transmission rates hover at around 19 percent. Here’s how to keep as many of your family members as possible clear of the coronavirus.

• Quarantine the sick family member in one room and designate a bathroom for their use only. Add a HEPA filter at the entrance of a quarantined room, if you can, for increased protection for others in the house, suggests Dr. Silva.

• Pick one caregiver to tend to the sick family member. Don’t have that person also care for kids in the house.

• Wear gloves to handle the sick person’s dishes, glasses, and utensils (and consider disposable options), and avoid touching your nose, mouth, and eyes. Discard gloves and wash your hands well afterward.

• Ask the ill family member to wear a mask whenever they’re around other relatives (yes, even shuffling down the hall to the bathroom).

• If possible, open windows and turn on fans in rooms to circulate clean air from the outdoors.

A version of this article originally appeared in Parents Latina's December/January 2021 issue as “Winter Health 101."

Parents Latina

• By Kate Rockwood