Topic A: The Health Advisory

Question 1  What is a Health Advisory?
Answer: The Health Advisory is the written outcome of a thorough independent evaluation of your health status and and an audit of the care you are getting, performed by a physician who is neither under pressure from your health plan to limit costs nor in a position to benefit from how much diagnostic work or treatment is needed. The independent medical evaluation and the health care audit are the mechanism for producing the personal Health Advisory for an individual patient.

Question 2  Why is the term "advisory" used?
Answer: An advisory is just short of a warning. It is a recommendation as to what to do or not to do. An advisory is sometimes called a "heads-up," a call to pay attention to something which may be hazardous. It is neither adversarial nor judgmental.

Question 3 Is an independent medical evaluation a new concept?
Answer: No, the IME has been in existence for many years, used largely by attorneys or insurance companies themselves to determine liability for benefits to those who have been injured or disabled. Insurance companies have understood for many years that the physician loyal to the patient might weight opinion towards the interests of that patient rather than towards the expenses of the insurer. The patient who arranges for his or her own Health Advisory unambiguously recaptures that physician loyalty.

Question 4  What does the personal Health Advisory include?
Answer: The advisory includes a review of the patient's health status and care, essentially an audit of the medical management, along with appropriate recommendations for the patient to take back to the plan physician. If recommendations are made for evaluation or care more extensive than that being offered by the health plan, they may be backed up with citations from the medical literature.

Question 5  What does the patient need to do to secure an independent medical evaluation and personal health advisory?
Answer:  Schedule an appointment with the physician conducting the independent medical evaluation at the American Health Advisory Center. This may be in person, if the patient is in the Washington, DC area, or by phone if the patient is not able to come to Washington, DC.

Secure copies of all relevant medical records, so that the AHAC physician can review these before talking with the patient. These include recent physicians' notes, blood studies, consultations, EKGs, and pathology and X-ray reports.

Fill out a health inquiry form provided by AHAC prior to consultation with the AHAC physician. This will include a listing of the patient's medical history, questions and goals.

Question 6    Does the physician need to be seen by the AHAC physician?

Answer:  This is desirable but not necessary. At least a telephone interview is important. It is also extremely helpful for the patients to put in writing what they see as the problems with their health care. The health advisory is an examination of care being received or proposed for the patient, rather than a direct examination of the patient.

Question 7   What does the patient have at the completion of the evaluation?
Answer:  A thorough personal health advisory report with recommendations and supporting documentation.

The confidence that the opinion of the AHAC physician is unrelated to the cost of care or the amount of resources that care might consume.

A strong position when dealing with the health insurance plan.

Contact DrRobinson@MD-1.com for further information.
Copyright, 1997, American Health Advisory Center

1056 Thomas Jefferson St. NW Washington, DC 20007-3813

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