Medicine

Coming soon to Undermined by Healthcare: We’ll cover the Doctor Side, the Money Side, the Patient side and the Big Picture of Healthcare

Image by Huma Kabakci via Unsplash

Healthcare topics you’ll see in the coming weeks & months in Undermined

If you’re like me, you find healthcare convoluted and confusing to navigate. I’ve learned a few tips and tricks from my experience as a chronic patient for almost a quarter-century.

Below are some of the areas and topics I plan to write about in the coming weeks and months. I won’t necessarily go in this order — I’ll start with what seems most important or what people I know are going through first, and jump between sections — but I do hope to get to all of these.

If you’re interested, follow or subscribe. I’ll try to make it worth your while.

For many Americans, our health condition puts us in the middle of an ongoing tug-of-war between our healthcare providers and our insurers. Each technically “serves” us, but they are far more occupied by their next chess moves against each other — drawing up cost agreements, lobbying congress, and defining new aspects of care each year — all to maximize profits or just stay in business.

This fight has driven medicine to levels of complexity that are beyond human capabilities to manage. We’ll take a look at the dynamics that drove this evolution and how they still dictate the main business of healthcare today:

  • Healthcare is not about you. The infinite complexity that sidelines patients
  • A brief history of haughtiness. How medicine got a big head
  • A system divided. The map behind those infinite call transfers
  • Feelin’ AI’ght. Will AI will save healthcare?

Just getting a doctor’s visit today can be really difficult. If we are lucky enough to get in the door with an appointment, there are further steps that are even harder to navigate. We are left to figure out how and when to get our next appointment, wait unspecified times to hear back on specialty referrals, decide whether to trust our doctor blindly or seek a second opinion.

  • Picking a doctor: Specialties & special personalities
  • Hunting down healthcare: Where I go for what | Importance of Primary Care
  • Foot in the door (ouch!): How I get doctor’s appointments with minimal pain. | Mainly expect a wait.. Also getting on waitlists. Also calling back to check on waitlists.
  • Getting a referral. Don’t get dropped in the doctor handoff. | Medical review and when to make yourself annoying
  • To bring or not to bring. What to have or leave at home when checking into the hospital or infusion center
  • MyChart and its limits: How I use and go beyond the electronic health record
  • How I fired my doctor. Life is too short for BS and disrespect
  • Even caregivers cross lines. What to expect from filing a complaint
  • History bonus: Why is my doctor such a jerk?

The bills that healthcare providers and insurance fight over — totaling in the hundreds of millions of dollars each year — are scaled for their bank accounts, not ours.

As Americans getting sick, we have more to worry about than just finding good treatment and getting better. We’re also at risk, at any point, that the haggling between our doctors and insurers over any single bill might fall apart. When it does, that corporate-calibrated charge drops into our laps — where it is likely to drain our savings or bankrupt us.

I’ll be covering these topics about insurance, bills and healthcare paperwork:

  • Who’s got the tab? An overview of how money works in healthcare
  • Who you callin’ deductible? Understanding & choosing health insurance
  • D14576298730595 is the magic number. Why I always ask insurance for the “call reference number.”
  • Pre-authorize yourself. CPT codes and
  • Basic batches. How I read medical bills, EOBs & MSNs
  • Don’t pay right away: My philosophy on collections & debt
  • Go with the cash flow. Get your money back when a provider doesn’t bill insurance
  • BIR (don’t get left in the cold!). Setting up shop to track multiple bills & reimbursements
  • Care to the Max: How I work the out-of-pocket maximum
  • Medicare-aoke. Government health insurance and those who sing along | Medigap, Medicare Advantage, Secondary insurance & more.
  • The Art of the Appeal: Humanity trumps bureaucracy
  • At your limit: Disability, COBRA & SSDI
  • Rare Disease bonus: Take advantage of the Third-Party Payor scam

Advocating for ourselves and taking ownership of our experience with healthcare — as flawed and frustrating as it can be — is an essential part of ensuring we get the care we need.

This comes in many forms, from standing up for ourselves with our doctors, to tracking and managing our drugs and the various overlapping conditions that a single doctor might not be familiar with.

Managing our healthcare experience also involves going beyond healthcare itself. Connecting with others going through similar experiences, ensuring your doctor hasn’t missed diagnoses or treatment options, and anticipating how society’s biases manifest in the exam room — all of these are part of maintaining our dignity through an illness or injury.

Here are some of the topics I aim to address:

  • Advocate for yourself. Standing up as human against an inhuman system of care
  • How I go to the doctor. A guide for the professional patient
  • Second opinions & “Doctor Google.” Do your own research without alienating your doctor
  • Drugs and other pills. One of our biggest responsibilities as patients
  • Tracking side effects. Great information you’ll wish you didn’t need
  • When drugs are out of stock. Skills for supply chain scarcity
  • Telling others you’re sick. Things to consider before going public as a patient
  • Power in community: How to bond with others who share your disease without undermining your autonomy
  • When treatment goes away: Existential loss in quality of life
  • Affairs in order. Living wills, durable powers of attorney, DNRs and thinking through the hard stuff when you can
  • Youth, interrupted. When our bodies don’t live up to social expectations
  • Sexism in the exam room. A guest panel on women’s unique experiences of care
  • Black and invisible. A guest interview on “social death” and the dynamics behind healthcare inequities
  • Affirming gender. A guest interview on gauging bias, leading the conversation on your terms, and finding safe spaces to trust with your vulnerability
  • Aging out of society and into care: An discussion on advocating against obsolescence
  • Chronic Care bonus: Curating the full picture your doctors won’t
  • Rare Disease bonus. You can be a rockstar even if you’re dying (clinical trials, celebrity interviews, specialty pharmacies & private jets)

Think of something you’d like to see covered here? Email theundermined@proton.me.

To keep up with these topics as they’re released, visit, follow or bookmark:


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