Your doctor has given you a diagnosis. What happens now?
You may need to work with more than one health care professional to treat illnesses like diabetes, cancer, arthritis, or heart disease. They'll work as a team to give you the care you need.
Depending on your disease, you may need to visit different clinics that each specialize in one type of testing or care. You may see some specialists for procedures like surgeries or for treatments like radiation. You might see others for nutrition counseling or physical therapy.
Professionals called nurse care coordinators or patient care navigators can guide you through each step of your treatment, so you know what to expect.
And even if you see many doctors, new technology lets them share information about your treatment, test results, and prescriptions.
Guide You Through Care
Your doctor might refer you to a specialist to help you manage your condition. For example, they might send you to an endocrinologist if you have diabetes or to a cardiologist if you have heart disease, says Kirsi Hayes, RN, a nurse and health coach at Baylor Physician Services in Dallas.
At her large hospital, nurses, social workers, and therapists with special training also offer patients extra care and support, in case they need ongoing help managing their disease at home, Hayes says. They also help with questions a patient might have about the health care system.
If you have a disease like cancer, “your social worker, care navigator, dietitian, and even clinical trials can all be a part of the health care team,” says Doris Jones, RN, a nurse navigator at DeKalb Medical Center in Decatur, GA.
Who’s on Your Team?
As you're treated for your disease or as you manage it over time, you might see one or more of these people:
- A care coordinator, advocate, or navigator (usually a nurse) to keep track of your treatment
- Doctors who specialize in treating specific diseases. For example, cardiologists, endocrinologists, rheumatologists, or neurologists.
- Nurses, nurse practitioners, or physician assistants who can answer your questions, do tests, or in some cases, prescribe drugs
- Surgeons who do operations
- Physical or occupational therapists to help you deal with pain or problems doing tasks
- Social workers, psychologists, or counselors to help you cope with emotional symptoms
- Imaging technicians who give X-rays, ultrasounds, or magnetic resonance imaging (MRI) scans
- Nutritionists or dietitians to help you manage your diet
Pam Briggs, RN, is a nurse navigator at a heartburn treatment facility outside Atlanta. She talks with patients and coordinates their care no matter what type of specialist they need to see.
“I also perform tests, read the test, go with the patients to surgery, and follow up after surgery,” she says. “I think my position gives the patient the feeling that someone cares. They always have a point of care for all of their questions and concerns. Quite often, it’s me they call before their physician. The process of getting answers from the office can be quite burdening for them.”
How Do Referrals Work?
When you get your diagnosis, your doctor or surgeon might refer you to a specialist for treatment. If you're diagnosed with cancer, for example, you may need to see a radiation oncologist. “This is usually based on the need to determine the stage of cancer so that the proper treatment plan can be decided,” Jones says.
If you want or need a second opinion on your diagnosis or treatment plan, ask your doctor to refer you to a specialist who’s covered by your insurance, Hayes says. “When you learn about a newly diagnosed disease that can greatly impact your life, there often are many questions and concerns,” she says.
Your insurance company may require you to get a referral to a specialist or to get another opinion before your policy will cover your treatment.
How Will the Team Stay Informed?
Many doctors now use electronic medical records systems (EMR) to record your diagnosis, test results, prescriptions, surgeries, and other treatments in a computer network. Every member of your health care team, if in the same practice or hospital system, can directly share this info with each other.
“With EMR, it is easier for physicians to send their notes to each other from within their offices,” Jones says. “Within the hospital’s system, which the physicians can access, it is easy for everyone to see the information in one place, from notes to test results.”
This might cut down on overlaps or delays in your treatment, and make treatment decisions more accurate, Hayes says.
If there are members of your health care team who aren't within the same practice, this information can be copied and sent to them.
What Role Do I Play?
Get involved in your care, Jones says. Take notes during your appointments, or ask a friend or family member to. Write down all of your questions about your treatment, she says.
“No matter how important a question, patients will forget what they wanted to ask, so I encourage them to write down questions as well as the answer,” Jones says. “Medical terminology can be like a foreign language. Write things down so you can look back at it later.”
Can I Still Call My Doctor?
If you work with specialists to treat your disease, your main doctor can still be involved in your ongoing care, and they can help you tailor your treatment plan to suit your needs or lifestyle, Hayes says.
“It is very important to have a primary-care physician who directs care, and for you to stay connected with your doctor at regular follow-ups, if you’re discharged from a hospital," or if you have other changes in your health, she says.
When the two of you have a trusting relationship, your doctor can help you get the most from your treatment plan.