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Patient Education Aids, Insurance, Informed Consent

Patient Education Aids, Insurance, Informed Consent

Patient Education Aids
The book, Wilson’s Temperature Syndrome – A Reversible Thyroid Problem, has proven to be an excellent patient education aid. It has made a vast difference in how well the patients understand and recognize the manifestations, the pathophysiological mechanism, and rationale for treatment of Wilson’s Temperature Syndrome. And therefore, there is much better patient compliance and far less time needed for patient orientation. I, personally, was quite surprised at what a difference it makes. I always try to make a point of making sure that the patient understands very well all the issues pertinent to his/her treatment. I feel as if I do pretty well at explaining everything, and I’m sure to answer as well as I can any questions the patient might have. So imagine my surprise when my patients read the book when it came out, and many exclaimed, “Oh-h-h, now I understand what’s going on, and reading that book was like reading the story of my life, and I’m sure now more than ever that we’re on the right track.” The amazing thing was that these patients were ones that I had thought I had thoroughly educated. These were patients with whom I had personally spent a lot of time training over about 6 months during about 8 or more visits. If patients read the book, it saves everyone a lot of time, and many take great comfort in reading it. Having read the book, patients are much less likely to use the medicine inappropriately because of faulty assumptions. The book answers for the patients most of the questions that come up during treatment. Understanding better the management and the expected clinical course helps patients with longer-standing cases that require more management to experience less frustration and discouragement. So that patients can conveniently obtain a copy of the book from their doctor, the publisher will wholesale copies to physicians (1-800-621-7006).

Also, the Wilson’s Temperature Syndrome Patient Instruction Sheet (see page 211-214) (or click here to see online version) is printed on one sheet of paper and is designed to quickly convey all the information patients need to know to get started on the treatment. It is available in quantities of 20, 50, and 100. It explains certain important principles, and contains specific instructions about the treatment. It explains how to take, average, and log temperatures; how to take the medicine; what side effects may occur and why, and what to do about them; what one might expect from the treatment. In short, it removes much of the burdens and difficulties on patients and doctors of implementing this approach.

Claims can be submitted for: 783.9 Wilson’s Temperature Syndrome (persistently impaired conversion of T4 to T3 brought on by a major stress and characterized by a consistently low body temperature). The preceding code, diagnosis, and definition should be included on superbill and claim form. Treatment for Wilson’s Temperature Syndrome is usually covered by insurance companies but letters of explanation are sometimes requested. They can include presenting complaints, clinical presentation and reason for suspected diagnosis. Patient’s response to therapeutic trial may also be included, if available. Wilson’s Temperature Syndrome can be considered a subset of Hypometabolism but may be given a separate code by ICD-9 if a separate code is decided to be advantageous.

Informed Consent
Proper informed consent is an important tool that provides both physician and patient the necessary opportunity to make informed decisions. Informed consent has become a familiar part of the practice of medicine, and seems to be appreciated by the patients. An extremely frank consent form that errs on the side of overstating the risks, while referring to alternative approaches and risk of nontreatment has a couple of advantages. One, it reinforces to the patients that they are anything but being “talked into” taking treatment. Two, patients are more likely to take their treatment seriously with better compliance (which is quite important especially in terms of obtaining optimum benefit from treatment). Three, patients are reminded of the inexact nature of the practice of medicine which helps allay any unrealistic expectations and misunderstandings that might create problems down the road. Finally, since the potential benefit from successful treatment of Wilson’s Temperature Syndrome can be so great (almost too good to be true), strongly worded consent forms that err on the side of overstating the risk help balance the input so the patients can hopefully make a more reasonable, conscious decision about whether they really want to pursue treatment. It is easy, and well worth the time to get unusually good informed consent.