Patients interested in seeking care from the Mayo Clinic, Johns Hopkins, Memorial Sloan Kettering Cancer Center or another big-name medical institution often think they need some sort of connection or “in” to do so. Reality: Anyone may request an appointment at one of these recognized facilities, regardless of geographic location or personal connections…and very often no physician referral is necessary, although it might make things easier.
Bottom Line Personal asked patient advocate Annette Ticoras, MD, how to get the best medical treatment…
Pick your place. Do you have friends or family members who have been successfully treated at a certain big-name medical center? Have you read about a promising treatment protocol being used at a specific iconic hospital? Start researching that institution. You also can ask your current doctor for a recommendation by saying, “I trust your diagnosis/treatment recommendation, but before I start this process, can you recommend a hospital that specializes in cancer/autoimmune/organ transplant?”
Call your insurance carrier. Most renowned hospitals accept insurance, including Medicare. Search the hospital’s website for a list of its accepted insurance companies, then double-check with your insurance carrier. Also ask the insurer if a referral is necessary. If your hospital of choice isn’t in-network, ask your insurance company, “If my current in-network physician writes a referral, does that change my coverage at all?”
Contact the hospital. On the hospital’s website, look for the “Make an Appointment” button, typically prominently placed on the home page…or call the hospital directly. You will be connected with a care adviser or an intake coordinator who will walk you through the initial steps, including reviewing insurance coverage and outlining what medical records the facility will need.
Share your medical records. You may be able to download your medical records yourself from your patient portal or simply call your health-care provider’s office and request them. If your current doctor’s office uses Epic’s MyChart electronic health record platform, there’s a good chance that the new institution does as well, which means that the new provider can easily access your biopsy results, imaging scans and more.
Plan your travel. The hospital you choose will offer a packing checklist (including seasonal items, such as a winter coat if you’re traveling from Georgia to, say, Minnesota in January) and a detailed list of medical documents to bring, including a list of all your medications and your Medicare or insurance card. The hospital’s medical concierge team can help you coordinate travel details and hotel or lodging, often at discounted rates. In some cases, lodging even may be physically connected to the hospital itself.
If staying onsite for treatment isn’t an option: If staying near the hospital is cost-prohibitive or you’d simply prefer to be treated at home, ask if the hospital can provide you with a treatment plan that your local medical team can carry out. The local physician has to agree to this new plan and have the means by which to provide that care safely or he/she may be able to find a system nearer to your home that offers the new preferred treatment plan.
Consider getting a virtual second opinion. If having an expert from a top hospital review your arthritis, cardiac or cancer case will help you feel rock-solid confident about your diagnosis and/or treatment plan but travel isn’t in the cards, there is another option. Yale Medicine, Massachusetts General Hospital, Duke Health, Cleveland Clinic, University of Chicago Medicine and more offer virtual second-opinion programs, also called “remote second opinion programs.” Insurance likely won’t cover this, but you usually can use funds from your Health Savings Account or Flexible Spending Account. Rates range from around $700 (Stanford Medicine) to $2,400 (Dana Farber).
Procedures vary, but generally you create an account with the institution…are assigned a care coordinator…and send in the requested medical information. You will receive a written diagnosis or treatment plan several days to a week or so later. Some programs also include a telehealth or phone consultation.
Note: A handful of states do not permit second opinions over state lines. Check your program’s website to be sure.