August 2019 Healthcare Forum

Introducing a New Paradigm (Model) For:

Obtaining Quality Medical Care

Significantly Reducing Your Medical Costs


We would like to introduce you to a new model (paradigm) that we believe protects you from medical errors (the 3rd leading cause of death in America) that occur most frequently during medical periods of transition (e.g., admission to a hospital; change to a new physician). Applying this model may empower you to make better healthcare decisions. The T-C model may help reduce your out-of-pocket medical expenses (subject of September’s Forum).

Prize-winning author, surgeon and Harvard researcher, Dr. Atul Gawande, reduced complications of surgery by 35%; reduced the death rate by 47% by using checklists to evaluate and prepare patients for surgery and in every single step of the surgery process. For example, patients being considered for surgery had to be carefully checked for medical problems that might complicate surgery. The examining doctor used a checklist to make certain no medical problems were overlooked. Surgical checklists were then applied to many hospitals worldwide with similar startling results – the basis of Dr. Gawande’s bestseller, The Checklist Manifesto.

Can the simple use of checklists utilized by Dr. Gawande be adapted to provide similar safeguards and benefits for patients’ interactions with doctors, hospitals, and other aspects of America’s imperfect healthcare system?

Let’s use, as an example, the benefits of making a checklist in preparation for your initial visit with a new doctor. Changing doctors can be a difficult transition. Unfortunately, it occurs more frequently within the past few years because doctors retire earlier, you’ve changed to a new insurer and your doctor is not a contracted (not “in-network”) provider, or your doctor has dropped his/her contract with your insurer. Changing doctors entails many steps. Using a checklist can be “just what the doctor ordered” to improve the chances the transition goes smoothly.

The following checklist may seem a bit “overkill” (excuse the pun), but we want to be overly inclusive. Modify the list to make it suitable to you. Office visits, even initial visits, have become shorter, so it’s best to prioritize your checklist.

First Appointment with New Doctor


  1. List of questions, in order of importance, to ask your new doctor.
  2. New doctor has received all my medical records from former doctor(s).
  3. Bring a detailed list of all current medications; over-the-counter meds; questions about meds. Or, bring the actual meds.
  4. Bring doctor all your important, most updated documents, (living will, healthcare/financial P.O.A.; HIPAA). Make sure your lawyer and all significant others have most update documents.
  5. Send or bring updated personal health records (PHR).
  6. Consider bringing a family member (or patient advocate) to appointment.
  7. Bring writing pad and pen and/or tape recorder to appointment for you or your family member to record important details and summary of the visit.
  8. Start new checklist for completing any changes in treatment plan (e.g., fill new prescription(s); tests to complete; obtain test results).
  9. Decide if you feel comfortable with, and confident in, your new doctor.

The end of Chapter 1 – “Taking Control of Your Healthcare” in our Amazon, best-selling book, Insider’s Guide to Quality, Affordable Healthcare, has twenty-two Key Points. You could convert some of these key points into a checklist to safeguard you from medical errors occurring at transitions – (e.g., admission to and discharge from a hospital).

Please send your questions/experiences about your challenging encounters with America’s complex medical system to our secure website: Your identity is protected. Include your email address so we can either respond directly to you, or post our answers in the August forum.

If you believe family and friends can benefit from our forum, suggest they sign up on our website. Our new book is available from Amazon, Barnes and Noble, and other bookstores nationwide.

Wishing you a long, healthy and productive life,

Dr. Larry Lazarus and Dr. Jeff Foster

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