[caption id="attachment_39238" align="alignleft" width="121" caption="Ellington"][/caption] Tempers are flaring across the country as Congress--at President Barack Obama's urging--attempts to change healthcare as we know it in the United States. Although many people have strong opinions about how patients should best be cared for, medical doctors generally have a perspective born of the experiences in their day-to-day practices. Dr. Virgie Bright Ellington, a board certified internist, believes that basic healthcare for every citizen is long overdue. As an internist for 13 years, Ellington has cared for adults who are middle-aged and older and who suffer from chronic diseases. In that time, and over the last two years as a consultant who oversees nurses and nurse practitioners at Enhanced Care Initiative, a support program for homebound cancer patients, she has determined that doctors are plagued by a lack of time with their patients. As a result, she says that patients are leaving their doctor's visits without receiving proper comprehensive medical care. Believing that the trend is directly related to a faulty healthcare system and hoping to provide patients with preventative education, Ellington, wrote What Your Doctor Wants You to Know But Doesn't Have Time to Tell You (Hilton Publishing; $16.95) in order to help educate patients. In the 120-page guide, Ellington informally cruises through topics based on the field of medicine and what that doctor -- be it cardiologist, gynecologist, or dermatologist, etc.–would want the patient to know about his health. In this interview with BlackEnterprise.com, Ellington, explains why the drawbacks of our healthcare system are detrimental to patients, she offers advice on how to manage financially debilitating medical costs and tips on communicating with your doctor. BlackEnteprise.com: What prevents doctors from spending more time with their patients? Dr. Virgie Bright Ellington: Insurance companies run medicine in the U.S. They are for-profit companies with shareholders and investors that want to make more money every year. The insurance companies are directly responsible for how much time your doctor will spend with you. They pay doctors a certain amount per diagnoses, which in turn means doctors want to see more patients per hour so that they can afford the overhead of their practice, i.e. utility bills, employee salaries, and employee healthcare. In order to make more money, the insurance company has to ask the patients to pay a higher percentage of the premiums and co-payments and/or pay the doctors less. Usually it is a combination of all three. What questions should someone ask to get their doctor's full attention? At the very beginning of the visit, tell your doctor, "Look this is what I'm concerned about and this is what I'm afraid of. Now that you know something about me doctor, what is the most important thing that I should come away with today given my lifestyle and my health, family, and social histories?†Even if you think it is harmless, tell your doctor about any ongoing changes to your body or how you function. Also don't forget to schedule routine maintenance with your doctor, i.e. the annual blood tests, colorectal exams, pap smears, mammograms, and prostate exams. Healthcare reform may be right around the corner, but in the meantime what suggestions do you have for those who can't afford full coverage? I think it is criminal and immoral that the wealthiest country in the world can't offer basic minimal healthcare to its citizens. Emergency medical care can bankrupt a person and keep them from doing things like buy a house. Look into catastrophic insurance. With catastrophic insurance (also known as a high deductible health plan), you are still responsible to pay out of pocket for all of your preventive healthcare, but if you are hit by a bus and are hospitalized, you are covered. The premiums for that are much less than for regular insurance. What advice would you give individuals who are struggling under debt from past medical bills? Medical bills are the No. 1 cause of bankruptcy in the U.S. People put their medical care on their credit cards, and unfortunately they have to do it because it is an investment in their health. Instead of paying medical bills, if and when you can get around to it, ask for mercy. The physician always outsources their billing to someone else. Appeal directly to the physician, not their billing company, because the physician might not be aware of the tough time you are having paying the bill. Try to work out a payment plan. If you talk with them and if you are proactive, they sometimes may reduce part of the bill, but it is unlikely that you will get it wiped out clean. What motivated you to write this book? The idea for the book came to me more than 10 years ago when I would sit and talk to patients as a physician in training at the Cambridge Hospital in Boston. There were so many things that I didn't have time to squeeze into my patients' 15 minute office visit. I thought there has got to be a way to get all of this information out at once. Seeing patients in a practice is great if they can get to you, but I only see a small fraction of people for a small fraction of time. I wrote this book because I wanted to give the same information to everyone around the world that I wanted to give to the patients in my office.