A prerequisite of being a smart healthcare consumer is being informed of the pros and cons of your options as we talked about in our last article. Understanding the information that we receive from our providers and how that may differ will help us to be clear with how we wish to be treated.
Depending on where you are in the country, you may receive very different levels of medical care. A 2016 study found that among hospitals with 1,000 or more C-Sections, the frequency of this procedure for lower risk patients varied up to 10x. Research looking into regional medicine differences largely shows that extra medicine & procedures on average does not result in healthier patients.
While every patient is different, it is hard to ignore differences in the way some are treated surrounding major medical events. A sampling of 2,100 doctors across America estimated that on average, 21% of everything done in medicine was unnecessary, with the number one justification for it being to prevent malpractice. In an increasingly litigious society, it makes sense that some providers may be overly cautious with their care. What’s even more interesting is that studies have shown that physicians frequently have a low-level of desired care reflected in their own healthcare documents. We observe this same phenomenon among the physicians that we serve as clients.
For many, it may not be their goal to receive the maximum amount of medical treatment possible. Let’s look at some of the documents necessary to keep our treatment in line with our wishes.
Documents To Prepare
Depending on the state that you live in, you will have different titles for your healthcare estate documents. These documents are “advance directives” that legally direct your treatment preferences, in advance, and identifies a substitute decision maker if you are unable to make those decisions yourself. The first and foremost important consideration for the powerholders should be that you trust them. We recommend a deep “bench” of these named individuals, if possible, in the event someone is unwilling or unable to serve in the role.
This surrounds end of life care and what treatments you would and would not want to be used to keep you alive. Many have revisited these in light of COVID-19 and include but are not limited to Cardiopulmonary resuscitation (CPR), do not resuscitate (DNR), do not intubate (DNI), life support, ventilation and dialysis.
Healthcare proxy/Healthcare Power of Attorney
Who you appoint in this document will be your primary advocate to make healthcare decisions on your behalf when you are unable to do so. This is a responsibility that may involve considerable time coordinating with healthcare professionals and can be a highly emotional responsibility.
The Health Insurance Portability and Accountability Act (HIPAA) restricts access to an individual’s medical records and information without permission. Granting HIPAA authorization allows doctors to provide information on your health to a trusted third party. We recommend having a stand-alone HIPAA authorization document.
Financial Power of Attorney
This document names an individual who would be able to act on your behalf in a financial capacity. There are a few ways to structure this power where they have this power including upon a certain event (springing) or to be in place until you revoke it (durable). We like that a durable power can be used for a variety of reasons within short notice, however, this may concern some as the power holder has access immediately. Our clients find it reassuring that we act as an additional layer of protection and can readily raise attention to any irregular mishandling of this power on the accounts we oversee. With the increase in fraud and elder abuse cases, we require a verbal confirmation of all cash requests.
Making Sure Your Wishes Are Followed
While more than 80% of patients say they wish to avoid hospitalizations and other high intensity care at the end-of-life, studies show that their wishes are often overridden. It is not uncommon for their preferences and advanced directives (which may be difficult to review in time sensitive situations) to be overlooked. Instead, the care may be driven by the local care system, physician practice style, and the capacity of the institution. That is not to say the documents should not be drafted, rather, it underscores the importance that your power holders are well aware of your wishes as well as your physician.
Reviewing and Changing
Consider reviewing these after a new diagnosis, a change in marital status, passing/moving of a powerholder and about every 5 years. Copies should be distributed to the physician and power holders as updated.
We partner with our clients to promote their wellbeing through all stages of their lives so they can focus on what is most important to them and rest assured that a plan is in place.
Please reach out to your RegentAtlantic wealth advisor if you’d like to have a conversation about drafting the right estate planning documents for you.
Important disclosure information
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This article is not a substitute for personalized advice from RegentAtlantic. This article is current only as of the date on which it was sent. The statements and opinions expressed are, however, subject to change without notice based on market and other conditions and may differ from opinions expressed in other businesses and activities of RegentAtlantic. Descriptions of RegentAtlantic’s process and strategies are based on general practice and we may make exceptions in specific cases.
RegentAtlantic does not provide legal or tax advice. Please consult with a legal and or tax professional of your choosing prior to implementing any of the strategies discussed in this article.