Amber: Yeah, excellent. And that's exactly why I wanted to have you on today. I had kind of a unique experience with healthcare growing up. My mom is a nurse practitioner, and so I had kind of more of an inside track on learning how to take care of healthcare than some young people did. I'm also disabled, which means that I have a lot of healthcare needs, and so I became really passionate about that transition age healthcare. You mentioned that you're transitioning into being more independent, and that's exactly what the National Institutes of Health defines as transition age.

Transition age healthcare is healthcare for those young people who are just starting to become more independent, along with young people who might just be starting to make their own healthcare appointments, who might be coming off of their parents' insurance and start being fully financially responsible when they go to the doctor. This is a pretty common situation for people around our age, that 16 to 25 or so demographic.

Celeste: Yeah. This is specifically what we're going to be talking about today: those first steps of getting into healthcare. Today we really want to focus on sharing information for that demographic, because right now there isn't a whole lot targeted towards us when it comes to making this transition.

One example that comes to mind is when I was having severe and prolonged migraines. Understanding the differences in treatment between the emergency room to my primary care physician, to specialists, that really helped me feel more comfortable in that process is having that understanding. So we want to go through those definitions in hopes that listeners can become more confident and empowered while receiving healthcare.

Amber:  Exactly. I'd also like to take a second right now to tell the audience that while a lot of what we're going to talk about today is based on our experience, we've also got a lot of concrete resources to back up this information. Links to every resource used in the creation of this podcast can be found in the episode description, along with a link to a summary infographic of this episode as well. All that being said, let's go ahead and jump in.

I have been currently working on my eyesight. That is one of my big healthcare needs right now. I've been having blurry vision, along with severe vertigo, and it's been quite a journey.

I started off at just a regular optometrist and they told me that they couldn't get me better than 20/40 vision with glasses. So they sent me to an ophthalmologist, who is a very specialized eye doctor. They actually went through the full length of medical school. They don't just do glasses. They know a lot about people's eyes. They didn't know what was wrong either, so they sent me to a retina specialist, which is even more specialized. They didn't know what was wrong either. So they sent me to an ocular geneticist, which there's only one of those in my state, so I had a very long wait to go see that person. They still don't know what's wrong, so I'm going to a neuro-ophthalmologist, who works on the brain and the eyes and the connection in between.

It's been this whole big, complicated process, and it's been a lot of hurry up and wait. So my biggest concern for this, besides knowing if I should even be worried about it at all, was knowing who I should even go to in order to talk to them about it.

Celeste: That seems like, just from a listener's standpoint, so intimidating, securing all of those different specialists and all the appointments. We're going to go through that today. The first thing we want to talk about is the importance of preventive healthcare.

Preventive healthcare is routine healthcare from many sources, like dentists, psychiatrists, vision specialists. They help maintain health and identify and treat potential problems before they become serious. So, Amber, what it sounds like you're talking about is a little bit of preventive care right now. You're trying to get your eyesight figured out before it gets too bad.

A big example of preventive healthcare is going to the dentist. You see, my family is really big, and my parents have a lot on their plate, which meant that for a span of several years, neither myself or my siblings went to the dentist. Without this regular preventive healthcare, some of us developed issues with our teeth because we weren't getting that normal care. Now my family is back on track and we've been able to incorporate that preventive care back into our busy schedules.

Something we really want to stress is that ignoring preventive healthcare, getting that medical attention before something bad happens, can have a really negative impact in several areas of life. In a medical sense, 60% of American adults have at least one chronic illness or condition. Preventive healthcare can make experiencing these conditions a lot less painful and a lot less costly, according to the CDC.

In more of a social wellbeing sense, healthcare.gov explains that letting a small issue go untreated can lead to requiring more of your time and energy down the road, and you might not be functioning as highly as you could. Lastly, in an economic and financial sense, preventive healthcare is generally less expensive than healthcare for truly problematic conditions that interfere with your life, and sometimes providers even give discounts to patients for seeking preventive healthcare in many specialties.

Amber: Yeah, that's such a cool thing that I think a lot of people don't know. Specifically, these issues of health problems growing worse later or maybe requiring more treatment later are really important in the lives of disabled young folks. I, myself, am disabled. And I want to mention at this point too, that while good health is a great goal and we all truly deserve to feel comfortable and achieve that good health, it's not a failure not to do that for whatever reason. Health is the goal, but it's not a requirement.

I have trouble still feeling valid and worthy when I'm sick or moving slower from an injury. And that being said, getting that access to preventive care when I can, has been super important as someone with chronic illness and different disabilities. My general quality of life can really spiral out of control pretty quickly when I don't keep up with it.

For example, I broke my leg at the beginning of 2020. It was pretty severe. I had also dislocated it. I broke both bones in three places. It was a huge deal. I did not take care of it very well. I got immediate treatment, but then when I was recovering, I started walking far too quickly. I got in my walking cast and I just started trying to bear full weight. I did not keep up with my physical therapy right after I broke it. And so now I have not a huge limp, but I have a pretty constant limp, and sometimes I need assistive devices. Even when I'm walking, I sometimes need a cane or a knee scooter.

 People look at you kind of weird when you're 22 and walking around with a cane, but it's something that I require now because I just really didn't keep up with that preventive care. Even though it was a big deal and was an injury, I didn't keep up with it afterwards.

Now that we've discussed why healthcare really matters and especially that routine preventive care, I'd like for us to chat about the different kinds of healthcare that exists and the kinds of situations you might be in when you need them.

Celeste: Definitely. I agree. Let us dive into that. There are many different types of healthcare people receive that aren't considered preventive care. For example, emergency care, as defined by the World Health Organization, is healthcare you'll receive from an emergency room, urgent care, and maybe even a walk-in clinic or mental health crisis center. So, emergency care can look like a broken limb, if you're very mentally ill and you want to be near somebody if you feel like you might harm yourself, if you're very ill - all of these cases in which you can't wait for an appointment and you need to see somebody urgently, that's what we call emergent care.

As I mentioned a little earlier on, there was a span a few years ago when I was having constant and mysterious migraine headaches that were lasting for weeks on end. It would get to a point where my pain was so severe that I couldn't wait for treatment, making it an emergency situation where we had to go to the ER.

Another really important type of healthcare that we're going to spend some time discussing is primary or regular care, which defined by the healthcare.gov is healthcare from a doctor's office, eye doctors, dentists, psychiatrists, or therapists, outside of crisis centers, public health offices, et cetera. Some examples of what primary or regular care would be your annual checkups, your sports physicals, anything that you have with your psychiatrist that happens on a regular basis, things like that, where you would go on a regular schedule to get your checkups to make sure everything's going smoothly.

Amber: Right. So it feels important at this point to talk about primary care providers, which is something I get asked about pretty much anytime I step into a healthcare space. Who is your primary care provider? Who is your PCP? And my answer to this is just the name of my regular doctor, or in my case, it's actually a nurse practitioner, but it's the provider I go to for my annual checkups.

Celeste: I'm just going to jump in here. For my family growing up, my siblings and I all had the same doctor, or PCP, at a family healthcare clinic, which made it a lot easier for my parents that we were able to go to the same place.

Amber: Yeah, I also had, and I actually still have, the same PCP as the rest of my family, so I can definitely relate to that.

So you probably remember then when you were a kid and you would go to the doctor and they would tap your knees and look in your ears and everything—that is primary care. Nobody ever really taps my knees anymore, but I still get those little postcards in the mail every year from my doctor's office telling me it's time for my annual checkup. The Cleveland Clinic actually also says that's the first part of maintaining good health is letting your primary care provider keep an eye on that surface level of your body and mind just to make sure that nothing is starting to get sick or injured.

I know it's also really helpful to still see dentists and eye doctors regularly, and counselors or psychiatrists as needed. I struggle with the dentist part myself. I relate to what you were saying earlier, Celeste, but I'm doing a little bit better with that now that I handle my own life schedule.

Also, as a disabled person, I have really benefited from maintenance or preventive physical therapy. Physical therapists who provide this kind of care, which a lot of them honestly do, they help people train their body how to move in the best way to prevent future pain and injury. So I had talked earlier about breaking my leg and needing physical therapy in the immediate time after that, but eventually PT became maintenance for me once it had been long enough after I broke my leg. It's something I've been trying to pick back up on. And it's actually the main reason that I don't walk with a constant, significant limp now and why I don't always need assistive devices.

Celeste: But there are some things that count as emergencies, like your broken leg was definitely an emergency, but sometimes there are issues that fall in the middle that aren't regular or preventive, but they also aren't emergent.

An example I have with that is I was having really persistent gastrointestinal issues. It wasn't emergent, so I went to my PCP, who referred me over to a gastroenterologist. This is the case for many conditions. You may feel fatigue, joint pain, heartburn, or something that needs to be examined further, and your PCP can write you a referral or point you in the right direction. A referral is needed to see most specialists. It's a note that your doctor's office sends to the specialist's office stating that you need to see them.

Overall, a PCP is usually your first point of contact when you're having non-emergent issues that really need to be taken care of. It's like a big web. Your PCP will just point you in the right direction, so you're not on your own when it comes to these things. You have a lot of support there. You have a lot of help.

Amber: Exactly. Sometimes getting a referral like that can be just as easy as calling your doctor's office, especially if it's for an issue that you've been working on together for a while. It never hurts to ask, and sometimes you can save that little bit of time and money not having to go through a whole appointment.

So we've talked about what healthcare to get and why at this point generally, but now the big question that always comes up is how to find it, which I know can feel really overwhelming. Thankfully, with some practice, I've been able to nail down some of the more reliable ways to get started, and I'm sure you have as well, Celeste.

Celeste: Yes. One of the biggest things that I like to tell young people is don't be afraid when you're looking for a new PCP in your area, to look at a bunch of different offices, look at a bunch of different providers, go through their website, read their bios. A lot of times, providers will have it written down if they work well with trans folks or neurodivergence. There's also religious-based healthcare clinics, like the one I went to growing up. Going through, reading, comparing, and contrasting, getting a sense of who you'd feel more comfortable with, and that way, you know you have a lot of options.

It's not just one and done. You can go ahead and go doctor-shop, meet with them a couple of times, go back and forth. But a really important piece to take out of it is going through their website, reading their bio, and see who they work well with, and if they have any of those special populations like trans, LGBTQ, or neurodivergent people.

Amber: Exactly. When you're looking for those provider bios in the websites, you have a couple of different options. You can search yourself in Google. It's very important if you're going to do that, you have the correct terms, so make sure that you find out who exactly you're looking for especially if you're looking for someone that isn't just a primary care provider. If you're looking to see who you'd like to get a referral for, make sure you're using the terms gastroenterologist or neurologist, finding out who exactly it is that you need to go see.

The other option is to actually figure out which insurance you have, either by asking your parents, maybe finding your insurance card, something like that. Then, you can go to your insurance website, and you can actually type in your location or your zip code, and they will give you a list of the providers that accept your insurance. That is probably the most important thing in finding a provider is making sure before you go that they accept your insurance so you can get that help with paying for that healthcare.

I don't want to miss out on covering what actual care options someone who's not insured might have. First and foremost, there are a lot of providers nowadays that offer what's called sliding scale pay, which means that they charge you based on your income or your household income if you're still living with family or caregivers.

Additionally, the majority of community health clinics or public health offices offer pay what you can plans, which literally just means that you pay what you can that day. They'll send you a bill for the remainder. But the thing is that bill technically holds no weight. You can pay as early or as late as you want, in whatever amounts you want, and it never shows up as a collection or impacts your credit score or anything like that. Urgent cares and emergency rooms are also often required to provide care whether you're insured or not.

Secondly, if you're seeking insurance, there are a lot of options there too if you're over 18. You can visit healthcare.gov to find resources about how to get insurance, including insurance from what's called the Marketplace, which can often be really affordable, or you can look into Medicaid. We're going to discuss the ins and outs of insurance in a future podcast, but we just wanted to make sure that we offered some of those options during this discussion too.

Then moving on in terms of logistics; one other thing that I have really noticed myself, because I am a very busy person, is just the different kind of things you can do to try and integrate getting this healthcare with the other busy parts of your life. You can ask for doctor's notes, even for regular primary care appointments. That is absolutely acceptable. You can take that to school. You can take that to work. You absolutely have a right to request time off from those things for non-emergency healthcare. You don't have to be super sick just to be able to get some time off to go see your doctor.

                Also, if you've got a really busy schedule, don't be afraid to ask your doctor's office if there's any way they can work with that. Maybe they can get you a slightly later appointment than that doctor would normally give, because they know that you work until 5:00. They really do care, and they want to help work with that schedule and make sure that you can get this healthcare.

Celeste: That's really important, and that's something that's comforted me a lot during this process is knowing that doctors in healthcare offices are not working against you; they're working with you. They really want to help you. They got this job so that they could help people. So just keep that in mind as you go through your process; they're not working against you.

So just to go ahead and summarize a little bit about what we've talked about. First of all, a PCP, they're going to be your first point of contact, and it's really important that you find yourself a PCP that you're comfortable with. In order to find that, I think a great place is to start with your insurance and just cross the people off your list who don't carry your insurance, then go ahead and do your research. Search those terms that you think you might need. If you know historically you have joint issues, maybe search for that more specifically. And don't be afraid to go around and hop around different offices until you find someone who you're confident and comfortable with.

Starting to become more independent when it comes to your health is a really daunting step, but such an empowering one. And taking care of yourself and your health is so important and something that Amber and I really want to help you to do.

Amber: We aren't the only ones who want to help you either. I have met so many wonderful healthcare workers that genuinely just care so much about their patients as people. There are definitely plenty of them out there. Healthcare is a very scary ride, but it's not one you ever have to take by yourself.