Being An Expert Patient

Jim Skinner
Presenter: Neal Howard
Guest: Jim Skinner
Guest Bio: Jim Skinner is the founder and president of the Smart Patient Academy, an insurance benefits enrollment and communications company based in Texas. Its sister company, JMS Benefit Solutions, is an insurance brokerage and consulting firm that works with mid-size employer groups, both domestic and foreign owned

Segment Overview:
Jim Skinner discusses being an “Expert Patient”.


Health Professional Radio

Neal Howard: Hello, you’re listening to Health Professional Radio. I’m your host, Neal Howard. Our guest in studio today is Jim Skinner. Jim is actually an insurance broker. At the age of 42, he was diagnosed with stage III colon cancer and a life-threatening brain tumour after running marathons and being in otherwise perfect health. He is now an author as well as a cancer survivor. How are you doing today, Jim?

Jim Skinner: Doing pretty well.  As my friends like to say, “You know, you’re a miracle that you’re alive, and every day above ground is good.”  It’s been a blessing to be here talking to you, Neal, and I look forward to our discussion.

Neal: As a fellow cancer survivor, I can relate, and I’m really excited to talk to you today.

Jim: Yeah.  At some point, you have to introduce a little bit of humour into it.  I do, at least, to cope, because otherwise, it’s not too fun to listen to.  But the reality is that … my friends used to say that the brain tumour part of it was exploratory surgery.  They weren’t quite sure if there was a brain there to begin with [laughs].

Neal: The tumour might have been bigger than the brain, yeah?

Jim: Yeah, exactly.  Exactly.  Other than the brain tumour and the cancer, I’ve been a really healthy guy.  The funny part about it is that I’ve, as I like to say, I’ve been the … as an expert in health insurance, I’ve been kind of the honorary test monkey in the healthcare system.  I was able to go through the system with that perspective.  In other words, here’s how insurance is supposed to work, and here’s how it actually works.  There’s a big discrepancy between the way it’s academically explained and the way it happens in reality.

Neal: Now, as an insurance broker … you are in health insurance brokerage, yeah?

Jim: Yes, sir.

Neal: Okay.  Now, having sold health insurance and counselled people on specific policies and things of that nature, when you found yourself in the midst of your illness, did you see massive changes in the way that you presented your insurance as opposed to the way it really was in your own personal situation?

Jim: Well, I guess I would say I became much more involved and much more active and much more assertive as I went through the process.  The entire process that I’m talking about from cancer through the brain tumour, to current is about a 10-year period of time.  During that period of time, I learned how to be what I would call an expert patient.  The more expert you are as a patient, the more involved, the more responsibility you take, the more assertive you are, the better team that you build around you to protect you, the more effective the health care you receive will actually be.

You’re a partner in the process with your treatment.  A lot of people don’t get that from the beginning.  They kind of take a passive approach.

Neal: There you go.

Jim: You know, “I’m here. I’m the victim,” which is not … it’s not untrue.  You are.  You’re scared, you’re intimidated, you don’t have information, you’re in a hostile environment.  There’s all sorts of reasons not to function logically, and it’s too much to expect that you will.  But in the end of the day, what I hope to do is impart a little bit of the experience that I had so other people don’t have to go through what I went.

Neal:  Okay.  When you’re talking about being an expert patient, what you’re saying is to be involved, take control, do your research, and know your situation as opposed to just saying, “Well, I’m the patient.  You’re the doctor.  You’re the smart one.  Heal me,” and leaving it there.  That’s what you’re saying, yeah?

Jim: That’s exactly what I’m saying.  Yeah.  I would add in a few more adjectives, one of which would be ‘assertive.’  Because when you’re intimidated—and you as a patient are going to be intimidated and out of control and lost—it’s very difficult to actually be assertive and challenge some of the limited thinking that might affect your care.  There are mistakes that happen all over the place when you get into this.  An intimidated person doesn’t tend to challenge you to the cost or maybe the clinical analysis.

Until you do that, you really are just passively going through the system.  So it is important to be assertive.  Assertive doesn’t mean–

Neal: Aggressive.

Jim: Abrasive.

Neal: Yeah.

Jim: Aggressive.  It just means more confident, and just willing to ask questions.  Just one other quick example that’s really key, is that a lot of people are very afraid to ask for a second opinion.  As a matter of fact, I just got off a phone call about a half an hour ago with the mother of the 27-year-old, who has a brain tumour that’s malignant.  They were scared to go get a second opinion because they thought that it might impact the level of care they have with their primary neurosurgeon.

That goes to the heart of what we’re talking about here about being a little bit assertive.  It’s your life, and you’ve got to take some control of it.

Neal: Now, when you’re talking about being assertive, taking control, not being afraid to ask questions, that is something that is traditionally the norm when it comes to doctor-patient relationships, as you stated.  Now, in this environment of healthcare reform, the Affordable Care Act, it would seem the intimidation factor would be tenfold as opposed to 10, 20 years ago.  How can a patient navigate this new jungle of healthcare law without being intimidated and still get the same level of care that we basically all deserve?

Jim: Well, it’s a good question.  There’s two answers to that.  I would start off by saying that when we go on and we talk to folks out there and we’re explaining how to use health insurance and putting it all into context, one of the things that we’re really clear about when we talk to folks is to let them know there’s an old paradigm.  There’s an old healthcare system.  There’s a new healthcare system, independent of Obamacare.

There are permanent changes that are happening to the healthcare system that require a brand new consumer.  That new consumer has a new role, and that new role requires you—whether you like it or not, this is just reality—it requires you to be aware of prices, to take responsibility for your personal situation, and actually be somewhat assertive.  The health insurance that drives that kind of behaviour is that whole paradigm, the consumer-driven health plans, the ones with the high deductibles.

Neal: Yes.

Jim: And high deductibles change people’s behaviour financially.

Neal: Absolutely.

Jim: There are about 19 million people now in health plans like that, about 19 million individuals.  And then you have the family members.  I’m not quite sure how many covered lives—but it’s double or triple that number—that are actually out there accessing doctors, offices, providers with these consumer-driven plans.  Those plans change the behaviour of the consumer.

They naturally tend to look out for their own best interest and are a little more assertive when they have their own financial skin in the game.  That’s a well-known phenomenon.  What’s less well-known and less advertised is that same mindset and the same skill set and tools that you use to be financially smart are the same tools you use to be an expert consumer of healthcare—an expert patient, if you will.

Neal: You’ve been listening to Health Professional Radio.  I’m your host, Neal Howard.  Our guest in studio this afternoon has been Jim Skinner.  He’s a health insurance broker and an expert in healthcare insurance.  We’ve been here today talking about ways that consumers can protect themselves while they navigate this jungle, if you will, of new healthcare reforms.  It’s been great having you here with us today, Jim.

Jim: Thank you, Neal.

Neal: Transcripts of this program are available at and also at

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