The U.S. health care system may be among the most complicated out there. And there’s not a whole lot of places to go for help.

“In medicine, people don’t have the same tools to be able to make decisions as they would if they were going to buy a plasma TV at Best Buy,” said Dr. Michael Caravelli, an orthopedic surgeon at The Center Orthopedic & Neurosurgical Care & Research in Bend.

Caravelli, frustrated by the fact that there isn’t an obvious place for people to get unbiased information on a sector so central to their well-being, decided to create one himself. He’s launched a class series at Central Oregon Community College called Navigating the Health Care System. Now in its second year, the classes feature more than a dozen local providers giving patients pointers they feel will empower them in the health care setting.

“It’s an opportunity for prospective patients to learn how to really understand better how to get the answers you need for being your own best patient advocate,” he said.

The three-class series, held from 6 to 8 p.m. on Oct. 6, 13 and 20 at COCC in Bend, will cover topics such as the role of a primary care physician, patients’ roles in their own care, managing medications, pain treatment and federal health care reform. The classes are part of COCC’s Community Learning division, which offers non-credit coursework in subjects such as art, computer skills, finance and cooking.

When Caravelli hosted the first round of classes last year, he found they promoted a healthy dialogue between physicians and community members, with both sides airing their frustrations.

“It was almost like this really cool patient focus group,” he said.

Last year, between 20 and 30 people attended the classes. Caravelli said he expects more will show up this time around — maybe up to 50 — but he wants to keep them small to allow for good, honest communication.

In office visits, patients ask Caravelli a lot of questions about the health care system, far more than he’s able to answer. Oftentimes, they’re wondering what will happen with health insurance coverage in the future. Whether they’ll still be able to see their doctors. They’ll also ask about simple things, such as how much their insurance covers for a procedure, and whether it covers certain medications, he said.

“You’re talking the whole gamut,” he said. “The complete continuum.”

Dr. Meredith Baker, a urologist with Bend Urology, will talk in one of the classes about making the most of doctor’s visits by being prepared for them.

Often, patients assume when they visit a specialist that their primary care provider handed over all of their patient records, but that’s not always the case because it requires having them sign a release form, she said.

“Patients are always surprised,” she said. “They’re like, ‘Well, don’t you have my list of medicines?’”

Patients should bring a list of medications and supplements they’re taking to doctor’s visits, Baker said. That way, the doctor can make more informed decisions about his or her treatment, she said. And while it’s common for patients to fill out their paperwork in a rush when they show up to appointments, it would be better if they already had their information written down on a piece of paper that the doctor can photocopy and keep on file, Baker said.

“I can give that right back to them, and that’s something they can have on hand for every doctor’s visit,” she said.

Dr. Stephen Mann, president and medical director for High Lakes Health Care, will talk about the importance of having a relationship with a long-term primary care provider.

Today’s health care system is highly fragmented — even doctors are overwhelmed by its complexity, Mann wrote in an email. More and more, patients need to be informed about health care and about their own treatment, he said.

“We are moving from a paternalistic model of care to a side-by-side collaborative care system,” Mann said, “and for many people, it is a difficult transition to a shared model in which the patient fully participates.”

— Reporter: 541-383-0304,

tbannow@bendbulletin.com