Staying Frugal with medical issues?

[cschin4]

My way of dealing with this - Don't run to the doctor for every ache, pain, symptom, etc. Most things are self-limiting.

[disneysteve]

Originally Posted by cschin4

My way of dealing with this - Don't run to the doctor for every ache, pain, symptom, etc. Most things are self-limiting.

This is so true. I see it every single day in my office.

A typical visit goes something like this:

Dr: What brings you in today?
Patient: I have a terrible cold that I just can't get rid of.
D: How long have you been sick?
P: I woke up with it this morning.
D: What have you taken for it?
P: Nothing.

I am constantly baffled by people who come to the doctor for the most minor of problems without ever attempting to take care of them on their own. If I do some heavy work and my back gets sore, I take some Advil. If I have cold symptoms, I'll pick up some NyQuil. Unless symptoms are persistent or severe, it would never even cross my mind to go to the doctor. And I was like that long before I was a doctor myself so I can't attribute it to that.

Of course, the flip side is that patients that won't come in until they are half dead. That isn't a good plan either.

[cschin4]

I tend to think like this: If I go to the doctor today for heartburn, etc, I ask myself do I really want to follow through with the medical workup such as EGD, medication, etc? Of course, people should go see their doctors for chronic or serious problems. But, unless I am hemorrhaging or have acute abdominal pain, chest pain, etc, then I can manage my own problem for a few days. Then, if I get worse or don't improve, I call my doc. I also discuss my meds with my doc. I have taken meds such as heartburn pill, thryoid pill, etc but have been medically managed and did go off these medications with my doc. Some people are put on pills "for life" and then not really re-evaluated to see if they really need to take these things forever. Some pills are "for life" but some can be discontinued, etc.

[cschin4]

And, I also know some people who go to the doctor for just about every ache and pain. And, then their doctor prescribes them something. They take one pill and decide it "gave them a headache, upset stomach", etc and they decide on their own that they really don't need it or want to take it. So, I wonder why they keep on going to the doctor!

[getforfree]

Some medicines have more side effects than help. Most of the times it is not worth it to take medicine for headache, and then end up stomach problems. I think most medications just treat simptoms, not the actual disease. If I have any pain, like head or back, I just try to get some rest instead. At least it doesn't have any sideeffects like pill.

[Ima saver]

I never take medications like asprin, cold meds, etc. I just wait it out, and I get better.

[disneysteve]

Originally Posted by Ima saver

I never take medications like asprin, cold meds, etc. I just wait it out, and I get better.

I've frequently told patients that if I give them a prescription, they'll be better in 7 days. If I don't, it will take a week.

[Ima saver]

That is funny! I don't know if I have just been lucky or what, but I have almost never been sick!

[Fern]

No one here has mentioned mail prescription services. If your employer's plan offers something like Medo by Mail, it definitely saves $$ to have your doctor write out a prescription for a year at a time and it's delivered to your door AND you pay less than if you went to your neighborhood pharmacy on a month to month basis.

I am very unhappy with the US healthcare system. I have had a chronic, lifelong health condition since i was 28, which requires very expensive meds. luckily it's been beign most of my life, but the cost of the meds means i will always have to be work until i'm 65 and medicare picks up the tab. Actually, right now they do not cover my particular medication, so who knows what i'll do when the time comes.

A friend of mine works p/t at Starbucks, only becus they are one of the few companies that offer health insurance to pt workers. Health insurnace these days is no longer a perk or side benefit of employment, it's critical! Especially as you get older. You could be in the greatest health and something completely unanticipated could change everything overnight. It's not worth it to save a few bucks and take risks with your health and life savings.

[disneysteve]

Originally Posted by Fern

No one here has mentioned mail prescription services. If your employer's plan offers something like Medo by Mail, it definitely saves $$ to have your doctor write out a prescription for a year at a time

Just wanted to clarify this. You don't get a year's supply at once. You get 90-days worth and your doctor can put up to 3 refills on the original prescription.

Personally, I will only give 90 + 3 refills to patients who are very compliant and always keep their visits. Otherwise, patients wouldn't come back for a year. I see it all the time.

[getforfree]

Maybe they only come back because they need that medication. Sometimes going to doctor is a waste of time and money. Espesially if all you need is to renew your prescription.

[disneysteve]

Originally Posted by getforfree

Maybe they only come back because they need that medication. Sometimes going to doctor is a waste of time and money. Espesially if all you need is to renew your prescription.

If a patient is on a long-term medication, odds are good that it is to treat some condition that warrants periodic monitoring: high blood pressure, diabetes, high cholesterol, hypothyroid, arthritis, asthma, gout, acid reflux, depression, etc. Far too many patients think that all they need to do is keep taking their medicine and they see no reason to ever go back to the doctor. It isn't that simple. That's why I often hesitate to give long supplies to certain patients.

[getforfree]

Oh, Ok. Sorry, I thought that doctors want their patients to come often, so they would make more money off of them. Or at least that the feeling I always get from my experience with doctors.

They would tell you to get all the check ups and appoitments you need and don't need. Last time I went for my check up, they told me to run all kinds of blood tests, then to come back to see the doctor again. I came back, the doctor said, the results are ok, and she also said that it's been so many years since I checked my vision. No, thanks! I know I can see good, I never had problems with that. I had a good vision a few years ago, and I still have no problems to read anything, even street signs far away when I am driving. She couldn't find anything wrong with my health, so she was hoping to have an extra appointment because I haven't had my vision checked for years.

That time I had a free medical, she said, it won't cost you anything. But, yea, it will cost me a half a day of my time. All that, so they could make more money.

I know many people in their 40s and older. Once they started taking some medication, they have to go to a doctor a lot, and they got even more sick. The health industry doesn't want people to be healthy. Most of the doctors don't care about patients. But I am sure there is at least a few that do. They want their patients to come back and not to die, so they would keep coming back.

[disneysteve]

Originally Posted by getforfree

I thought that doctors want their patients to come often, so they would make more money off of them.

I'd be lying if I denied that medicine is a business, just like any other. If patients could get all the care they thought they needed without ever stepping foot in the doctor's office, that doctor would go out of business and then where would the patient get those refills? Yes, we charge for our services. We have to make a living, pay our staff, pay the rent, insurance, supplies, etc. If patients never come in, we'd have no practice left.

she also said that it's been so many years since I checked my vision.

There is much more to an eye exam than just checking vision. A complete eye exam includes checking for glaucoma, signs of diabetes and hypertension and other vascular and neurologic conditions, many of which you could have and not realize. All adults should get an eye exam every 2 years (annually if you have diabetes).

They want their patients to come back and not to die

You say that like it is a bad thing. Am I supposed to want my patients to go away and die? My oldest patient turned 102 in August and I have quite a few in their 90s. Certainly, a lot of that is genetic, but I'd like to think at least some part of their longevity can be attributed to good medical care.

[Fern]

I have to say, i have a doctor like the one getforfree is describing. This doctor wouldn't even take a phone call with me when i had a simple quesiton about whether the meds i was taking for one condition were contraindicated for another med another doc wanted me to go on. She insisted i come in to othe office, aka, we get to bill you for 5 minutes of conversation, which i greatly resent, being on a very modest income/budget. Doctors like these are so transparent, just trying to maximize revenue for the office.

Other doctors seem better, but i think the one thing to remember is that YOU, only YOU, are responsible for your health. You can't rely on anyone else, even a physician, to remember all your details, issues, etc. You have to be proactive, ask a lot of questions and be prepared when you go in to see your doctor.

Some of you know that i had major surgery over the summer, and while the surgery went fine, i was very disappointed with the quality of post-op care i received in the (world-class teaching) hospital i was in for 4 days. So, once again, YOU (and your loved ones) are your own best advocate.

[disneysteve]

Originally Posted by Fern

i had major surgery over the summer, and while the surgery went fine, i was very disappointed with the quality of post-op care i received in the (world-class teaching) hospital i was in for 4 days.

If at all possible, you should avoid teaching hospitals during the summer at all costs. New interns and residents generally start July 1, so the hospital is filled with brand new docs who have zero experience.

Personally, I'd avoid teaching hospitals at all times, but that is going a bit far.

[puppypal]

Well, I know first hand when Our medical plan Switched to Blue Administrators of Arkansas First Choice we were required to buy our maintaince medications through a mail order company. Caremark.....
I had several issues with the medication they were sending me. I have been on two tyoes of meds for three years now and I had generics for at least a year through our local drug store. But when Caremark filled scrip the medication was broken tablets! All White and powdery and some would work while others would blow me away and then, when I least expect it I could take another and it was like taking nothing! I personally have real issues with that mail order thing. We have to sign to get like 24 tablets of sudafed but they will send 125 pain pills in the mail! Tell me that sounds right?
Glenda

[Fern]

Originally Posted by disneysteve

If at all possible, you should avoid teaching hospitals during the summer at all costs. New interns and residents generally start July 1, so the hospital is filled with brand new docs who have zero experience.

Personally, I'd avoid teaching hospitals at all times, but that is going a bit far.

That's an interesting point, especially with your being a doctor, hmmm.

Actually my beef was not with the residents, who showed more interest in talking to me than anyone else, but with the nurses.

[getforfree]

Originally Posted by disneysteve

I'd be lying if I denied that medicine is a business, just like any other. If patients could get all the care they thought they needed without ever stepping foot in the doctor's office, that doctor would go out of business and then where would the patient get those refills? Yes, we charge for our services. We have to make a living, pay our staff, pay the rent, insurance, supplies, etc. If patients never come in, we'd have no practice left.

There is much more to an eye exam than just checking vision. A complete eye exam includes checking for glaucoma, signs of diabetes and hypertension and other vascular and neurologic conditions, many of which you could have and not realize. All adults should get an eye exam every 2 years (annually if you have diabetes).

You say that like it is a bad thing. Am I supposed to want my patients to go away and die? My oldest patient turned 102 in August and I have quite a few in their 90s. Certainly, a lot of that is genetic, but I'd like to think at least some part of their longevity can be attributed to good medical care.

What I meant that the doctors don't want their patients to die, is that they want to make sure that they keep coming back, but they don't want them to be healthy enought to never come back either.

Now people live longer than before, but people are more sick in general than they were about 50 years ago. Even kids are more sick now than they were that time.

I also have a question about vision. Could it be possible that a person has glaucoma and other stuff if he/she can see very good? I have no problems to see street names from far away, and I can see good when I read a book. I mean do I still have to check for all that if I never had any problems with my vision? I really hate to go see doctors. I can even say I hate them in general, not personally. All they see in you is money.

Patients should come to doctors, but only if they have any problem that can be solved with that visit. The doctors shouldn't make patients to come for no reason, so they just would make more money. I don't really care if a doctor pays his bills, I just don't want to spend my time and money on useless appointments.

[disneysteve]

Originally Posted by getforfree

Now people live longer than before, but people are more sick in general than they were about 50 years ago. Even kids are more sick now than they were that time.

Where exactly are you getting that info? I think people are far healthier today. We have better preventive care, greater early detection and far better treatments overall. Conditions that were disabling or fatal 50 years ago are now no big deal. Many forms of cancer are now curable. Diabetes is far better managed. Heart disease deaths have been declining. Vaccinations have virtually eliminated numerous diseases. I could go on and on.

I also have a question about vision. Could it be possible that a person has glaucoma and other stuff if he/she can see very good? I have no problems to see street names from far away, and I can see good when I read a book. I mean do I still have to check for all that if I never had any problems with my vision?

Yes, you could have a serious problem and still see just fine - early on. But if you don't catch and address the problems, they can lead to permanent vision damage or loss. Nothing beats early detection. Hence the value of regular exams.

I really hate to go see doctors. I can even say I hate them in general, not personally. All they see in you is money.

Wow. It sounds like you've had some really bad experiences. What you describe might apply to a few doctors you've come in contact with, but it certainly doesn't describe the vast majority of us. Anyone in medicine knows that it isn't the field to choose if all you care about is money. There are dozens of jobs where I could be making far more money with far less responsibility and hassles.

Patients should come to doctors, but only if they have any problem that can be solved with that visit. The doctors shouldn't make patients to come for no reason, so they just would make more money.

I agree with your 2nd sentence, but not your 1st. Are you suggesting that patients should only come for a problem that can be resolved in one visit? That would eliminate probably 80% or more of what doctors do. I can't "fix" hypertension or diabetes or arthritis or asthma or cancer or a whole slew of other problems in one visit. They require ongoing monitoring and care over months and years. Yes, if you come in with a sinus infection I can prescribe an antibiotic and send you on your way. But if you come in with diabetes, you will need lifelong care.

I don't know how old you are or what caused such a negative view of the medical field, but I hope you'll keep a more open mind in the future.