Avoid unnecessary medical tests

This is a guest post from a dear friend. As a cancer survivor, she has a lot of experience dealing with doctors, hospitals and insurance companies. She does not work in the health care industry, but is very savvy and not afraid to ask questions. She has been a huge supporter of Frugal Nurse as she, too, sees a need for patients to be more aware and wary of the health care they receive.

After a recent trip to her doctor’s office, she called me with the following story and asked if I would be interested in sharing it with

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Ebola in the US

Ebola 24/7!

Two months ago I posted that I was not concerned about an outbreak of Ebola in an American city. By “outbreak” I mean a rapid spread of the virus resulting in many people becoming ill and dying, as is happening in West Africa.

I stand by that belief.

However, listening to and reading the non-stop media coverage of Ebola in the US, I can understand why so many are verging on panic. Mainstream media is designed to “sell” news rather than inform the public, and fear is a powerful motivator when it comes to selling something. I’m … Continue reading

Three questions to ask your physician

demand-evidenceBe a proactive patient

In addition to talking to my doctor friends, I spend a lot of time reading various doctor blogs because I want to better understand our health care system from their unique point of view.

The majority of those I read seem to agree with me that the industry has morphed into a giant profit-making machine—profits first, patients second. Many physicians write of their loss of autonomy and the ability to treat patients in a thoughtful, patient-centered and cost-effective way.

More than ever, they say, patients need to be informed and take control of their health care. … Continue reading

The demise of annual exams and the doctor-patient relationship

Are annual exams a waste of money?

Based on the most recent evidence, I would argue yes. I posted about annual exams a few months ago, and quoted the following from the Society for General Internal Medicine (a primary care specialty group):

Routine general health checks are office visits between a health professional and a patient exclusively for preventive counseling and screening tests. In contrast to office visits for acute illness, specific evidence-based preventive strategies, or chronic care management such as treatment of high blood pressure, regularly scheduled general health checks without a specific cause including the “health maintenance” annual

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Hola! Puerto Rico opens for health tourism

puerto rico health tourismWhat is health tourism and why Puerto Rico?

I read the other day that Puerto Rico wants to jump into the medical tourism ring and compete with those countries where it is already pretty well established, such as Mexico and Costa Rica.

Medical tourism, as the name implies, is traveling to another country to receive more affordable medical care.

[Puerto Rico’s] administration says that it commissioned a market study from which it deduces that medical costs on the island are between 40 percent and 60 percent lower than in the mainland U.S.

Such a move, if successful, could be a … Continue reading

Do you need an annual pelvic exam?

annual pelvic exams unnecessaryYet another screening exam found unhelpful

Earlier this month, the American College of Physicians (ACP) published its recommendation in the Annals of Internal Medicine that routine annual pelvic exams are unnecessary for healthy, non-pregnant women with no gynecologic symptoms (bleeding, discharge, pain, etc.).

The ACP looked at evidence on pelvic examinations dating back almost 70 years and concluded:

… no data support the use of routine pelvic examination (excluding cervical cytologic [Pap] examination) for reducing the morbidity [disease] or mortality [death] of any condition. Furthermore, limited evidence suggests that screening pelvic examinations may be associated with pain, discomfort, fear, anxiety,

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Dr. Oz – Pitchman for profit

Called before the Senate

Over a year ago I wrote a post dissing Dr. Mehmet Oz for his overuse of the word “miracle” on his TV show. As I said, there are no miracles when it comes to getting and staying healthy—just common sense, hard work and perseverance.

But those things are boring and don’t make good television, do they? Talk shows (and that’s really all the Dr. Oz show is) need to keep ratings high. They need to excite viewers and encourage them to buy the advertised products, or ratings fall and advertisers pull their support.

Fortunately for those … Continue reading

Do you need an annual exam?

The yearly reminder

The other day I received in the mail a form letter from my physician’s office reminding me that I am due for my annual “well woman” visit. The letter also pointed out that if I have an ACA-compliant health insurance plan, the cost for the exam would be 100% covered as a preventive benefit.

I have three problems with this letter.

  1. Although my current physician is part of my new insurance plan’s network, the hospital she works out of is not. What if I needed to have surgery or be hospitalized? My care would then be given
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“American Addict”

american addictA uniquely American public health crisis

Last weekend I finally watched a film that has been sitting in my Netflix queue for some time. American Addict, produced by a physician, Gregory Smith, MD, is a well-made, informative and compelling documentary about America’s drug culture.

I don’t mean dope and crack and methamphetamine. I’m talking about the overuse and abuse of prescription drugs—pain pills, sleeping pills, antidepressants, antipsychotics, and stimulants.

It’s a public health crisis that is costing this country billions of dollars in health care costs, health insurance fraud, criminal activity, local and federal drug enforcement, loss of employment … Continue reading

Patient satisfaction scores

They aren’t what they seem

When I buy a product on Amazon or Ebay, I like to read the reviews, see how many stars a product or seller rates. Did the product arrive on time and in good condition? Is the product as the seller described? Did the product work as expected?

A high rating, indicating customer satisfaction, should be a good thing, right?

Normally, yes. But not when it comes to judging physicians.

For example, a friend of mine is a surgeon, a really good surgeon. Last year he saw a morbidly obese woman to consult about an elective … Continue reading

Slow medicine: “God’s Hotel”

slow medicine gold's hotelA remembrance of things past

I picked up a book the other day that filled me with nostalgia, a yearning for a return to the way medicine used to be practiced 30 or more years ago.

Yes, I’m probably guilty of looking at the past through rose-colored glasses, but reading God’s Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine by Victoria Sweet, MD, reminded me of the era before “bureaucratic medicine” when doctors and nurses had more time and more autonomy to deliver the slow medicine or patient-centered care she describes.

Related post: “Knocking on Continue reading

“The Treatment Trap”

the treatment trapWhat is too much medicine and why is it bad?

I’ve talked about it before: Health care costs are crazy high; the cost of insurance is increasing to meet those costs; and more patients than ever are being harmed by the treatment that is supposed to help them.

The overuse of medical care is directly responsible, and increased patient (consumer) awareness is needed to help turn this trend around.

Reading The Treatment Trap: How the Overuse of Medical Care is Wrecking Your Health and What You Can Do to Prevent It by Rosemary Gibson and Janardan Prasad Singh would be … Continue reading

Is your electronic health record (EHR) accurate?

electronic health recordsAccess to your records is important

If, like me, your health care has been disrupted by new insurance coverage and the loss of your doctors and/or hospital network, it’s important that you have a hard copy of your health records.

I’ve always advised patients to keep copies of all their important health reports—x-rays, lab results, operative and pathology reports, etc.

A timeline of surgeries and hospitalizations is a good idea, too.

And it’s vital to keep an up-to-date medication list, including any frequently used over-the-counter products such as baby aspirin, ibuprofen, antacids, vitamins and herbal supplements (to name but a … Continue reading

Helping doctors save you money

lab slipA doctor posted this photo the other day. It’s a typical lab result slip with a twist—look closely and you’ll see a column for “cost”.

When doctors want to treat an infection, they generally get a “culture and sensitivity” first. That is, they take a sample of whatever is infected (urine, skin, blood, or other) and send it to the lab. The lab grows (“cultures”) and identifies the bacteria, and then tells the doctor which antibiotics the bacteria is “sensitive” to, that is which will kill it.

Antibiotics can be extremely expensive, especially the newest ones that can cost Continue reading