Archive for October, 2008

Bargains in Health Care

Posted on October 22, 2008. Filed under: Affordable Health Care, Preventive Care | Tags: , , , , , , |

Many of my patients are as concerned with costs as with the state of their health. Because of that, I work with them to make sure health care is both affordable and comprehensive. By far, the cheapest form of health care is prevention. So in my practice, I focus on  intercepting disease or health issues as early as possible or preventing them altogether. It does not take much to be a little creative. Here are some cost-saving ideas patients can take to their doctors.

Physicals do not have be administered exactly every 12 months.  There is nothing wrong with getting checkups every 15 to 18 months — a process I call “straddling.” For instance, last year many of my patients came for physicals in October, November or December, and if they were healthy, we will not schedule their next physical until early 2009. Yet only 13 to 16 months have transpired between physicals, allowing the patient to “straddle” two calendar years — 2007 and 2008 — with only one deductible payout (in 2007).

Lab tests can run in the hundreds of dollars. Again, with some thought and research, there are ways to save. For instance, for patients who are covering costs for bloodwork, we use the services of HealthCheckUSA, a nationwide company that offers discounted lab services at a savings of sometimes more than 50 percent. A complete health profile blood test valued at $530 only costs $200 at HealthCheck.

Another way to save on bloodwork is to have all basic tests run before the physical. That way, your doctor will have the test results in hand for the appointment, saving both of you the time and expense of a follow-up visit to review test results.

Your doctor can also shop around for lower costs. For tests like chest x-rays, which I always recommend for physicals, I refer patients to outpatient radiology facilities in San Antonio like South Texas Radiology, O’Neill and Associates and M&S Imaging San Antonio, where x-rays and a radiologist’s interpretation of them can be as low as $60. That’s considerably cheaper than at a hospital, where x-rays alone can run $125, and the radiologist’s interpretation could be $25 to $35 more.

These facilities are often cheaper for other tests as well. For patients who can pay with cash at the time of the test, many facilities will discount their fees. Ask your doctor for recommendations.

For women 40 and up, I recommend pelvic sonograms, which are noninvasive, safe and are cost effective. I ask the radiologist to examine the pelvis and provide additional views of the kidneys, which can give us valuable information about other organs. This type of sonogram has led to the early diagnosis of liver and kidney cancers as well as ovarian cancer well before the cancers could manifest. Insurance usually covers pelvic sonograms, especially if a woman has symptoms in the pelvic region.

I recommend colon cancer screening with a 60-inch scope for patients in their 40s.  However, most insurance covers only flexible sigmoidoscopies (24-inch scope) before age 50; that test is cheaper than a full colonscopy because it is performed without sedation in the specialist’s office rather than a surgical center. I get around this by asking the colon specialist to use the longer scope in the under-50 patients.  With the longer scope, he can perform a more thorough exam. The cost of around $150 is much less than $800 for the full colonoscopy.

If costs are a concern, don’t hesitate to have a frank talk with your doctor. Remember, your doctor is your advocate. He can shop around for cost savings and refer you to labs he uses regularly for discounts. Many doctors will often lower their own fees to their patients to help make healthcare affordable. After all, his goal is the same as yours: to ensure your health.

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HPV Vaccinations the Surest Way to Fight Cervical Cancer

Posted on October 11, 2008. Filed under: Cancer, HPV | Tags: , , |

With all of the controversy over mandating vaccinations for the human papilloma virus (HPV) for female immigrants to the U.S. and sixth-grade girls throughout Texas, we shouldn’t lose sight of one key fact: This vaccination saves lives. Period.

As a family physician, I advocate both testing and vaccination for HPV in all of my female patients. Offering vaccinations to 11- and 12-year-old girls is a reasonable and easy way to eradicate deadly cervical cancer.

Every woman should know her HPV status, regardless of her age. HPV is, indeed, sexually transmitted. The virus has many subtypes; some are harmless but others are the likely causes of cervical cancer. The virus can lie dormant for many years before causing infections or cancer. The HPV assay is a highly accurate test that examines the DNA “footprint” of the cells and detects subtypes that are most likely to cause cervical (more…)

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How Doctors Should Think

Posted on October 11, 2008. Filed under: 8 Causes of Death, Cancer, Cardiovascular, Diseases, Recommended Medical Guidelines |

Every business forecasts its performance predicated on past experience except medicine. Yet, health care could benefit from that approach because there is statistical probability for everything, including health. Most predictable is the fact that some day we all have to be dead. To be dead, there has to be a cause of death.

To predict our likely cause of death, all we have to do is resort to statistics. For instance, statistics prove that two thirds of all death is attributable to cardiovascular causes, such as heart attacks, strokes, and aneurysms. Because we all know the statistics and the primary risk factors (cholesterol, high blood pressure, smoking, obesity, and stress), doctors should be aggressive in identifying and intercepting those risk factors as early as possible. From that alone, we would reduce our chances of dying of a cardiovascular event considerably.

If we can ward off a cardiovascular problem, we can live long enough to get cancer, the second most-common cause of death. Lung cancer is the number one cause of cancer-related death, even in nonsmokers. All that is required to have this disease is that we have lungs. But the main reason it is so (more…)

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