Tuesday, December 15

Skip the doctor

Before anyone jumps all over me, I'm not suggesting you avoid regular medical care. In fact, I'm saying quite the opposite.

Too many Americans avoid being seen by a medical professional for financial reasons. Whether they are uninsured or they simply have high co-pays/deductibles and low funds, they try to ignore symptoms that could be very serious indeed.

It's a stupid risk to take. From a health standpoint, you're risking your life in order to save some money. And you can't spend money if you're dead. Yeah, what you have probably isn't life-threatening. But what if it is? You can bet Jim Henson had health insurance, but for whatever reason, he dismissed his symptoms and it cost him his life.

Meanwhile, it's also a bad financial bet to make. Great, you saved $150-200 by not going to the doctor. But once those symptoms worsen and get to the point that you are worried enough to get seen, you may be forced to go to the ER. Even if you're not admitted to the hospital, you'll be getting a bill about twice as steep as a normal doctor. It's also possible that, by waiting to be seen, your condition will have gotten severe enough to necessitate a hospital stay. Then you're really looking at the big bucks.

In the end, you need to find balance between saving your bank account and saving your health. Here are a few tips to help you along your way:

Know what it isn't

Despite my little lecture above, I'm well aware that a lot of Americans go to the doctor unnecessarily. They become convinced they're very sick, and no amount of logic can dissuade them. When money is tight, of course, this is less likely to happen. But it's good to be cautious. There's nothing worse than sucking up the cost of a doctor's visit only to discover there's really nothing wrong.

Know the difference between a sprain and a break. I know from personal experience just how painful sprains can be. But you should be able to tell the difference between a sprain and a break. For one, sprains tend to swell up. I know the old wisdom is that if you can move it, it's not broken. I don't know how true that is, but it may be one guideline.

At any rate, the best treatment for a sprain is RICE: rest, ice, compression, elevation. Also consider some ibuprofen. Other than that, there's not much to be done. Except to pledge to be more careful next time.

Also, know the difference between the flu and... everything else. It's a popular one to get wrong. People think a stomach flu is the flu. They think a bad cold is the flu. In short, they think anything that is highly unpleasant must be the flu.

In fact, if you're throwing up, you probably don't have the flu. Usually, it's a stomach bug, which is often a case of mild food poisoning. Drink some flat Coke or the juice from some canned fruit. The pectin will settle your stomach. You should feel better in 24 hours.

If you're stuffed up and/or have a sore throat, you probably don't have the flu. You have a cold. It's hardly fun, but there are tons of products out there and lots of Walgreen's Register Rewards/CVS Extra Bucks to get when you stock up. So take some Nyquil and see if some rest helps. (To be fair, if the sore throat lasts, you may have strep. Usually, this is will involve a sore throat without any sort of relief for a couple days on end.)

Finally -- and this is the acid test -- if you don't want to die, you probably don't have the flu. I've had the flu. It was only two years after I had been in the hospital, on life support, for 3 straight months. And I remember, in the middle of it, thinking, "This is the worst I've ever felt." (About two minutes later, I realized how absurd that was. On the other hand, I got narcotics in the hospital.)

I felt fine that morning. By 1p.m., I started a tad "ooky" to use the technical term. By 4 p.m., my skin ached from contact with my (softest) shirt. By 7 p.m., I was lying prostrate on the couch, being racked by coughing fits. That night, I had alternating fever and chills. After a day or two of medication, I began to feel human again. But it was miserable in the meantime.

Of course, I can't say how H1N1 feels, but Tim's mom did have it. When her friend asked her how she felt, she said, "Like I got hit by a truck." So I'm guessing that one is self-evident too.

Nurse line:

This may be one of the best ways to get some quick, free medical advice. Most hospitals have a line you can call to speak with a nurse. While this is hardly a substitute for a real visit to a health professional, it can be a good first step. There are a lot of times that we go into the doctor's office unnecessarily.

If you can't find the number, simply call the hospital's main number and ask if they have a nurse on call to answer a couple of questions. It helps if you jot down a list of symptoms or concerns before you call. Once you have a professional on the line, try to be concise without skipping over anything.

Don't expect a diagnosis over the phone. This person isn't a mind reader. But you should come away with a bit of advice. Most often, you're told to try one or two things from home. If the symptoms don't get better or worsen, the nurse will tell you to make an appointment with your doctor. (Depending on the type of symptoms and their severity, you may be ordered into the doctor/ER immediately. But it's rare.)

MD? Nah, ARNP:

If you do need to be seen -- but not in an emergency room -- your best bet is to find an ARNP. These professionals can order tests and prescribe medication just like a doctor. But their rates tend to be significantly less.

I can't quote you a general price range. Tim is new to the world of being uninsured. But the one I found for him charges $75 to a new patient -- at least, one paying out of pocket -- and $50 thereafter.

The exception to this rule can be specialists. For example, the psychiatric nurses I've found around Phoenix are far pricier than their non-specializing counterparts. The first appointment is $150-220, with the follow-up appointments going for about $60-75. That's the same as a lot of psychiatrists.

Actually finding a medical professional without an insurance database can sometimes be trying. My suggestion is to google "ARNP" and your city. If that doesn't provide enough results, you can always try using the Medicare website. You don't have to be on Medicare to find a provider through the website. Just go to the site and look for "Find a provider." You can specify what kind of medical professional you want, from ARNP to general practitioner to specialists. You can put in your exact address and see results by distance.

One note of warning: This is a large database. A lot of the information is old or not terribly clear. Doctors tend to have a lot of ties to various offices. So getting the right number can be a pain. I ended up calling a heart hospital once, looking for a GP. Another doctor I was looking for had outdated information. I did some searches and found a newer number, only to find out she was no longer there. After calling three more places, I found out she was now working in the Air Force.

In other words, be prepared for some frustration. And a lot of calling. The best thing will be to do the research before you need an appointment.

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