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The Thrifty Patient: A Doctor’s Guide To More Affordable Healthcare

October 11th, 2012 by Dr. Val Jones in Book Reviews
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No matter the outcome of the presidential election this year, it’s likely that Americans will be spending more of their money on healthcare going forward. Dr. Davis Liu, a family physician at the Permanente Medical Group in California (and a contributor to this blog), has written a primer on how to get the most bang for your healthcare buck. The Thrifty Patient: Vital Insider Tips For Saving Money And Staying Healthy is a helpful little book for those smart enough to read it.

The first step to becoming a “thrifty patient” is to reduce your need for professional healthcare services. This lesson is perhaps the most important of all: lifestyle choices are the largest controllable determinant of how much healthcare you will consume. Daily exercise, healthy eating, and preventive care services (such as vaccines and screening tests) are the most effective ways to avoid expensive healthcare.

Dr. Liu offers tips for selecting a doctor, questioning the necessity of tests and procedures, choosing less expensive treatments, getting a second opinion, and learning to get the most out of a short doctor visit. He explains why annual check ups may not be necessary, and lists all the preventive health screening tests you’ll need (according to age) to maximize your chance of avoiding many major diseases or their expensive outcomes.

According to Liu, an excellent primary care physician (PCP) can be the best ally in avoiding unnecessary medical costs. Without a PCP’s guidance, 60% of patients select the wrong specialist for their symptoms or concerns. This can trigger a costly cascade of extra testing and referrals. Liu recommends trustworthy websites that can aid in disease management and patient education – suggesting that “Dr. Google” may not be so bad after all, armed with a correct diagnosis from a healthcare professional and links to credible sources of information.

Being thrifty isn’t necessarily “sexy” – but practical tips for avoiding unnecessary and expensive interactions with the healthcare system could add up to some pretty amazing savings (both financially and emotionally). Anyone who takes Dr. Liu’s advice to heart is likely to live longer and better – I just hope that the people who could benefit most from these tips find their way to this book. Perhaps you know someone who needs an early Christmas gift? 😆

The Thrifty Patient can be purchased here on Amazon.com

How Tanning Beds Nearly Killed Me

October 3rd, 2012 by Dr. Val Jones in Health Tips, True Stories
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When I was a teenager I did some stupid things, but looking back I think that the worst decision I made was to go to a tanning salon. At the time I remember tanning salon staff assuring me that it was “safer than the real sun” and the fastest way to get a healthy-looking glow. “You could bake in the sun all day, or spend 20 minutes in a tanning bed for the same effect” said the staff. So after trying several sunless tanners in varying shades of orange and having them slough off like patches of dirt, I decided to make my alabaster skin a nice, even shade of light caramel with months of tanning each year.

Fast forward twenty some-odd years and I’m in the surgeon’s office having a wide-margin re-excision of a melanoma on my back. I’d been wearing sunscreen since my early twenties, carefully protecting myself from UV radiation. I had realized the error of my ways after a serious conversation with a dermatologist, but I had “gotten religion” about skin protection too late. My fate was already set from the tanning bed exposure.

A new study in the British Medical Journal (BMJ) estimates that tanning beds may be responsible for hundreds of thousands of non-melanoma skin cancers per year in the United States. As for melanoma (the deadliest kind of skin cancer), the World Health Organization has determined that the risk of melanoma is increased by 75% when the use of tanning devices starts before age 30. In fact, they classify tanning bed exposure as a “group 1 carcinogen” – in the same class of human toxicity as asbestos, tobacco, and mustard gas.

I was surprised to learn how common tanning bed use is, especially in Europe. According to the BMJ study, 10.6-35% of people in Germany, France, Denmark, and Sweden have used a tanning bed at some point in their lifetimes. The global nature of this problem is daunting – and with research suggesting that tanning has addictive properties, it may be as difficult to get people to avoid tanning salons as it is to have them quit smoking.

As for me, I learned my lesson and I have the scars to prove it. I was lucky that a dermatologist caught my melanoma before it spread, but now I need to be on the look-out for more of them and redouble my efforts to stay out of the sun. If you’ve ever used a tanning bed and have fair skin and freckles, you should probably keep your dermatologist on speed dial. That temporary “sun-kissed glow” can easily turn into wrinkles and Frankenstein scars in the not too distant future – along with a potentially fatal cancer diagnosis. Trust me, it’s not worth it.