People run the gamut on how well they take care of their health. Some people avoid the doctor at all cost and others seek care immediately when they have an inkling of a health issue. What is the right balance? Ignoring health problems can be costly for both your health and finances, but going to the doctor too often can be just as costly in the same way. In this article, I cover why this is and how to achieve a better balance in seeking the health care you need.
Are you the type of person that goes to the doctor at the drop of a hat? Or are you the opposite and will likely be carried into the emergency department by your cold, blue toenails? How you access health care is a function of your personality and is likely shaped by behaviors learned in your family, your financial resources, and your previous health care experiences.
The 2012 book “Your Medical Mind” by Drs. Jerome Groopman and Pamela Hartzband explores health care personalities and how individuals can make better decisions about their health. There was no mention in their work about the financial implications of health care decisions, but my financial planning brain immediately put two and two together. If you can identify your health care personality and learn how to make better health care decisions, you can save a lot of money!
A maximalist is the type who wants to unearth every possibility of ways to maximize their health. They may be more likely to utilize specialists, turn to alternative care, and undergo every screening available. In addition to the financial cost, why can this be a bad thing?
Risk of “Fascinomas”
Your body is a work in progress in that cells are constantly dividing and dying. In fact, cell mutations that can turn into cancer happen frequently, and your repair systems do a splendid job of stamping out most of those mutations before they become a problem.
Sometimes cell turnover may result in benign permanent changes – cysts in the liver and kidneys and fibroids in the uterus are perfect examples. Most of the time these changes don’t cause any trouble and you don’t even know they are there. The problem occurs when they show up in testing for some other medical problem.
These incidental findings are considered are jokingly called fascinomas. A fascinoma is a fascinating little finding on your scan that is likely not significant. But what happens next? It depends.
In our litigious world of medicine, some doctors are less willing to accept risk than others. Many doctors may reassure you and say don’t worry about it. Others may get follow up scans to make sure there are no changes in the future – of course this costs money! A few may even go as far as recommending a biopsy. A biopsy costs more money and you have the risk of complications from having a procedure.
If you need a scan for a medical problem, of course it should be done. However, stay away from those full body screening scans! These scans can send you and your wallet down a rabbit hole. You’ll waste time and “worry minutes” over something that is nothing and put yourself at the risk of medical mishaps if further testing needs to be done.
Ending up with a medical label
Doctors get paid based on how much work they do. Billing for an office visit is based on the level of medical decision making. If your problem is easy and doesn’t require testing or much brain power, your bill will be much than if the doctor must be a top-notch detective, order more tests, or consult specialists. Basically, the more you complain about, the higher your bill.
To support those higher bills, doctors must also provide a diagnosis in the bill that validates the level of service they provided to you. They can’t charge you a level four visit for a hangnail. Because they must validate their charges, you may end up with a diagnosis in your medical record that you aren’t expecting.
For example, suppose you follow up with your doctor for a routine visit for high blood pressure. You think you are fine but your blood pressure in their office is slightly high at 145/95. The doctor asks you questions to determine what could be causing the increase. Are you taking your medication correctly, eating a lot of salt, or are you having any stress? You mention that work has been stressful and you aren’t sleeping well because of the anxiety of potentially losing your job. She then encourages you to work on the stress and wants to see you in a month to recheck you.
What is your diagnosis? You think it is just hypertension, but since the doctor took extra time counselling you on stress and anxiety, you may now have an additional diagnosis of anxiety. Is this a big deal? Potentially, yes. You might now be charged a level four visit instead of a level three, which will be a bump in the billing. But there is a bigger problem. With that new label of anxiety, if you need to apply for disability, life, or long term care insurance, this could cause you to pay higher premiums than someone without that label.
It is important to share how you are doing with your doctor, but make sure you understand all your diagnoses listed in your chart and ask the doctor to document problems that are resolved or no longer relevant. This can save you a load of hassle if you ever need to purchase insurance coverage.
What is the right balance?
What is the best way to access health care without going overboard? First, remember that more health care is not better health care. Stick to health screenings recommended by less biased organizations, such as the U.S. Preventive Services Task Force.
Next, make sure you understand what your doctor is doing for you and why. If they want to order a test, ask how it will help your problem. If they don’t have a good answer, ask if that test really needs to be done.
Finally, make sure you understand everything in your medical record. By being proactive, you can avoid mistakes in your record that can affect your future care, health care costs, and other insurance costs. And a great side effect of being proactive in understanding your health record? You are more likely to do your part to stay in good health!
