Health: Five ways to get higher value medical care in river city
MOHLER’S MEDICATION MAXIMS
Every year, one-third of the money spent on this commodity in the United States is wasted. No, it’s not our endless political campaigns, the inefficient military or bottled water. It’s our out of control medical care delivery system and those wasted office visits, tests, x- rays, prescriptions and surgeries. Some wasteful medical care has long been dispensed right here in Western Colorado. I am, guilty, as you suspected.
What is High Value Medical Care?
It’s a simple equation: Value = Quality / Cost
Quality of care should mean, “What dear patient, do you cherish, fear, value about your future health and the health care you will receive?” For me, quality is avoiding tests, the hospital, surgery and pills, as much as possible. It’s my family physician, Dr. Mike, helping me navigate the mangled medical milieu. It is early hospice and the option to not be resuscitated when the time comes.
Costs may refer to dollars and suffering. Chemotherapy adds 40 vomiting filled days to the end of your life for $65,000. Is that high or low value for you?
Five Strategies to Garner Higher Value Medical Care
1. Latch onto a primary care physician who will listen to you. As Sir William Osler, one of four founding professors of John Hopkins Hospital, stated while talking to doctors, “Listen to the patient. He will tell you the diagnosis.” If your physician will listen when you give him your diagnosis, you will save a lot of testing.
2. Let all your medical care givers know that you are a 21st Century Patient, and you want to share in the decision making process. Making your own desires and fears known is critical to ending up with the medical product that you value, not what your doctor values.
3. Practice healthy skepticism about all things medical. Remember that a third of all medical interventions that you have ever undergone were probably of low value and wasteful.
4. Follow the Seven Year Rule about taking new medicines. Do not consume a medication until it has been on the market for at least seven years. It often takes this long for the unusual side-effects of new medications to show themselves.
5. Ask your physician if she sees drug reps, or takes sample medications. If she does not, thank her, as she is saving you, and the medical system, lots of money. Recall the study done in our own community and replicated multiple times elsewhere. Prescription costs are significantly higher for patients who are cared for by docs who listen to pharmaceutical salespersons than those who do not. Taking brand name samples, particularly of drugs taken long term, is an even more potent way to increase your pharmacy costs over time. Availability of the “new and improved” sample drugs disappears quickly!
Free Press health columnist Dr. Mohler has practiced family medicine in Grand Junction for 39 years. He has a particular interest in pharmaceutical education. Phil works part-time for Rocky Mountain Health Plans. Email him at firstname.lastname@example.org.
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