Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Not everything is terrible in the U.S. health care system

Janice Boughton, MD
Meds
January 10, 2017
77 Shares
Share
Tweet
Share

A couple of weeks ago I started taking medicine to lower my blood pressure and another to reduce my cholesterol. This was a controversial move, given my deep distrust of the practice of medicine, when it is practiced on me, and especially regarding pharmaceuticals.

I know that, as a woman of 55 with a very active and healthy lifestyle, no chronic diseases and, most importantly, as a nonsmoker, I am at very low risk for any of the conditions that high blood pressure or high cholesterol could cause to happen. I am unlikely to have a stroke or a heart attack, develop narrowing of the arteries to my legs or develop kidney failure. The blood pressure and cholesterol levels have no effect at all on how healthy I feel. But one day, while pointing an ultrasound probe at my own neck, I saw a small plaque (a thickened area) in my left carotid artery. It was very calcified, which meant that it had been there a long while, but my carotid was not pristine. It is undeniable: I have vascular disease.

Will this lead to a stroke? Does it imply that the arteries around my heart are also affected? I don’t know, and I may not find out. But I do know that taking a cholesterol-lowering drug helps reduce heart attacks in patients with vascular disease around their hearts, and I extrapolate that it may help reduce further changes to my carotid arteries that may lead to a stroke. My blood pressure is a bit high, and bringing blood pressure down does reduce stroke risk. I don’t know that it will reduce my stroke risk, however.

So it was not entirely clear that I should take either cholesterol or high blood pressure medication. A little reduction in my low risk may not be worth taking a medication with potentially profound side effects and associated high costs.

I decided to try the medication to assess whether it gave me trouble of any kind. If it did not, I might have nothing to lose. The blood pressure medication, lisinopril, has been on the market for decades. It is strongly associated with a reduction in the common complications of hypertension. Its main side effects are a nasty nagging cough and dizziness. It can also cause life-threatening swelling — usually, of the face — but this is rare. I have had no swelling, no dizziness, and though I can feel just the tiniest bit of increased tickle in my lungs, it is hardly noticeable.

Regarding the cholesterol medication, atorvastatin (formerly known as Lipitor), it, too, has been around for a long time and has been extensively tested and found to be pretty safe and effective. It can cause muscle cramps and weakness, and I have been told by some patients that it makes them less mentally acute. It can cause gastrointestinal upset and may be associated with weight gain and a risk for diabetes. I have no trouble so far.

As for the cost, I have had to shell out nearly $5 in copays each month, with my insurance footing about $1 of the bill. This is not expensive. This is a superb deal. I get it from my local pharmacist, not even from a mail order or Walmart’s $4 plan. It is cheaper than Walmart’s $4 plan! In 20 years I will have spent around $1200, plus there will be the occasional blood tests to monitor my kidney function. I checked my cholesterol after being on it shy of 2 weeks, and it was dramatically lower. I, once again, am not sure that this will translate into better health, but it is not odious at all.

The moral of this blog is that not everything is terrible in the U.S. health care system. I could, and will, complain about the surrounding process that leads to people like me being on medicine at all, including issues like medicalization of the healthy and blockbuster drugs being widely adopted without adequate scrutiny, but presently I will give generic atorvastatin and lisinopril a big high five.

Janice Boughton is a physician who blogs at Why is American health care so expensive?

Image credit: Shutterstock.com

Prev

What a radiologist learned about a thoracentesis from a pulmonologist

January 10, 2017 Kevin 0
…
Next

The double meaning of despair in the hospital

January 10, 2017 Kevin 0
…

Tagged as: Cardiology

Post navigation

< Previous Post
What a radiologist learned about a thoracentesis from a pulmonologist
Next Post >
The double meaning of despair in the hospital

More by Janice Boughton, MD

  • Why physicians should start thinking about climate change

    Janice Boughton, MD
  • An experiment in removing the heart from medicine

    Janice Boughton, MD
  • The politics and commercialization of fecal transplants

    Janice Boughton, MD

Related Posts

  • How social media can help or hurt your health care career

    Health eCareers
  • Turn physicians into powerful health care influencers

    Kevin Pho, MD
  • Why health care replaced physician care

    Michael Weiss, MD
  • Health care is not a service commodity

    Peter Spence, MD, MBA
  • Why the health care industry must prioritize health equity

    George T. Mathew, MD, MBA
  • Improve mental health by improving how we finance health care

    Steven Siegel, MD, PhD

More in Meds

  • Can personalized medicine live up to its hype in health care?

    Ketan Desai, MD, PhD
  • The effects of the nationwide stimulant shortage on a private psychiatry practice

    Christine Tran-Boynes, DO
  • Why North American medical cannabis can’t compete globally

    Michael Sassano
  • How were we duped and what can we do about the opioid overdose crisis?

    Ronald A. Zent, MD
  • Caught in the middle: How health insurance companies influence cancer drug selection

    Paul Pender, MD
  • Timely treatment decisions: the promise of surrogate markers

    Layla Parast, PhD
  • Most Popular

  • Past Week

    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • From physician to patient: one doctor’s journey to finding purpose after a devastating injury

      Stephanie Pearson, MD | Physician
    • Lifestyle change: the forgotten solution in health care

      Tyler Petersen | Conditions
    • An unspoken truth about non-compete clauses in medicine

      Harry Severance, MD | Policy
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Why are doctors sued and politicians aren’t?

      Kellie Lease Stecher, MD | Physician
  • Recent Posts

    • The rise of generative AI in health care: Here’s what you need to know

      Anil Saldanha | Tech
    • Finding peace through surrender: a personal exploration

      Dympna Weil, MD | Physician
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • Unlocking the secret to successful weight loss: Curiosity is the key

      Franchell Hamilton, MD | Conditions
    • The teacher who changed my life through reading

      Raymond Abbott | Conditions
    • Revaluating mental health assessments: It’s not just the patient you should consider

      Tomi Mitchell, MD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Supporting the Mental Wellness of Physicians
  • Can Mothers Pass Obesity on to Daughters?
  • Strategies to Inform and Advance Rational Vaccine Design
  • Parkinson's Tied to Common Chemical; Injectable Brain Implants; Migraine Drug Recall
  • Ozempic Back on Shelves; More Positive Fezolinetant Data; Caffeine Cuts Fat?

Meeting Coverage

  • Trial of Novel TYK2 Inhibitor Hits Its Endpoint in Plaque Psoriasis
  • Durable Vitiligo Responses With Topical Ruxolitinib
  • High Rates of Psoriasis Clearance With Investigational TYK2 Inhibitor
  • Rapid Improvement in Atopic Dermatitis With Topical PDE4 Inhibitor
  • New Approaches in the Bladder-Sparing Paradigm
  • Most Popular

  • Past Week

    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • From physician to patient: one doctor’s journey to finding purpose after a devastating injury

      Stephanie Pearson, MD | Physician
    • Lifestyle change: the forgotten solution in health care

      Tyler Petersen | Conditions
    • An unspoken truth about non-compete clauses in medicine

      Harry Severance, MD | Policy
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Why are doctors sued and politicians aren’t?

      Kellie Lease Stecher, MD | Physician
  • Recent Posts

    • The rise of generative AI in health care: Here’s what you need to know

      Anil Saldanha | Tech
    • Finding peace through surrender: a personal exploration

      Dympna Weil, MD | Physician
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • Unlocking the secret to successful weight loss: Curiosity is the key

      Franchell Hamilton, MD | Conditions
    • The teacher who changed my life through reading

      Raymond Abbott | Conditions
    • Revaluating mental health assessments: It’s not just the patient you should consider

      Tomi Mitchell, MD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Not everything is terrible in the U.S. health care system
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...