Are you a thrifty patient? How to get the care you need and save money

It is increasingly becoming the year of the Thrifty Patient. People are paying for more medical care and are more responsible for the costs of getting that care via higher deductibles and co-pays. Patients don’t have a choice but to be involved in their care. Though the recent 2008 recession saw a decrease in overall medical and health care utilization as a sign of better informed patients, I believe that was simply because people deferred needed care in order to keep their jobs. With the economy getting better, more people will begin to seek care again. The question is how can they save money on medical and health care costs?

Use Dr. Google and the Internet thoughtfully. The first key is to understand when to seek medical care and when to safely skip. Abdominal pain. Is it a simply stomach virus or an early appendicitis? Winging it? Not a good idea. The former can be handled safely at home. The latter needs to get medical attention quickly as delay can cause more complications, more time in the hospital, and you guessed it, more money that you have to pay! Is it the flu or pneumonia? Sprained an ankle? Is it broken or just a really bad sprain? Why wing it? Be thoughtful on your research. Two excellent websites are at Family Doctor and at Healthy Children, managed by the American Academy of Family Physicians and the American Academy of Pediatrics.

Make every doctor visit count. If you do need to seek medical attention, then make sure you are prepared. Think about how you might tell you doctor your symptoms. Tell it in chronological order with a beginning, middles, and end of the story. Even with all of the tests available to doctors, the most important tool we have to getting the right diagnosis is what you tell us. People and illness can be complex. An abnormal test in the right situation can clinch an accurate diagnosis. An abnormal test in a different situation can be a red herring. If you are paying for each office visit as well as any follow-up lab work, tests, and treatment, decreasing the number of times you need to seek care will save you time and money.

Minimize unnecessary duplicate testing, medication, and treatment. Get your old medical records. As this blog post notes, a patient brought me in copies of her colonoscopy. Though her doctor recommended a repeat in five years, even though she is completely healthy and has no family history, reviewing her personal history, preference, and national colon cancer screening guidelines, this patient was pleased to postpone the next colonoscopy for another five years. Saved time and money! Did you have a recent blood test for cholesterol? What was the number? Is another one needed soon? You and your doctor can’t know, especially if you have switched doctors (increasingly more common as people change jobs, companies changes insurance coverage, and doctors close their individual practices and move to larger ones).

Ask questions. Is this really necessary, doctor? It can be tough to ask because many of us don’t like confrontation. Even worse, it can be harder when it is a patient asking a doctor this question. Yet we know too many people take antibiotics for colds. Too many people get MRIs for a simple low back strain. As this blog post demonstrates, this can occur even with cholesterol lowering medication. Doctors, like you, are increasingly busy. If you don’t stop to ask, they may not tell you the pros and cons of any choice they make for you. Tell them if you are concerned about the cost of another medication, another test, and another follow-up.

Prescription medications. The second highest cost of medical care after health insurance premiums. Use the tips above. If you have your old medical records, you might know other medications you’ve taken in the past which may be ineffective for you. If you doctor unwittingly writes the same medication, you pay for this oversight. Ask questions, particularly if a particular medication comes in generic. If not, then ask if there is a similar medication which does the same thing for less. Be wary of free medication samples. Unless it treats the problem completely (antibiotics for a bladder infection), taking a free sample gets you hooked on an expensive medication long-term, which may not be necessary. Finally, don’t automatically say you don’t want medication. You certainly don’t want unnecessary prescription medications. No one has turned me turn from getting a prescription for pneumonia, yet patients want to ignore treating with medications, the silent killer, hypertension, which causes heart attacks and strokes. Of course, we all should make lifestyle changes to decrease risk. But when that isn’t enough, should prescription medications be a reasonable addition to keep you healthy?

Get a primary care doctor. I don’t say this because I’m a primary care doctor. I say this because medical and health care is confusing. Thirty second soundbites and commercials tell you to get this medication, stop taking this other medication, and to be sure to ask your doctor about disease XYZ. Have you been checked yet? What is the truth and what isn’t? Wouldn’t it be nice to have an expert on your side who is helping you look out for you? I mean the entire you and not just an organ system, like specialists. On a regular basis, I help patients cut through the clutter and get to what really matters. It isn’t just about treating illness, but also keeping you well. Ever wonder if those mailers from the Life Line Screening are worth it? No need to wonder anymore.


I passed up an opportunity to be in the business community by being a doctor.

I haven’t regretted it. Too many times my family members had medical problems. Too many times the health care system fell short by not giving them the right care. Fortunately, many times (though unfortunately not all times) we were able to sidestep potential missteps.

The health care system is sadly going to me more confusing and complex for more patients as it becomes more costly. It does not need to be that way. Indeed 2013 and the years afterwards will increasingly be the year of  the Thrifty Patient. With a little knowledge and an approach to work with your doctor in a different way, you too can get the care you need and save money in the process. Once the health care system becomes as patient focused and friendly as other services we take for granted then we can retire this phrase, the Thrifty Patient. Until then, educate yourself, learn, and post your time and money saving ideas here.

Davis Liu is a family physician who blogs at Saving Money and Surviving the Healthcare Crisis and is the author of The Thrifty Patient – Vital Insider Tips for Saving Money and Staying Healthy and Stay Healthy, Live Longer, Spend Wisely.

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