Talking Money with Your Doctor: Drugs and Tests for Less
by Gary Cordingley, MD, PhD
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The need to manage money is a fact of life. When it comes to
managing medical expenses, it pays to be proactive.
Would you buy groceries without knowing their prices? I suspect not.
You probably compare the costs of different boxes of cereal in order to
get the best deal. But when it comes to medical care, do you even ask for
the prices involved?
While it's true that good health is priceless, and cutting corners on
health care is risky, there is still much you can do in order to obtain
the same good value in medical care that you insist upon in other areas of
your life.
If you lack a prescription plan that pays for your medications, it's
high time you discussed the cost of drugs with your doctor. Your doctor's
number-one choice in medication for your medical condition might be
expensive. There are usually reasonable alternatives that cost less. You
should take advantage of your doctor's expertise in estimating trade-offs
involved with each of your options.
Apart from prices, your doctor is already balancing a number of
important factors in making a drug recommendation. First, of course, the
drug needs to be medically effective—otherwise, why bother? The doctor
also takes into consideration what other medications you are taking, what
other illnesses you have, your age, your gender, the drug's side-effect
spectrum, and also its convenience aspects, like how many times per day it
has to be taken and whether or not blood-tests are required to monitor it.
A drug that might score high on effectiveness and side-effects might still
be inconvenient. An alterative might be both convenient and effective, but
pose a higher risk of side-effects.So the truth of the matter is that your
doctor is already sorting through all sorts of trade-offs in choosing a
medication to prescribe. Factoring in the prices of alternative drugs just
builds on the comparing-apples-to-oranges process you are paying your
doctor to do for you in the first place. But if the doctor doesn't know
that you lack a prescription plan, he or she might not include the cost of
drugs in these reckonings and you might be stuck with a prescription that
wrecks your budget.
The next step in obtaining maximum value for your investment in
medication is to shop it around. Let your fingers do the walking by
phoning several pharmacies for a price-check. I even write out a script
for my shy patients who get nervous when they talk to medical personnel.
It goes something like this: "Hi, I'd like to do a price-check on my
prescription medication. How much would it cost to buy thirty furosemide
20 milligram (or whatever) pills? Thank you very much. Have a great
day!"
In repeating this process with different pharmacies you will discover
there can be quite a spread among even nearby drugstores. Suppose that
your ten minutes on the phone saves you $20 on your prescription. Then you
have just earned money at a rate of $120 per hour each month for
your efforts. It is time well spent.
Cost-consciousness is also valuable when it comes to medical tests. If
the cost of a medical test is prohibitive (as is often the case) and you
don't have the luxury of letting someone else pay for it, then encourage
your doctor to talk through your alternatives with you. Does the same test
cost less at one facility than at another? How important is the test? What
could go wrong if you skip it, delay it or substitute a less expensive
test? What are the chances of a serious repercussion?
Unfortunately, your doctor usually has less latitude when
cost-optimizing your medical tests, but what could it hurt to ask? You
might be glad you did.And how about optimizing the doctor's fee? This is
also a fair topic for discussion. When you are considering an appointment
with a new doctor it is certainly appropriate to ask for typical fees.
However, in the current U.S. medical marketplace, the doctor's time is
usually the least expensive component of medical care. The doctor's fee is
usually much less than the costs of medications and tests. So while it is
perfectly reasonable to shop around for affordable doctor fees, when it
comes to choosing a doctor, quality issues should come first.
(C) 2005 by Gary Cordingley
ABOUT THE AUTHOR
Gary Cordingley, MD, PhD, is a clinical neurologist, teacher and
researcher who works in Athens, Ohio. For more health-related articles see
his website at: http://www.cordingleyneurology.com/
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