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How to be a smarter (and more cost-effective, less stressed) patient

One thing we like to rail about is the high cost of health care -- and justly so. On the one hand, I don't mind paying doctors for their specialty (who wants to be the guy who says, "hey I want the cheapest doctor! who cares about credentials!") or drug companies for the healing medications they spend years and millions developing. On the other hand, sometimes I think we just aren't smart enough about our health care.

Sometimes I think we are too fast to accept health care exactly as dispensed and too slow to consider ways to make it work better for us (our bodies and our wallets).

Let me share a short anecdote and a few things I learned this week about being smarter with health care, choices we have that we may not know about and how to get doctors and pharmacists on board. In short, let me tell you about being an empowered patient who takes charge of our own health and wellness.

It all started last Wednesday when the pediatrician leaned back from my daughter and said, "Those are some dense, crackly lungs...we're going to try an inhaler, but you better be prepared to head to the hospital for an X-ray." And it just went downhill from there. Then the school nurse called about a problem with my younger daughter and within a couple of days we were at the specialist for her. Next my older daughter had a major reaction to the antibiotic and we had to change classes.

I bought half a dozen medications for my kids in less than four days. If we had gone with the original plan (prescribed treatment and medication) it would have more or less cost the equivalent of my mortgage, and that's not counting the office visits. We would manage to meet our $5000.00 deductible in a week.

You have that much spare change laying around? Me neither.

1. My pediatrician does it right: ask your doctor what she has on hand for you.
A big difference between my pediatrician and our specialist is that our pediatrician always checks for coupons, rebates and samples. I deeply appreciate that she is conscientious of our bottom line. When my daughter was diagnosed with seasonal allergies, our pediatrician gave us samples. We were able, without spending a fortune, to figure out which antihistamine most helped her. Other times she has provided rebate and coupons. If your pediatrician doesn't offer, ask.

2. When getting a prescription, ask questions. Find the right medications for you. Ditto for any treatment.
Why this prescription? How much does it cost? Does my insurance cover it? Is it easily available? Are there alternatives in this same class that are equally efficacious? Is a generic acceptable?

It may seem overwhelming, but your doctor's office or local pharmacy can help and, having done this, I can say it takes less time than you think. The antibiotic the specialist prescribed was (a) hard to find -- I had to call 7 pharmacies to find one that carried it, and (b) explained why that was: it cost over $800 so few doctors prescribed it or patients took it.

That's why I include the next tip.

3. Ask your pharmacist.
Most local pharmacies have a consultation window. Use it. You may encounter a surly, unhelpful, rushed or uncommunicative pharmacist. All pharmacies and pharmacists are not created equally. Change pharmacies if you can to get a pharmacist who will help you and be a partner in your wellness.

You're going to cite insurance, time, convenience and a bunch of other obstacles to this if you're like me. Bah humbug to all of that. Most of us have at least a couple of convenient pharmacies and it is well worth the potentially extra few minutes to get a great pharmacist. I changed pharmacies yesterday for this reason. Why?

  • The first six I called just said regretfully they couldn't help me. When service providers imply "not my problem, can't help you" they are not a fit for me.
  • The seventh pharmacy also said they did not have my drug in stock but they said it like, "No, and..." so I listened.
  • That Walgreens pharmacist said she had a different dose and would call the doctor to see if they would alter the prescription. This was beneficial because it meant a smaller amount for my child to take at once and a solution to my problem, plus the bonus of both prescriptions at one pharmacy (versus my near capitulation to splitting them across town). So be aware you can tweak prescriptions, too. So ask.

When I arrived to pick up my prescription, and nearly fainted from shock, the pharmacist began talking to me about alternatives.

NOTE: Pharmacies are very good in my experience of being open about cost, so I strongly advise calling the pharmacy before walking away with a doctor's prescription to get an idea of both availability and expense.

The pharmacist asked for my daughter's diagnosis and, using that and the prescribed antibiotic, suggested four alternative drugs that were less than $50 for me. We called the doctor's office and were prescribed one of those four.

That leads me to my next tip.

4. Be an empowered patient and keep your own health records.
I had to deal with a lot of diagnoses, information, tests, test results, prescriptions and more. I had to carry information from one health care provider to another.

The more information I provide to one doctor from another, the less redundancy and the more targeted care can be.

I shared the nurse's screening to the specialist and the physician's assistant and back to the nurse. It was invaluable to be able to have all the information I needed at my fingertips. I could answer every question put to me. How? I recently downloaded and started using an app called PocketHealth.

This app lets me input my own and my family's health records. I started using it after I started working on the account--so I will be forthcoming about that. But I have truly come to appreciate it. Especially in the last week.

Once I started using it, it prompted me (umm, not literally, just mentally) to start asking for copies of tests, results, etc. I do need to input that information, but it's worth it to be able to track, manage, review and share the health information.

I tend to overwhelm myself and think I need to start at the very beginning. In this case, I started in the middle. I'd been filling in the same health forms about four times before I wised up and realized I could input and re-use. So, my records start now and I can fill in as need be. I find time while waiting at kid events, for example.

Most of all, I can save money by not having to repeat the tests and save health (or life) by including important information such as my daughter's reaction to the antibiotic so we never get that one again (and don't they all sound alike). I can stop feeling guilty because I don't know the answers for what and when for our health care, quit feeling stressed about filling out forms or racing hither and yon to fetch records because I can't find them.

In conclusion...

I was frustrated that my doctor prescribed hard to find and overly expensive drugs. I was frustrated that they didn't know or care what hardship this would create for me. I felt guilty that money played a factor in health care for my children. I felt angry, too. I felt stressed and overwhelmed by the number of health hardships we faced all at once. I felt a little at sea with it all. However with the help of some good health care providers and technology, I found ways to solve problems and overcome that helpless feeling. I found the way to be an empowered patient getting both the care I needed at prices I could afford.


Jardinero1 said…
Great piece Julie. Looks like a really useful app.
Colleen Pence said…
Julie, this is a fantastic and incredibly helpful post. Thanks for sharing your experience. I'm bookmarking this for your tips and I'm installing PocketHealth right now.
Julie Pippert said…
Jardinero, thank you. Yes, the app has been really helpful. I immediately input the bad antibiotic and the good one. Unfortunately the bad one is 1/4 the cost of the good one, but it's safety not cost in this instance and I can NEVER remember drug names and times taken. Now I can track it. I am trying hard to be a smarter health consumer.

Colleen, thank you SO MUCH. That means a lot and I sincerely hope this is helpful for others.
Ed T. said…
Julie - thanks for the heads up on the app. I am using a different one, in conjunction with a bracelet (, but I totally agree that having this information WRITTEN DOWN so you can provide it when visiting a new place can be a real time (and life) saver.

Magpie said…
Of all the things that jumped out at me in this, I was insanely jealous that you ONLY have a $5000 deductible. Mine's $10K for me and my one child.
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