With health care costs rising and more data than ever available to analyze the care people seek, there’s a growing focus on stopping wasteful medical spending.
It’s not just a concern for policymakers or those without health insurance. Even Americans with health coverage are paying more out of pocket thanks to the rise of high-deductible health plans.
A recent study from the Washington Health Alliance found that in one year, Washington residents received $282 million worth of screenings and procedures that were likely unnecessary.
We talked to primary care and public health doctors in Spokane and looked at recommendations from the U.S. Preventive Services Task Force, Choosing Wisely and other consumer-focused health care sites to come up with a list of common places money can be wasted in health care – and some changes you can make if you’re interested in being healthy while getting the most bang for your buck.
Think twice about getting imaging
Whether it’s an x-ray or MRI, looking inside your body can cost hundreds or thousands of dollars and exposes you to radiation. Those are both good reasons to avoid scans that aren’t absolutely necessary.
Patients sometimes think imaging will help provide a treatment plan or diagnose a condition, but often that’s not the case. Doctors can do tests on ankle injuries to determine if an x-ray is needed, for instance.
Lower back pain is a particular area where unnecessary scans are common, even though the best treatment plan is to start with hands-on work like physical therapy, massage or even yoga.
“It’s very evidence-based and works,” said David Ward, a family medicine doctor at Kaiser Permanente’s South Hill clinic. If those steps don’t resolve symptoms, then imaging might be necessary.
Colds and sore throats (usually) don’t need antibiotics
Most people know antibiotics are overprescribed, and that it’s a problem which contributes to drug-resistant bacteria. But people still request antibiotics from doctors for illnesses caused by viruses, which will clear up on their own.
While strep throat is a bacterial illness, most other causes of sore throats are viral.
“Strep throat is a childhood (and) adolescent illness and is uncommon in adults,” wrote Dr. Bob Lutz, health officer for the Spokane Regional Health District. Adults who are concerned about having strep should get a throat swab before seeking drugs.
Similarly, there’s a myth that green, yellow or brown mucus during a cold-like illness is a symptom of a bacterial infection, Lutz said. Both bacteria and viruses can cause those symptoms, and other details about the onset and duration of illness are more telling.
Bottom line: check with your doctor if you’re not getting better on your own, and don’t pressure them into prescribing antibiotics.
Rethink “better safe than sorry” for screenings
Whether it’s checking for cancer or having blood work done, many medical screenings patients seek out of caution aren’t needed and can cause unnecessary stress and expense.
Guidelines for things like Pap smears and colonoscopies change as medical science advances, and it can be hard to keep track. Your doctor should know what’s current, but there are also consumer resources to help.
The U.S. Preventive Services Task Force looks at medical research and evidence and issues guidelines for screenings and other treatments based on how well they work. Their recommendations for consumers are online at uspreventiveservicestaskforce.org.
Choosing Wisely, a national initiative trying to curb medical waste, also has patient guides online at choosingwisely.org.
If you’re generally healthy and not taking medications that require regular testing, you can probably skip regular lab work to check things like cholesterol unless your doctor suggests otherwise.
“If they’re not recommending certain blood tests, that’s a good thing,” he said.
Save the ER for emergencies
Hopefully it’s clear from the name that emergency rooms should be reserved for medical emergencies. But what counts, and what happens if you’re not sure where else to go?
Many medical groups and health insurance companies offer phone lines you can call, 24 hours a day, if you’re not sure whether your situation is a medical emergency. If you have a primary care doctor, you can also call their office for advice or help.
People without health insurance often seek out emergency rooms for care because they can’t be turned away. Patients with other options will receive faster and more cost-effective care elsewhere, however.
Some things that seem like emergencies can be treated at urgent care centers, including simple broken bones. Spokane and Spokane Valley have a program called Ride to Care that can take you to an urgent care center free of charge if you call 911 with a condition that doesn’t require emergency room care.
Keep it generic
For both prescription and over-the-counter medications, generic drugs work just as well as their brand-name counterparts, Ward said.
That’s the same line discount shampoos and off-brand snacks use to sell their products, but for drugs, it’s backed by the FDA. The acetaminophen in the store brand works just as well as the acetaminophen in Tylenol.
Drug companies come out with new or cutting-edge drugs too, and those may be what you need. But if you’re taking name-brand drugs and generics are available, it’s worth asking your doctor about.
“I would ask your clinician which of your meds could be changed to generic and still be right for you,” Ward said.
As for what to do more when it comes to health? Most doctors say their patients don’t need more tests or screenings. Instead, they cited lifestyle choices.
Exercise, even if it’s for a few minutes
Research has shown exercise is good for you, even in tiny amounts.
If a gym is daunting or you’re self-conscious or unsure, find something easy you can work into your life: a short walk, taking the stairs at home or work, or even turning on your favorite song and dancing in the privacy of your own home.
“If it’s just two minutes a day, commit to that and it’s so much better than zero minutes for your health,” Ward said.
Don’t go on a trendy diet. Just eat healthy.
Trying to crash diet or lose weight rapidly isn’t healthy. Focus on picking healthy foods and changing your lifestyle gradually instead.
There are many different schools of thought on healthy eating, but most agree on a few basic things. Eating less added sugar is a good idea, and most of us would benefit from more fruits and vegetables.
Ward suggests picking a plan that resonates with what you like to eat and sticking with it, whether that’s a paleo diet or just trying to cook more from scratch. And many doctor’s offices have nutritionists you can seek help from if you’re not sure where to start.
Good relationships can save your life
Harvard researchers have spent 80 years studying a group of men who were sophomores at the university in 1938. Though that group isn’t representative of the whole U.S., it has given scientists some surprising insights into living a long life.
One of their biggest findings: quality relationships have a huge impact on health and longevity. For the men in the study at age 50, satisfaction with personal relationships was a better predictor of physical health than cholesterol levels.
Spending time with family, friends, a community group or even your pet might be one of the best things you can do for your long-term physical and mental health. And in most cases, it’s free.
Have a doctor, even if you don’t need one right now
Even if you’re young, healthy and think you’re invincible, you should have a doctor.
That doesn’t mean you need to see them every year for a check-up if you’re doing well. But being tied in to a doctor’s office means you’ll get reminders about preventative care you need, and gives you a place to go if something happens.
Without an established relationship with a doctor, patients may have a harder time getting an appointment when they need one, or feel they have few options besides the emergency room.
And your doctor should be someone you trust and feel comfortable asking questions of. It’s perfectly okay to ask them how much a test will cost and what other options you have.
“This is their body, their health, their life, and I’m a coach and a cheerleader,” Ward said.
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