Archives For healthcare costs

$600 vs $8

October 1, 2012 — 1 Comment
A photo of doctor orders for Advil

Really? After the $600 MRI co-pay…an $8 Advil treatment is prescribed?

So I go to my orthodpedist for recurring pain along my left tibia. I was thinking: shin splints. Nothing major, but I’m in enough pain that walking and jogging is ouchy and it’s been getting worse for the past few weeks. Doc orders an in-house x-ray. Appropriate -yes?

It proved to be inconclusive (no apparent stress fracture, etc.). Whew!

Doc: “But given your sensitivity Ashley…(when he touches my leg the pain is so intense that I jump)…I’m not sure.”

Doc: “In fact given your history, I have to ask you: when is the last time you had blood work done?”

My history is breast cancer. I’m four years past the diagnosis and treatment but cancer (really any kind of cancer), is always lurking. Remission is not a cure. So of course I interpreted his follow-up question the way so many people in my shoes do: I assumed the worst. Bone cancer maybe?

Next thing you know he is recommending a STAT MRI – apparently the only way to get a clearer view of not only the bone, but the tissues around the bone. I agree. Make the appointment. Get to the MRI facility the next day. Pay the deductible (gulp). And spend an hour enjoying the “bang, bang, bang, bang, bang, bang” of the tunnel. The following day I’m back in my doctor’s office after two consecutive nights of no sleep.

Verdict?

Doc:  “Inconclusive. So I think what we’ll do is start you on some Advil with some PT to strengthen some of the surrounding leg muscles. Then we’ll see how you do for the next few weeks.”

 <A slew of vitriol followed. Edited for clarity (and scrubbed of obscenities) my message was simple, if not loud. Really loud.> 

Me:  “Why would you scare me into an MRI instead of STARTING with the conservative treatment of Advil and physical therapy? Or let me put it another way: Why did I spend north of $600 in co-pays and deductibles, when I could have spent $8 for a bottle of Advil?

To be honest, I don’t remember the rest of the conversation because I was so mad. I was escorted to the check-out window by a PA who was called to help “calm the patient.” And where I paid my bill,I declined to make a PT appointment because I can Google “exercises to strengthen calves/shins/ankles” for free thanks. And I’ll be damned if I’m giving that practice any more of my money.

I rode my broom all the way home in a fog of red, I was so pissed.

Truth is, I’m most angry at myself. I should have questioned the MRI order. I know better. I’ve been working in healthcare for 25 years. I know how this works! I know all about unnecessary testing, etc. I should have asked for alternatives and options. should have asked him what he thought the possible causes were. Shoulda, coulda, woulda.  

Lessons Learned:  1) As patients we share responsibility in controlling healthcare costs. If tests sound excessive – ask questions. 2) If you have a pre-existing condition – don’t allow that as an excuse for a provider to leap-frog over a common-sense conservative approach straight to high-dollar diagnostics.

P.S.  Happy to report that four days later: $8 worth of Advil seemed to work.

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