Monday, 11 July 2016

Health Care - How to Manage

Consider the case of a middle-aged executive from the New York City area who experienced chest pain. He went to a cardiologist, who ordered a full workup, including a CT scan of his chest. The scan found no heart problem, but at the edge of the film the radiologist noticed "something funny" in the neck area. A neck surgeon performed a biopsy and found nothing wrong. The cardiologist then performed an angiogram to look for abnormalities in the blood vessels. Complications from that procedure landed the executive in the hospital for a brief period. By the time it was over, his bills were more than $150,000 and he still had no diagnosis. Eventually the pain disappeared on its own.

Months later, when the executive's chest pain returned, he told his medical history to an internist who asked him what he was doing at the time. "Oh, we started gardening again," the man told him. It turned out that overzealous use of his string trimmer had strained a chest muscle, a condition that required no treatment other than an over-the-counter pain reliever. None of the high-priced specialists had considered muscle strain, a common condition often mistaken for heart pain.

General Physicians are trained to manage the "whole person," who can help keep seriously ill people doing well and out of the hospital. Consider Conservative & Palliative treatments before opting for risky, expensive & painful radical and extraordinary treatments.

  • Conservative treatment is aimed at preventing a condition from becoming worse, in the expectation that either natural healing will occur or progress of the disease will be so slow that no drastic treatment will be justified. It is designed to avoid radical measures or operative procedures. 
  • Palliative treatment is designed to relieve symptoms, and improve your quality of life. It can be used at any stage of an illness if there are troubling symptoms, such as pain or sickness.
  • Radical treatment is vigorous treatment that aims at the complete cure of a disease rather than the mere relief of symptoms. 
  • Extraordinary treatment is usually highly invasive and might be considered burdensome to the patient.
Radical medical care can lead to more pain with no gain. Though the idea that more health care is better seems to make sense, none of the above necessarily helps you live better or longer. In fact, too much medical care might shorten your life.

What you can do:

  • If you have a choice, consider using a General Physician or Specialist Doctor attached to a hospital who practices conservative care.
  • Work with your General Physician, or the specialist in charge of your specific condition, on preventive measures that can help you avoid unneeded hospitalizations.
  • When hospital stays are needed, try to ensure that a family member or friend is there whenever possible to monitor the patient's care.
  • For tests, ask: Will this test change the way you treat the disease? If not, what is the benefit of doing it? Is this test likely to lead to follow-up tests, biopsies, or other diagnostic procedures? How will this benefit my health?
  • For treatments, ask: Is this likely to extend my life, and if so, for how long? How do its side effects and risks compare with the symptoms and risks of my disease itself? What will happen if I do not have the treatment?
  • Develop a good, long-term relationship with a your General Physician. When medical problems arise, ask this doctor or your main specialist to coordinate all of your treatment.
  • Keep and update your own medical record. Whenever you get care from any other doctor, hospital, laboratory, or clinic, have a record of it sent to your General Physician and to yourself.
  • Keep an up-to-date list of all your medications, including prescription drugs, over-the-counter drugs, and dietary supplements. Include brand and generic name, dosage strength (such as 10 mg), and dosing schedule (such as once a day). Note any drugs that have caused bad side effects.
  • Don't be pressured into agreeing to invasive life-support treatments, such as feeding tubes, without a thorough discussion of the patient's prognosis, personal preferences (if known), and overall condition.

Health Insurance Policy covers hospitalization expenses* for 24 hrs or more only, with some exclusions during first two years. Make sure to buy family policy for Rs.2 lakhs or more (max. Rs.5 lakhs) and renew in time every year.

Finally, branded medicines are very very expensive in India. Most common medicines are available as Generic Medicines, 20-40% cheaper than branded medicines, and are available in Generic Medical Stores.

* Hospitalization expenses nowadays amounts to a lakh of rupees even for minor procedures in private / corporate hospitals.

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