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Healthcare Priorities

Posted Aug 27 2012 1:41pm

August 27, 2012

Patient “M” is thirty-something and I have been caring for her for years.  She is a very hard working, responsible adult with a lot on her plate.  As with so many young adults, she is financially strapped, over worked, and overwhelmed with the transition to adulthood.Patient “M” needs to see the gastroenterologist for an esophagogastroduodenoscopy (EGD).  She has chronic acid reflux which, while controlled by over-the-counter (OTC) medication, needs to be monitored.  An EGD costs approximately $2500 and Patient “M” has a $2500 deductible insurance policy.  When I asked her why she had not scheduled the test, she started listing a litany of things she has to do and asked me to write an article on managing priorities.Patient “M’s” car needs repairs and has student loans that need to be repaid.  She has rent and utilities payments.  She needs winter work clothes and a new washer to clean them.  She works 60 hours a week but is paid for 40 hours.  She has family responsibilities.  She has priorities; and, since the OTC medication is working, an EGD is not a priority.Where on your list of priorities is your health?  In my experience, healthy people fail to appreciate being healthy.  Health is low on their priority list.  Unhealthy individuals keep health as their number one priority until they feel better, then move it down the list.  Patients who have lost their health or suffered a cataclysmic event move their health to the number one slot and keep it there.  Unfortunately, health stays their number one priority because they never quite get their health back.So, what should “M” do?  How should she prioritize her EGD?  OTC meds for reflux are capable of hiding significant underlying disease.  Barrett’s esophagus is a precancerous condition of the esophagus caused by chronic acid reflux.  Esophageal cancer is devastating and often lethal.  “M” has had reflux for years.  While her OTC medication controls the symptoms, “M” is at risk.  “M” needs to move her EGD towards the top of the list.  She needs to talk to the gastroenterologist about a sensible payment schedule.  She needs to take the time off of work and make sure she stays healthy.While her other responsibilities must be met, if she loses her health, she loses everything.  As a doctor, I think health should always be your number one priority.  Without your health, you cannot care for your parents or children.  Without your health, you cannot work a 60 hour work week.  Without your health, whatever wealth you accumulate is worthless.Live “Wellthy”.  Establish a healthy lifestyle when you are young and protect your most valuable asset.  Remember, the life you save maybe your own.
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