I went to a urologist a couple years ago. He examined me and told me he was 85% sure what I had was not serious and would resolve on its own. However, if I wanted to be 100% sure, there was an in-office test ($450) and an MRI ($350) that he could order for me. I got the feeling he was probably really 95% sure I was fine. The urologist likely offered additional tests out of defensive medicine and the fact that some patients desire more care than others. I was cash pay so I opted out of it.
The website Get Pocket republished an article on how to prevent unnecessary medical care. Estimates vary but by most accounts 30% of medical care is unnecessary, wasteful or downright harmful. That’s a significant percentage considering many people have high-deductible plans that require thousands of dollars in care before health plan benefits kick in.
I often tell people to let your doctor know you are price-sensitive and you have a high-deducible heath plan. I’ve even had doctors ask me what kind of health insurance I have. One dermatologist changed his demeanor when he realized I had a $5,000 deductible even for drugs. I welcomed his help keeping my bill down. It later dawned on me that if I had first dollar coverage my care could have been more invasive and expensive. I had simple eczema from winter dry skin so it wasn’t like my condition was life threatening. Upon hearing my deductible he said something like, “Oh, I don’t think we need a biopsy then.” At the time I decided not to mention my HSA lest he change his mind on my treatment.
Health Pocket suggests asking your doctor four key questions to avoid care you don’t likely need. I’ve found that doctors often welcome my input because some patients want anything they can possibly get, while others would rather wait and see if it’s necessary. Let your doctor know your thoughts.
The first question is a blunt one:
“Doctor, is this really necessary?”
Oslo neurosurgeon Christer Mjåset, vice president of the Norwegian Medical Association, says that he experienced a jolt when a woman asked him this question, he recalls in a TEDxOslo talk. It was a first in his career — he’d never had a patient say this to him.
It occurred after Mjåset suggested spinal surgery to her; she was troubled by intense pain caused by a herniated cervical disc. While he’d performed this procedure many times before, it did come with risks — with paralysis from the neck down being one of the most serious. This led the patient to ask: “Doctor, is this really necessary?”
“You know what I realized right there and then?” Mjåset says. “It was not.”
Dr. Mjåset realized his motives were largely driven by enthusiasm for his work. Surgery was the most enjoyable part of his job. In the United States, surgery is far more lucrative for a surgeon than merely counseling patients one-on-one. That creates an incentive to operate.
The other questions patients should ask their doctors:
What are the risks?
Are there other options?
What happens if I don’t do anything?
These are all great questions. Furthermore, they are great questions regardless of your health insurance deductible. For example, patients with back pain often opt for surgery when physical therapy is equally effective. They don’t know they have options because they didn’t ask about them.
6 thoughts on “Ask Your Doctor Four Questions to Avoid Unnecessary Care”
Devon, in the future the doc will know you have an HSA because everybody will have them. But the name is changing to Health FREEDOM Accounts or HFA. Goodman better hurry if he wants to get tax-free HFAs taxed like a Roth because AFTER they raise the Annual Maximum Deposit from $3,850 in 2023 to $12,000 for a single and $24,000 for a COUPLE. The public will NEVER let them be taxed again. Which is different than current law as a single-parent may have FAMILY Annual Maximum Deposits.
Personally, I think they should leave it where single-parents could have the larger Family Deposits. What if a single parent has 5 children? We want to encourage children in America because we need future tax payers. But, the change clearly is a “Joint Tax Return” qualifies for the larger Annual Maximum Deposits.
The Catch-Up Clause for individuals over 55 increases from $1,000 to $5,000. So someone 55 years old or older may deposit $17,000 annually and couples may stash $34,000! Of course a single parent over 55 would have a Maximum Annual Deposit of $29,000.
People over 65 and on Medicare could have a HFA and an MSA! That means the Annual Maximum Deposit is $40,000 combined for the combination MSA and HFA. People will work longer to have employers make deposits into a tax-free HFA. What ever you have in your HFA at 65-years-old is not enough no matter how much you have. We will be able to say that for quite a while. Of course a 25-year-old couple stashing $24,000 away annually will have the opportunity to amass an amazing sum because of 40 years of compounding.
Remember, 65 is young in a 21st Century lifespan for some. I assume a majority of 25 year old women will live to be 100 if they don’t smoke or drink in excess.
Your health is good Devon and you don’t drink too much so maybe your wife will die before you. Probably not if she is a yoga girl. But if you are single and 100 years old with $50,000,000 in your HFA don’t think those 65-year-old women want to marry you for love. It’s money!
Ron you just reminded me I should make an HSA deposit before the year ends.
You can wait until 4/15/23 for a 2022 deposit. We used to get a ton of frantic self-employed people in April screaming that their accountant told them they had to spend all the money by 12/31. We just told them to not pay any attention to your CPA. He is confused with a Flex SPENDING Account. We had the National Account with 7-Eleven Stores at the beginning of MSAs. I was enrolling them in January of 1997. I remember Foreigners 7-Eleven Franchisees call frantic about their CPA’s advice. I just made my wife talk to them. She could understand what they were saying. I stopped selling to them because of the language problems. They just couldn’t understand TAX DODGE like an American.
Devon, if we play our cards properly we can end up with tax credits and larger HFAs that health insurance is a Qualified Medical Expense. That is really changing the amount of money being dedicated to retirement healthcare expenses. Trust me, put all your money into Allstate and sell United Health Care, Centene, Anthem etc. Those New Mexico people need HFAs bad. Too much Medicaid.
I just realized there are two more questions patients should ask: are you employed by the hospital? Do you work for or a partner of a practice owned by private equity?
Devon, I’m so glad you wrote this! This week I had a doctor’s office attempt to book me in another in-office visit just to move a date on a referral to one that the other doctor would accept. I told them that was unnecessary and a product of a flawed system pushing flawed incentives on them so to not take it personally that I couldn’t go along with it. They changed the date without a visit. :). But what a systemic mess.
Devon, I did a google search on “Tax-Free HSA” and this article was 1st. We are leaders Devon!