Money-Saving Tips for Prescription Medication

Consider these additional tips to save money on your prescriptions. Most of these helpful suggestions will work for anyone—in other words, no need to qualify to make most of these tips work for you.

1. Talk to Your Doctor. Tell your doctor if paying for prescription medication is a problem. He or she may have free samples or can tell you about other resources available.
2. Stop Taking Redundant Medication. Talk to your doctor to see if you still need to take all of the medications you are taking. Stopping a medication that is no longer useful is better for your health. It also saves you money.
3. Buy Generic. The generic version of a medication is usually a lot cheaper. In 2004, the National Association of Chain Drug Stores reported that the average price of a generic prescription drug was $28.74, while the average price of a brand-name prescription drug was $96.01—that’s three times more expensive! Be sure to discuss this with your doctor to find out if a generic version of your medication is right for you.
4. State-Sponsored Drug Assistance Programs. Check to see whether you are eligible for drug assistance programs in your state. Go to NeedyMeds.com to see what programs your state has at http://www.needymeds.com/ state_programs.taf
5. Senior Citizen Discounts. If you are a senior, be sure to ask your pharmacy for any senior discounts available.
6. Organizational Discounts. If you belong to an organization (like AARP), be sure to ask your pharmacy for any discounts available.

Additional Resources for Saving Money
The Web sites listed here all offer valuable information to help you find ways to save money on your prescription medications.

1. www.crbestbuydrugs.org/ This site contains important information from Consumer Reports about saving money on prescription drugs.
2. www.needymeds.com This site lists information about state programs, discount drug cards, federal poverty guidelines, and patient assistance programs and also includes copies of the forms.
3. www.helpingpatients.org This site has resources for patient assistance programs run by the Pharmaceutical Research and Manufacturers of America.

Written by: Jeffrey B Brown, MD. FACP

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How to Find the Best Doctor for You

Taking care of your health is a life-long job. It is a job that is 100 percent your responsibility. But you must not overlook the importance of picking a smart, reliable, and caring health care team to give you guidance, insight, and support in meeting your health care needs. Your health care team will include a primary care doctor or nurse practitioner, specialists, pharmacists, and other health practitioners.

This article was written to give tips, strategies, and evaluation tools to help you build an all-star health care team.

Picking the Best Team Captain

Every great team needs a great leader. Your health care team captain will be your primary care doctor or nurse practitioner. She will be the person you go to see first when health problems arise. She will act as a wise dispatcher sending you to see the appropriate specialists if your health condition requires it. If you already have a primary care doctor or nurse practitioner that you are happy with, that’s great! If not, here are some suggestions for how to find one.

Where to Look
The “best” team captain for you may not be that Harvard or Johns Hopkins trained doctor in the community, especially if this person is too busy or unable to relate to you. The first step to take in your search for Dr. “Right” is to ask around. Ask friends, family members, co-workers, or anyone else for good referrals. Certainly if you know someone in the health care field, go after them first for referrals. Also consider using the Internet in your search. Try going to www.familydoctor.org, www.healthfinder.gov, and a host of other Web sites on the Internet to help you find a potential doctor.

What to Find Out
Do some research on your own. Then, schedule a chat with your potential new primary care doctor. Look for answers to the following questions to convince yourself that he or she is the right health care provider and team captain for you.

1. Is she board-certified and licensed in my state? This is a simple question to ask the doctor directly or office manager. A board-certified doctor is a doctor who has passed exams in a certain medical specialty. If you have access to the Internet, go to the American Board of Medical Specialties at www.abms.org or call at 1-866-275-2267 to check for yourself if the doctor is board certified. To find out if your doctor is licensed to practice medicine in your state go www.docboard.org and click on your state medical licensing board.
2. Is this doctor accepting new patients? The best doctor in the world won’t do you any good if you have a medical need, but you can’t see the doctor for six months to a year. But if you have time to wait for that special doctor who comes highly recommended, be persistent. Call his or her office periodically to find out if the doctor can accept you as a patient. Persistence usually pays off!
3. How many days of the week does the doctor see patients? You want a doctor who at least sees patients three days a week. There are some great doctors who are very involved in important clinical research, management, and other professional activities. These non-patient-care responsibilities can unfortunately get in the way of you having access to them when you need to.
4. Where did the doctor go to medical school and residency? You want to find a doctor who went to an accredited medical school and residency program. Medical schools and residency programs have to meet certain academic standards to be an accredited program.
5. Is this doctor considering retirement or relocation soon? Ideally you want to find a doctor who’s going to be practicing in your area for a while so a long-term relationship can be established. Going through the trouble of finding a great doctor then having to go somewhere else in a few years can be very painful and unhealthy.
6. Does the doctor accept my health insurance? This is a simple and obvious question to ask. Clearly, you do not want to be stuck with a large bill just because someone at the front desk forgot to tell you that they do not accept your type of health insurance.
7. Is this doctor known for spending quality time to ensure that the patient understands his or her health problems? This question is so important. If your health care provider does not take the time to explain, in simple terms, your health problems to you, how can you help manage them? Remember the day-to-day care of most health problems is mostly the patient’s responsibility. So, you really need to get an understanding of what’s going on from your doctor.
8. Is this doctor able to relate to a person of my ethnic background? We all do not come from the same cultural background, share the same struggles, or interpret the world in the same way. Because of these differences, many misunderstandings can occur between two people who see and deal with the world differently. It is important to find a health care provider who understands who you are, where you are coming from, and how you express yourself.
9. Does this doctor speak my natural language? The importance of your health care provider being able to speak your primary language needs no explanation. Two people trying to work together on the same problem with a language barrier between them is usually non-productive.
10. Does this doctor see patients at my preferred hospital? Ask your doctor directly—or ask the office manager—at what hospitals does he or she have privileges to treat patients. After living in any city long enough, you will learn what hospitals you prefer, and what hospitals to avoid at all costs. Most doctors only see patients at certain hospitals, and if you end up in a hospital where your doctor does not have privileges to see patients, you will be on your own with a brand new doctor at your sickest moment.

Also, find out from your primary care doctor, in advance, who will be following you if you need to be in the hospital. A relatively new trend in health care is for some primary care doctors to not follow their patients when they need to be hospitalized. Instead, a hospitalist treats the patient and communicates with the patient’s primary care doctor during the hospital stay. A hospitalist is a physician who practices in the hospital and usually does not have a private practice. The care that hospitalists provide in the hospital can be good because they are very experienced in treating acute illness. But of course, he or she will likely be a doctor that you have never met before.

Tools for Choosing a Physician
Sometimes, just knowing how to do something or knowing the right questions to ask is not enough. We often need tools to go along with our know-how. Download the tools below (Q&A List: Choosing a Health Care Provider, Post New Doctor Visit Quiz, Doctor’s Visit Worksheet) to help sort out all the details that you’ll gather on your search for the best doctor. 

Download Free Doctor Search Tools

Written by Jeffrey B. Brown, MD, FACP

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Protect Your Rights as a Patient with Advance Directives

You have the right to choose what kind of health care you want—to determine what happens to you if you’re sick and unable to communicate. In addition, you have the right to determine what should happen to your body parts after you leave this world. These decisions can be made by completing something called advance medical directives.

In short, advance medical directives tell your loved ones what to do. They’re legal documents that allow you to give directions for your future medical care. There are two general types of advance directives: a living will and a durable power of attorney. It is important to know that these advance directives apply only to your medical care. They do not apply to your financial affairs. Please note that the information here is general. Because laws and regulations vary from state to state and are subject to change, the information in this chapter cannot take the place of legal counsel.

Living Will
A living will explains your wishes. This document is a set of written instructions that explain your wishes for the medical treatments you do want and don’t want if you become unable to speak for yourself. It’s important to understand that a living will is limited. It only becomes effective if you are terminally ill or in an irreversible coma and are unable to communicate. A living will specifically outlines your wishes if you find yourself in this type of condition.

Durable Power of Attorney
A durable power of attorney for health care puts someone else in charge. This document lets you name a person (an “agent” or “proxy”) to make your medical decisions if you’re unable to do so. This document may also be called a “health care proxy.” A durable power of attorney as opposed to a living will can apply whenever you are unable to communicate your own medical decisions, due to any illness or injury. In addition, your agent or proxy who knows your concerns can respond to situations that a document cannot address.

You Need Both
Every adult should prepare advance directives—both a living will and a durable power of attorney for health care. Basically, advance directives help protect your rights in the event that you’re unable to state your wishes. They give specific directions for your medical care by letting the medical staff know what medical procedures you would or would not want.

Tragically, an accident or illness can take away a person’s ability to make health care decisions. The trouble is that decisions still have to be made. If you cannot make those decisions, someone else will. As unfortunate as the Terri Schiavo case was, it taught us all a valuable lesson. In this case, the federal government intervened in a private medical matter because there were no clear directives. What became clear was the necessity of completing advanced directives—even if you are young.

Please consider taking steps to control these decisions now, so that they will reflect your own wishes in the future. Do so by preparing both a living will and a durable power of attorney for health care.It is important to note that you will still receive high quality care, even if you refuse life-prolonging measures within your advance directives. Even if you decide to refuse measures that will prolong your life (contained in ado not resuscitate order), the healthcare staff will do everything they canto get you well, except resorting to measures that prolong life, such as cardiopulmonary resuscitation (CPR), respirators, feeding tubes, and dialysis.

You can print out, for free, advance directives specific to your state at www.caringinfo.org or call at 1-800-658-8898.

Advance Medical Directives Tips
Here are some brief, easy-to-reference tips for advance medical directives.

• Plan to review your directives if moving to a new state.
• Sort out your feelings and beliefs. Make sure your advance directives reflect the values you live by (what’s most important to you)—for example, the way you feel about death, dying, pain, and suffering, as well as your moral and religious beliefs.
• Talk about these issues with people who matter to you the most: your spouse or partner, family members, friends, clergy, and heath care provider(s).
• Choose your proxy (agent) carefully. Be sure that he or she is totally committed to carrying out your wishes. Also consider naming a backup proxy in case your first pick is unable or unwilling to carry out your
  wishes.
• Change your proxy (agent) if you need to. Consider naming an alternative proxy in case your proxy moves, becomes ill, or dies.
• Get your directives reviewed before signing. Before you sign your advance directives, ask your proxy and health care provider to review your documents with you.
• Be sure to have your forms witnessed or notarized if required by your state.
• Keep the original forms in a safe, easy-to-reach place (such as your Health Power 101 Organizer). Give copies to your proxy, health care provider, hospital, nursing home, or anyone else who might be called in an emergency.
• Plan for an emergency. Keep a card in your wallet stating that you have advance directives and where they are located. (Your advance directives are included on your Wallet Health ID Card™.)
• Change your directives, if you need to. Be aware that you have the right to change your advance directives at any time, even if you’re in the hospital, as long as you have the capacity to understand your health condition and the consequences of your choices and able to express your wishes. If you do change them or revoke them, be sure to destroy the old copies and tell your doctor and anyone else who has a copy of your advance directives.
• Review your directives every five years so that they always reflect what you want.
• Always travel with your directives. Your advance directives will likely be valid in other state.
  

Common Terms Used in Advance Directives
As you consider preparing an advance directive or as you try to work with your loved one, it’s helpful to have an understanding of the terms frequently used in these documents.

Here they are:

• Cardiopulmonary resuscitation (CPR). Procedures to restore stopped breathing and heartbeat: artificial breathing, chest compressions, and electrical heart shocks.
• Coma. A sleep-like state from which a person cannot be awakened.
• Do not resuscitate (DNR) order. An order signed by a physician to prevent CPR from being performed.
• Irreversible brain damage or disease. Permanent changes that affect a person’s ability to think and communicate.
• Life-prolonging measures. Any treatment or procedure to extend life, including artificial nutrition/hydration, respirators/ventilators (machines to keep patients breathing) and dialysis (a special procedure that uses a machine to clean the blood when the kidneys are not working properly).
• Palliative care. Measures to relieve pain and suffering, but not to cure.
• Persistent vegetative state. A permanent coma.
• Terminal illness/terminal condition. A condition in which the patient is expected to die within six to twelve months.
  

Written by Jeffrey B. Brown, MD, FACP

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