For many Americans, controlling healthcare costs is continually top of mind. But, health experts warn that you should never skip doses of prescription medication or take a smaller dose than prescribed in order to save money.

Unfortunately, not everyone follows that advice. A 2019 report from the Centers for Disease Control and Prevention (CDC) revealed that over 11 percent of Americans aged 18 to 64 have admitted to not taking their medicine as prescribed in order to save money. Among uninsured adults, almost 34 percent said they were less likely to take their medications as prescribed due to cost concerns.&nbsp;&nbsp;

&ldquo;If you&rsquo;re not taking your prescription, it can&rsquo;t work for you. And if you&rsquo;re taking it at less than the prescribed dose, it could be working for you less,&rdquo; says Keith Roach, MD, associate professor of clinical medicine at Weill Cornell Medical College in New York City. &ldquo;If you are taking an antibiotic or antiviral medicine&mdash;when it is at the right dose in your body, it keeps the bugs from growing. But once that level gets too low, then they have a chance of learning how to defeat the medicine you&rsquo;re taking.&rdquo;

In addition, skipping doses or only taking a partial dose can have other negative consequences, including increased visits to the emergency room and hospitalizations.

Strategies for reducing costs 
The next time you&rsquo;re thinking about how to <a href="https://www.sharecare.com/health/financial-planning-health-care/slideshow/worst-case-scenario-cant-afford-meds">reduce your drug costs</a>, use one or more of these strategies&mdash;before your health ends up paying the price.

Be informed. Your doctor may not be aware of your medication coverage. Look at your health insurance plan website or ask your pharmacist about preferred tier medications. Then share that information with your doctor. &ldquo;Your doctor wants to help you and work with you to figure out a way of using your benefits to the maximum,&rdquo; Dr. Roach says.

Use generics. Ask your doctor to write a prescription for a generic substitute, if possible. Keep in mind that there are a few instances where a brand-name medication is necessary. If you have a concern about the medication prescribed to you, talk to your health care provider.

Shop around. Drug prices vary by pharmacy, so do your homework and call around before getting your prescription filled. Use an app or website, such as <a href="https://www.sharecare.com/health/prescription-drug-medication-adherence/article/track-meds-save-money-sharecare">Sharecare</a>, to search and compare prices for your medications. And don&rsquo;t just think of pharmacies as sources. Many big box and grocery stores fill prescriptions at a lower cost. Consider mail-order as well. Many pharmacies and insurance providers will discount a drug if you order a 90-day supply. If you need medication for longer than three months, ask your doctor for an extended prescription. Do not rely on internet or foreign pharmacies, as they may sell counterfeit or dangerous drugs.

Seek help from the drug company. Contact the drug manufacturer to see if you qualify for an assistance plan for either low-cost or zero-cost medication. Many manufacturers also feature coupons on their website for brand-name medications. However, keep in mind that a manufacturer can stop issuing coupons without notice, so this may not be a long-term solution.

Ask, &ldquo;Do I still need this?&rdquo; Sometimes a person&rsquo;s medication profile needs a good cleaning, especially if you are prescribed medication by multiple doctors. Don&rsquo;t be afraid to speak up and ask your healthcare provider if you still need to take a certain medication.

Consider lifestyle changes 
In addition to prescribing the right medications, healthcare providers will often suggest lifestyle modifications to help with certain conditions and their symptoms. Suggested changes may include:

<ul>
	<li>Maintaining a healthy weight</li>
	<li>Eating a wholesome diet</li>
	<li>Beginning an exercise routine</li>
	<li>Practicing stress-relieving tactics</li>
	<li>Quitting smoking</li>
	<li>Getting enough sleep</li>
	<li>Reducing or eliminating alcohol</li>
</ul>

Taking the time to make your health a priority can also have a positive impact your wallet.

&ldquo;Treating any underlying condition through lifestyle can sometimes eliminate the need for medications and has so many other benefits,&rdquo; says Roach. &ldquo;Not only can it you save money, you can save side effects.&rdquo;

Even if you practice healthy habits, it may not eliminate the need for certain medications. Do not stop taking any prescriptions unless directed by your healthcare provider.

Keep an open dialogue 
If you are worried about the cost of a medication, don&rsquo;t feel embarrassed about speaking up. Your healthcare provider may not realize your financial limitations. They also may not know if you have poor coverage or no insurance at all.

&ldquo;Your physician can&rsquo;t help you if they don&rsquo;t understand what your situation is. They can help find a regimen for you that is something you&rsquo;re going to be able to afford,&rdquo; says Roach. &ldquo;It&rsquo;s much better to have a regimen you can afford and take every day than it is to be on a more expensive medication that you can&rsquo;t afford to take or that you take only intermittently.&rdquo;

Medically reviewed in July 2019.

Sources 
QuickStats:&nbsp;Percentage of Adults Aged &ge;18 Years Who Did Not Take Their Medication as Prescribed or Asked for Lower-Cost Medication to Save Money Among Those Prescribed Medication in the Past 12 Months, by Number of Chronic Conditions &mdash; National Health Interview Survey, 2018. MMWR Morb Mortal Wkly Rep 2019;68:990. 
Cohen RA, Boersma P, Vahratian A. Strategies used by adults aged 18&ndash;64 to reduce their prescription drug costs, 2017. NCHS Data Brief, no 333. Hyattsville, MD: National Center for Health Statistics. 2019. 
Medicare. &ldquo;Lower Prescription Costs&rdquo; 
UpToDate. &ldquo;Coping with high drug prices (Beyond the Basics)&rdquo;Centers for Disease Control and Prevention. &ldquo;How You Can Prevent Chronic Diseases&rdquo;

5 Ways to Pay Less for Medications

No one looks forward to a&nbsp;<a href="https://www.sharecare.com/health/managing-your-health-care/article/what-to-expect-in-the-er">trip to the ER</a>. And as an ER doctor, there&rsquo;s nothing better than making a patient&rsquo;s diagnosis and seeing her feel better after treatment. But you may be surprised to learn there are a few little things you can do to make the experience a little more bearable and, depending on your condition, speed you on your way:

1. Don&rsquo;t be shy about your problem. 
You will not embarrass an ER doctor or nurse. We have literally seen it all and heard it all, so&nbsp;<a href="https://www.sharecare.com/health/managing-your-health-care/slideshow/7-white-lies-can-harm-health">don&rsquo;t be afraid to open up</a>. Knowing all the details of your symptoms, when the condition started and what may have brought it on helps us give you the very best care.

2. Ask before you pee.&nbsp; 
If you have to urinate,&nbsp;<a href="https://www.sharecare.com/health/health-care-basics/slideshow/10-things-nurses-wish-their-patients-knew">check with the nurse</a>&nbsp;first to see if we&rsquo;ll need a sample. I frequently have patients on whom I want to check a urine test for infection, pregnancy or some other reason, but then find out they just urinated. This means we (including you) spend another two hours waiting until you have to go again. Save yourself the time. When you feel the urge, ask a nurse or wait until you&rsquo;ve seen the doctor.

3. Do not eat before you come to the ER.&nbsp; 
Some procedures require sedation&mdash;and that means not eating four to six hours prior. Obviously this can&rsquo;t always be controlled, but if you suspect you may need the ER, don&rsquo;t have a snack before you head out the door. And once you get there, skip the vending machine. I have literally had patients sit there waiting for time to pass just so I can sedate them and treat their condition or injury.

4. Bring your medication list.&nbsp; 
Some drugs cannot be combined, so before we begin treatment we need to know what you take, including any supplements. Time spent tracking down your meds can also delay your care.

5. If you&rsquo;d like privacy with your doctor, just ask.&nbsp; 
You can always ask family to leave the room. But if you don&rsquo;t feel comfortable doing so, here&rsquo;s your exit strategy: go to the bathroom (ask the nurse to take you) and tell him or her that you want them out but are afraid to say anything. Whenever a patient makes this request (the nurse will discreetly let me know), I ask family to leave and I&rsquo;ll take the blame. That way, patients get the privacy they need without blowback.

6. Being nice will get you everywhere. 
It&rsquo;s hard to be kept waiting, especially if you&rsquo;re physically uncomfortable and worried about your health. Understandably, you may have a short fuse. Which is why a patient who is nice and appreciative can be the exception to the rule&mdash;and inspire staff to go the extra&nbsp;extra&nbsp;mile.

Medically reviewed in June 2019.

6 Emergency Room Secrets

You may have been told to &ldquo;take it easy&rdquo; after your recent hospital stay, but it can be pretty hard to relax with medical bills piling up. Should you just (eventually) pay them? Make a pile and stash them away? Neither! The fact is that while going through medical bills is a pain, doing so can very likely save you money. Here are eight tips to review the bills as painlessly as possible &ndash; and find ways to cut your costs.

1. If you know you need surgery ahead of time. Make sure that the surgeon you&rsquo;ve been referred to is in-network and affiliated with hospitals covered by your plan. &nbsp;Those two steps alone can save you thousands of dollars. If you find that a number of local hospitals are covered, call their billing offices and ask for estimates on your procedure. Nearby hospitals may offer the same service for a much lower price. Ask your doctor if he or she has privileges at more than one hospital and if the procedure can be scheduled at the lower-cost option.&nbsp;

2. After your hospital stay. Expect to receive a flurry of bills from the hospital, your doctor, the surgeon and any specialists who treated you. You may not recognize all of their names or even remember having some of the procedures. But don&rsquo;t panic about the total amounts due on the bottom line. Most likely your insurance company hasn&rsquo;t processed these bills yet. The amount that you&rsquo;ll ultimately owe may be far lower once your insurer makes its contribution. In addition, your insurer can often remove expensive, non-billable items, like surgical equipment.

3. Get an itemized receipt. Bills won&rsquo;t always contain details on specific services and items that you were charged for. Now&rsquo;s the time to call or visit the hospital billing office and request an itemized hospital receipt, which will provide more complete information. It&rsquo;ll be long and may be a little intimidating, but the time you spend looking it over can help you save big if overcharges are found. If you don&rsquo;t understand it, make an appointment with a hospital financial representative. They can help explain unfamiliar medical terms and codes.

4. Pay attention to details. In reviewing the itemized receipt, you&rsquo;ll want to look for errors, double charges or fees from services that you didn&rsquo;t actually receive. You may not know &ndash; or remember &ndash; all the details of your stay, so request a copy of your medical record as well and compare the two documents side-by-side. If you find errors on the itemized receipt, contact a manager in the hospital billing office and request that they deduct the charge from the amount due, then ask for a revised statement showing that the corrections have been made.&nbsp;

5. Organization is key. Create a filing system for your paperwork and organize it by date. Insurance companies look up claims this way, so it&rsquo;ll help when you call with questions. Also, if you get multiple bills for the same thing, you&rsquo;ll be able to avoid repeat payments by realizing that new bills match paid or closed claims that you&rsquo;ve kept on file.&nbsp;

6. Total your out-of-pocket expenses. Now that you&rsquo;ve done your homework and know that the balances are accurate, you&rsquo;ll be able to make a plan for getting them paid off.

<a href="https://www.sharecare.com/health/financial-planning-health-care/slideshow/worst-case-scenario-cant-afford-meds" style="color: rgb(7, 130, 193);">Find out how to cut your prescription drug costs, too.&nbsp;</a>

7. Negotiate. If you&rsquo;re unable to cover your out-of-pocket costs right away, speak to the hospital financial services department. They may be willing to negotiate your balance due because it can be better for their bottom line if you pay an agreed-upon price, rather than letting your bill go to collections. They may price match if you tell them about lower prices at nearby hospitals, cut costs if you pay your bill upfront or agree to an interest-free payment plan that suits your budget.&nbsp;

8. Ask about your hospital&rsquo;s financial-assistance program. Every hospital has its own application and requirements for financial assistance. Usually, information about programs can be found on hospital websites. If not, ask customer service or a financial representative for details.

Finally, do not ignore your bills. Ignoring your bills won&rsquo;t make them go away, but tackling them head-on can help decrease stress over your finances. Once you get started, that pile of papers will begin to feel less overwhelming. Healthcare providers are much more willing to work with you&mdash;and less likely to send your bill to collections&mdash;if you call them sooner, rather than later.

Learn more ways to manage money worries.&nbsp;<a href="https://www.sharecare.com/health/family-health/quizzes/money-matters" style="box-sizing: inherit; text-decoration: none; color: rgb(44, 154, 204); margin-bottom: 0px;" target="_blank">Take the Financial Stress Test to check your stress levels and learn ways to reduce it.</a>

Rose Hayes, RN, BSN, earned her Bachelor of Science in Nursing degree from the University of Virginia. She has over seven years of inpatient clinical experience in the acute care of the elderly, pediatric oncology and palliative care, and served as a Frontline Leader at Vanderbilt University Medical Center. Rose is an associate editor and producer at Sharecare.

8 Ways to Cut Hospital Costs

Since the Affordable Care Act&rsquo;s (ACA) Health Insurance Marketplaces opened for business in 2013, many more people have been regularly shopping for insurance. The variety of options&mdash;and even <a href="https://www.sharecare.com/health/health-insurance/article/make-sense-health-insurance-coverage">the vocabulary</a> you need to know&mdash;can be confusing. So, let&rsquo;s start with the basics.

What types of health insurance plans are available? 
In the Marketplace, you may see these kinds of plans:

<ul>
	<li>Health maintenance organization (HMO): These plans generally pay for care only from a specified network of doctors, hospitals and other providers associated with the plan. Sometimes, even certain pharmacies are specified by your network, meaning you may have to pay more for medications you purchase at other pharmacies. You also need to see your primary care doctor before you can go to a specialist.</li>
	<li>Preferred provider organization (PPO): These plans cost more than HMOs, but you have more flexibility. In a PPO, you can see any provider that you want, although you will still likely pay more for those who are out of network. You also don&rsquo;t have to get a referral from your primary care doctor before going to see a specialist.</li>
	<li>Point-of-service (POS or POS HMO): In this arrangement, you can select a primary care physician (PCP) and see only those doctors to whom your PCP refers you, in which case this would act just like a normal HMO. But with a POS, you also have the option to see specialists without a referral or go to doctors out of the network. If you do so, you will be responsible for a much larger share of the costs, if not the full cost.</li>
	<li>&ldquo;Catastrophic&rdquo; health plan: These plans are the least expensive up-front, but you&rsquo;ll have much higher out-of-pocket costs if something bad does happen. You may have to pay thousands of dollars before your coverage begins. These plans also cover less preventive care. In the Marketplace, they are available only to people under age 30 and those with other special circumstances.</li>
</ul>

What are the different kinds of insurance costs? 
A mistake many insurance shoppers make is looking only at each plan&rsquo;s monthly premiums, ignoring the other costs that can add up. As you compare your health plan options, make sure to look at the following:

<ul>
	<li>Premium: The amount that you pay to keep your insurance, regardless of whether you&rsquo;re using it or not. Think of it as a monthly (or sometimes quarterly or yearly) fee. One of the benefits of the ACA is that insurance companies have to justify premium increases of more than 15 percent per year.</li>
	<li>Deductible: How much you have to pay for healthcare services before your health insurance starts to kick in. As a rule of thumb, the higher your deductible, the lower your insurance premium. Plans with high deductibles may be great for people who don&rsquo;t expect to have high healthcare costs. But if you do have a healthcare expense, then you&rsquo;ll have to pick up more of the tab until you reach the deductible.</li>
	<li>Copay: The fixed amount you pay for a healthcare service, usually at the time of service. For instance, you may have a copay of $35 to see your physician or $15 for a medication. You can often find these amounts on your insurance card. Typically, the copays are lowest for doctors in your network and generic medications, and highest for doctors out of network and brand medications. Usually, these payments do not count toward your deductible, but check with your insurance company.</li>
	<li>Coinsurance: Your share of the cost of a health care service. Usually, this is a percentage you pay after your deductible. So, for instance, if you&rsquo;ve met your deductible and have 20 percent coinsurance, for your next $100 healthcare bill, you&rsquo;d owe $20.</li>
	<li>Out-of-pocket costs: The amounts that you pay for your deductible plus coinsurance plus copayments add up to your &ldquo;out-of-pocket costs&rdquo; for the year.</li>
	<li>Out-of-pocket maximum: After you&rsquo;ve spent this amount, your insurance will cover 100 percent of your covered healthcare services. Maximums vary by plan, and some plans don&rsquo;t count copays, deductibles or coinsurance toward the maximum, so check this closely.</li>
</ul>

Where can I get insurance? 
If you do not currently have insurance, you can go to the <a href="https://www.healthcare.gov/" target="_blank">Marketplace</a> to see a wide range of choices, including both private and government-offered insurance. To help you sort out your options, the plans are organized by the level of coverage they provide. You can also find out if you&rsquo;re eligible for any discounts on premiums or out-of-pocket costs. If you need help, a special ACA Insurance Navigator can guide you through the process at no charge.

But the Marketplace isn&rsquo;t the only way to buy insurance. You can also get coverage through:

<ul>
	<li><a href="https://www.sharecare.com/health/health-insurance/article/questions-health-insurance-before-job">Your employer</a>. If your company offers insurance and you like the coverage, you can keep it or use the Marketplace to check if better prices or plans are available.</li>
	<li>Your parents. Through the ACA, you can now stay on your parents&rsquo; plan until age 26; previously, people were not allowed to do so after age 19.</li>
	<li>An insurance company or broker. You can buy insurance on your own outside the Marketplace, and the plans will generally include the same guaranteed benefits and protections. But you won&rsquo;t be able to get discounts for which you may qualify.</li>
</ul>

Medically reviewed in March 2020. Updated in September 2020.

How to Pick a Plan in the Health Insurance Marketplace

Maybe you&#39;ve recently moved, or your old dentist retired, or you&#39;ve had a bad dental office experience. Whatever the reason, you&#39;re on the hunt for a new dentist. Where should you start? What qualities should you look for? What questions should you ask? Three oral health experts gave us their top tips for finding your dream dentist.

Search for recommendations. In the old days, if you were looking for a new dentist, you&#39;d ask friends, family members and coworkers for referrals. That&#39;s still a good place to start, but don&#39;t stop there, says Jerry Gordon, DDS, a dentist in private practice in Bensalem, Pennsylvania. He recommends looking at reviews on the Internet as well. &quot;If you do a search and eighty to ninety percent of the reviews are positive, that&#39;s a good sign,&quot; he says. &quot;On the other hand, seeing very few reviews or more negative than positive reviews are red flags.&quot; While you&#39;re online, check out the dental office&#39;s website so you can get a feel for the dentist&#39;s style and areas of expertise.

Ask your old dentist. If you&#39;re moving to a new area and you&#39;re leaving your old dental practice on good terms, ask your previous dentist for referrals. This tip is especially helpful if you&#39;re seeing a specialist, says Jonathan B. Levine, DMD, an associate professor at the NYU School of Dentistry. &quot;Let&#39;s say you&#39;re moving from New York to Miami. You could ask your current dentist, &#39;Who do you like in Miami?&#39; We all know each other from attending conferences and lectures, and we&#39;re going to send you to someone we trust and respect,&quot; he says.

Consider some key factors. &quot;Does the dentist teach? Is he or she academically oriented?&quot; says Dr. Levine. Teaching or being affiliated with a university is a sign that the dentist is likely to be keeping up with the latest advances and using state-of-the-art technology, he says. You&#39;ll also want to make sure the dental office has proper infection control procedures, such as barrier control and autoclaving. But it&#39;s also important to make sure you find someone you can trust and get along with, says Mark S. Wolff, DDS, professor and chair of the Department of Cardiology and Comprehensive Care at New York University College of Dentistry. &quot;The dentist must be willing to <a href="https://www.sharecare.com/health/managing-your-health-care/questions-ask-before-choosing-dentist">answer your questions</a> and should never dismiss them,&quot; he adds. &quot;You want someone who is going to care about not just your teeth, but also about other health issues, such as whether your diabetes is under control.&quot;

Send an email. If you have dental phobia, it&#39;s helpful to send the dentist an email with some preliminary questions and concerns, says Dr. Gordon. &quot;The answers you get from the dentist should hopefully allay many of your fears and anxiety.&quot; If you don&#39;t get a response, it may mean the office isn&#39;t well organized.

Medically reviewed in January 2019.

Choosing a Dentist You'll Want to See (Again and Again)

My patient came in with wrist pain. She had fallen and seen a general orthopedic surgeon in her small town, who did an x-ray and saw no fracture. Still in pain, she went to see him a week later with the same results, so she came to the ER. I didn&rsquo;t see any fracture either, so I snapped a picture of her x-ray on my phone and texted it to an orthopedic surgeon that specialized in hand and wrist. In five minutes he texted me back. He agreed that there was no fracture, but on his iPhone screen he had noticed that the bones were about 2 mm further apart than they should be&mdash;a subtle sign that she had ruptured the ligament connecting them and needed immediate surgery. Her surgery was arranged and she was soon on the road to recovery.

Am I criticizing the first orthopedist? Not at all. This woman had a complex injury that required someone who examined 20 wrist x-rays a day. Given the second doctor&rsquo;s specialty, he was better able to pick up on a tiny discrepancy. For a different type of bone-related injury (say a broken leg), the first orthopedist would likely have been a better choice than a hand surgeon.

The reality is that all doctors are not created equal. Many doctors have trained for many years and hours and they are exceptional. But no one can be exceptional at everything and each has his or her own strengths. When you have a particular condition, you should go to the physician best trained and experienced to care for you.

The problem is, most patients I speak with don&rsquo;t know that 1. These differences can have a major impact in their care and 2. They don&rsquo;t know how to find the right doctor for their condition. So, here&rsquo;s a cheat sheet of what I tell friends to look for in a doctor. Take these questions as a group&mdash;no one factor comes with any guarantees. But when you consider them together, you&rsquo;ll likely find a doctor who&rsquo;s the best fit for you.

1. Education: Where did the doctor go to medical school? Is it a name you&rsquo;re familiar with?

2. Training: How much&mdash;and what type&mdash;of training does the doctor have? All doctors are required to complete a residency that lasts three years or more, depending on their specialty. Also look for board certification, which means the doctor has a certain degree of experience and has passed multiple tests in that specialty. Some doctors go beyond that to a fellowship (a subspecialty). If you have a specific condition (glaucoma, ovarian cancer, ruptured MCL, carpal tunnel), it&rsquo;s always good to find out if the doctor you&rsquo;re considering has fellowship training. How do you do that? Look at their <a href="https://www.sharecare.com/experts">online profiles</a> and, if in doubt, call the doctor&rsquo;s office and ask.

3. Patient profile: What ages does the doctor treat? This is especially important if you&rsquo;re seeking care for a child. While most doctors receive some pediatric training, others have much more. It&rsquo;s imperative to see a doctor who understands how a child&rsquo;s growth will affect healing. The best way to be sure a doctor is, in fact, trained in pediatrics is to see which ones are affiliated with your local children&rsquo;s hospital.

4. Experience: Is the doctor practiced in dealing with your condition? When you need to have a procedure done, you want a doctor who does it all the time. You can increase these chances by going to a doctor with that subspecialty, but also try to find out the number of procedures the doctor does each year. Again, you can&rsquo;t just go by the numbers, but it&rsquo;s another piece in the puzzle to help you decide.

5. Get a referral: <a href="https://www.sharecare.com/health/health-care-basics/why-see-medical-specialist">Need a specialist</a>? Ask your primary doctor for a referral. In the nuanced world of medicine, physicians often know which doctors are better for certain conditions than others and can help point you in the right direction.

Still not sure? Use the same criteria above to find another doctor and get a <a href="https://www.sharecare.com/health/managing-your-health-care/when-second-opinion">second opinion</a>. This is especially important if you&rsquo;re having an elective procedure. By getting a second opinion you&rsquo;ll learn more about your condition and gain a different doctor&rsquo;s perspective for treating it.

Yes, these steps take time. But if you&rsquo;ve ever spent longer choosing a hairstylist/mechanic/caterer/home contractor than you have choosing a doctor, it&rsquo;s time to change that focus. Do yourself (and your health) a favor&mdash;take time to do the research. You&rsquo;ll have a better chance of finding just the right doctor when you need him or her the most.

Choosing a New Doctor? 5 Questions You Must Ask

Once your child is scheduled for surgery, there are several important steps you need to take to help ensure a safe and successful procedure. Easing any <a href="https://www.sharecare.com/health/surgical-procedures/article/scared-surgery-how-ease-fear">pre-surgery jitters</a> is a large part of the process but making sure your child is physically prepared is just as important. Knowing what to do in the weeks, days, and hours before the operation can help ensure the best possible outcome.

Pre-operative instructions vary among patients, depending on factors including their age, specific operation, and medical history. It&rsquo;s important to closely follow these individualized directions to avoid complications or surgical delays, says Mark McCollum, MD, a pediatric surgeon at <a href="https://www.sharecare.com/group/orange-park-medical-center">Orange Park Medical Center</a> in Orange Park, Florida.

Still, there are general guidelines most anyone needs to follow to be physically ready for surgery.

Weeks or days before surgery 
Be medication savvy. Make a list of all the prescription and over-the-counter medications or supplements your child takes. Note dosages and how often your child takes these drugs or products. Your healthcare provider will tell you what your child should continue taking as well as what medicines and supplements should not be taken before surgery and when to stop taking them.

Anything that could interfere with blood clotting&mdash;including many over-the-counter medications, such as ibuprofen and herbal supplements&mdash;should be avoided before the operation. Exactly when your child should stop taking them will depend on the specific medication or supplement involved. It&rsquo;s also important to let the medical team know if your child has an allergy to any medications or food as well as anything that could cause skin irritation, such as latex.

Monitor your child&rsquo;s health. Call your doctor if your child develops any signs of illness, such as a rash, runny nose, a sore throat, fever, or irritability within a week of the scheduled surgery, Dr. McCollum advises. Your child may need treatment before the procedure, or it may be delayed until your child has recovered.

Boost nutrition. Surgery stresses the body, so going into it as strong as possible can help achieve a good outcome. Optimizing your child&rsquo;s nutrition with a well-balanced diet&mdash;rich in fruits, vegetables, whole grains and protein&mdash;can help support a healthy immune system and promote <a href="https://www.sharecare.com/health/injuries-wound-trauma/article/how-care-wound-wont-heal">wound healing</a>, which may shorten post-op recovery time.

Meet the anesthesia team. This is often done on surgery day. But, if your child is undergoing a complex procedure or has other health issues, you may meet ahead of time with the doctors who will keep your child sedated during the surgery. Your child may also need additional tests or exams so doctors can provide anesthesia safely, McCollum says.

Take a pre-surgery tour. Some hospitals offer tours, which allow children who are scheduled to have surgery to see the facility where they will be treated and to meet the staff. This also provides them with an opportunity to ask any questions they may have before the day of their procedure. This is especially useful if your child is having a complicated operation and may have a lengthy hospital stay. Knowing what to expect may help ease anxiety and help your child feel more in control.

If the hospital doesn&rsquo;t offer a tour, your child&rsquo;s doctor can explain in an age-appropriate way what to expect and address any questions.

Prep your home. For anyone who has undergone surgery, getting around the house and performing normal daily tasks may be difficult. Your child is no different.

It&rsquo;s important to make accommodations to your home environment to make recovery from surgery as stress-free as possible. Your child&rsquo;s surgeon or another healthcare provider, such as an occupational or physical therapist, can help you determine what adjustments to make. For instance, you may need to move your child to a bedroom on a lower floor or move them closer to a bathroom. Make any necessary changes a few days before the procedure.&nbsp;

As the surgery date approaches 
In the days leading up to your child&rsquo;s procedure, your healthcare team will give you personalized instructions that are specific to your child. They will tell you the time of your child&rsquo;s procedure and when you should arrive at the hospital. You&rsquo;ll also review which medications your child may take and what is off limits and when to stop food and liquids. If you don&rsquo;t receive this advice, follow up with your child&rsquo;s surgeon or hospital.&nbsp;

Follow fasting rules: Your child&rsquo;s stomach needs to be empty before anesthesia to keep food and liquids out of his or her lungs. Each hospital has slightly different rules and your medical team will tell you what is recommended for your child, McCollum says.

But general guidelines are: Older children and teens shouldn&rsquo;t eat or drink anything other than clear liquids after midnight, or eight hours before anesthesia. Younger kids should avoid solid food six to eight hours before surgery. These include some items you might not think of:

<ul>
	<li>Candy and chewing gum</li>
	<li>Milk &nbsp;</li>
	<li>Orange juice</li>
</ul>

Kids&mdash;even older children and teens&mdash;can have clear liquids up to two hours before surgery. These include any drinks that you can see through and don&rsquo;t have pulp:

<ul>
	<li>Gelatin (Jell-O) or one popsicle with no fruit</li>
	<li>Apple or white grape juice</li>
	<li>Sports drinks, such as Gatorade, or Pedialyte</li>
	<li>Clear broth</li>
	<li>Water</li>
</ul>

Infants younger than 1 year old may have:

<ul>
	<li>Solid food, which includes baby food and baby cereals, up to eight hours before surgery</li>
	<li>Infant formula may be given up to six hours before surgery and breast milk can be given up to four hours before the procedure, according to the American Academy of Pediatrics.</li>
</ul>

The day of surgery 
Bathe your child: Make sure your child has a bath or shower in the morning or before bedtime the night before surgery. If your doctor gave your special wipes to cleanse the surgical area, don&rsquo;t forget to use them. Don&rsquo;t shave any area before surgery. If this is necessary, it will be done in the operating room, McCollum says. If you child is wearing nail polish or artificial nails, these should be removed.

Dress comfortably: On the morning of surgery, dress your child in loose-fitting clothes and be sure to leave jewelry and other personal accessories at home.

Bring a comfort item: Pack a stuffed animal, book, favorite toy, or blanket. This soothing item will help ease the transition from the familiar environment of home to the unfamiliar hospital, McCollum says.

Leave for the hospital on time: If you&rsquo;re late, the procedure could be delayed or postponed. The surgery center follows specific protocols to keep your child safe and these steps take time:

<ul>
	<li>Hospital staff will go over your child&rsquo;s health history, make sure all pre-op instructions were followed and take vital signs, which includes listening to your child&rsquo;s heart and checking his or her blood pressure and temperature.</li>
	<li>After your child puts on a hospital gown, you should have an opportunity to ask any last-minute questions you have about the surgery. The surgical team may &ldquo;mark&rdquo; the spot of surgery on your child&rsquo;s body with a marker.</li>
	<li>You&rsquo;ll talk to the anesthesia team and review how your child will be sedated. General anesthesia is either inhaled through a mask or given intravenously. The doctor may give your child medicine to calm nerves prior to starting anesthesia. <a href="https://www.sharecare.com/health/surgical-procedures/article/what-need-know-anesthesia">Anesthesia</a> is safer today than ever before. But, discuss any last-minute concerns that you or your child have, including how pain will be managed after surgery. &nbsp;</li>
</ul>

When it&rsquo;s time for the procedure to begin, your child will be transported to the operating room. Keep in mind that surgical teams are specially trained to make this transition as smooth as possible for parents and kids, McCollum stresses. Be calm and reassure your child that you will be in the recovery room when surgery is complete.

Medically reviewed in September 2019.

&nbsp;

&nbsp;

Countdown to Surgery: Are You Prepared?

As more providers start using electronic health records (EHRs), the dream is that it&#39;ll be easier for everyone to work together and share information&mdash;from the emergency room to your doctor&#39;s office to the pharmacy and billing office. The goal is to connect all the players on your healthcare team, all in your best interest, to make sure you&#39;re getting the care you need. Simply put, <a href="https://www.sharecare.com/health/managing-your-medical-records/article/5-facts-about-electronic-health-records">EHRs are the way of the future</a>.

<a href="https://www.sharecare.com/find-a-doctor">Find top doctors in your local health network with&nbsp;this simple tool&mdash;and get better care</a>.

But there&#39;s a dark side to EHRs, too. Like any new technology, they can lead to confusion, glitches and errors. And surprisingly, even EHR systems that have been in place for many years can have these problems, according to a study published in the Journal of the American Medical Informatics Association.

What&#39;s at the root of the problem? 
Researchers looked at 100 EHR safety investigations done within the Veterans Health Administration, which has been using its current electronic records system since 1999. Data from 55 different VA facilities showed that most safety issues were due to technical problems, such as system failures, software glitches, false alarms and &ldquo;hidden dependencies.&rdquo; Hidden dependencies happen when EHR updates accidentally lead to problems somewhere else in the system. Other safety issues included poor use of technology, such as data entry errors.

In the study, one example was a pharmacist who made a data entry error and then overrode the drug warning that came up&mdash;thinking it was a false alarm. This led to a patient receiving too much of a certain drug, a scary scenario for both patients and providers.

So what&#39;s the solution? Researchers from the VA study urge healthcare groups to keep the potential downsides of EHRs in mind at all times and to manage them with strong, internal systems designed to prevent, find and correct safety issues. Their study also shows that even long-standing EHR systems need ongoing testing and error-checking to be sure they&#39;re working and being used correctly by staff. While hospitals and healthcare facilities already take many steps to protect patients, the VA study is a reminder that new layers of safety will always be critical when it comes to new technologies.

5 ways to protect yourself 
Errors sometimes happen, but being a proactive patient can help you limit them. Here are five ways to reduce your risk of EHR-related errors and protect your health.

<ul>
	<li>Understand your condition. Knowing as much as possible about your treatment plan&mdash;for example, what your medications are, how much to take and when, and what to avoid&mdash;can help you recognize errors on your own at the pharmacy or during another step in your care.</li>
	<li>Ask questions and raise concerns. If something doesn&#39;t sound right, or if you simply aren&#39;t on the same page with your provider, speak up. This is especially true when your doctor or nurse is asking you to <a href="https://www.sharecare.com/health/critical-care/sign-consent-to-allow-treatment">sign a consent form for a procedure or treatment</a>.</li>
	<li>Request access to your records. Some offices and labs will give people secure access to their records online. <a href="https://www.sharecare.com/health/managing-your-medical-records/article/learn-how-to-get-a-copy-of-your-medical-records">You can also request a hard copy, but the office might charge you a small fee</a>.</li>
	<li>Keep a current, complete personal health record&mdash;and understand <a href="https://www.sharecare.com/health/managing-your-medical-records/article/see-if-you-need-a-personal-health-record">how a personal health record is different from your medical record</a>.&nbsp;</li>
	<li>Update everyone. Don&#39;t assume that your providers have all the information they need. Be sure to tell your <a href="https://www.sharecare.com/health/health-care-basics/primary-care-physician">primary care provider</a> about any changes in medications or overall health since your last visit, so he or she can see the entire picture of how you&#39;re doing and better coordinate your care.</li>
</ul>

Medically reviewed in January 2020.

How to Protect Yourself from Medical Records Glitches

Whether it&rsquo;s a bump on the head or a really bad cold, when your body suffers a blow, all you want to do is feel better.

But where do you go to get the care you need?

Next time you experience a nasty fall or you think you&rsquo;re suffering from a particularly serious case of the flu, this cheat sheet may help you decide whether you need the emergency room, an urgent care clinic or a call to your doctor.

Head to the ER if:

<ul>
	<li>You think you&rsquo;re <a href="https://www.sharecare.com/health/heart-attack/heart-attack-symptoms-men-women">suffering a heart attack</a>. If you&rsquo;re experiencing chest pain lasting for more than a few minutes, pressure or squeezing in the chest, a sense of fullness, shortness of breath, pain radiating down the arms, pain in the jaw or neck, cold sweats, nausea, dizziness or fatigue, call 9-1-1.</li>
	<li>You&rsquo;ve suffered a head injury. A slight bump on the head is one thing, but if you suffer a blow that causes you to feel dizzy, confused or sleepy, lose consciousness, vomit, faint or have trouble seeing, walking or talking, you need to go to the emergency room to be evaluated.</li>
	<li>You have a seizure, but haven&rsquo;t been diagnosed with epilepsy.&nbsp;Emergency care is recommended if a seizure lasts for more than five minutes, the person stops breathing, the person suffers a serious injury as a result, or the seizure occurs with a person who has diabetes, is pregnant, has a high fever or suffered a blow to the head.</li>
	<li>Your high fever won&rsquo;t go down. Fevers definitely make you feel terrible, but they can also be a sign that your body is fighting off an illness. However, if your fever is 105 degrees Fahrenheit and does not come down with treatment and/or is accompanied by trouble breathing, sore throat or difficulty swallowing, leg swelling, a bad headache, nausea, confusion, a rash, a stiff jaw or neck, vomiting or drowsiness, you should go to the ER. These could be signs of serious conditions such as <a href="https://www.sharecare.com/health/brain-nervous-system/what-is-meningitis">meningitis</a> or <a href="https://www.sharecare.com/health/bacterial-infections/what-is-tetanus">tetanus</a>.</li>
	<li>You think you&rsquo;ve broken a bone. A scrape may not be an emergency, but a deep wound or broken bone is serious. Skip the phone call to the doctor and go to the emergency room if you&rsquo;ve experienced a severe break. Signs of a broken bone include immediate swelling and discoloration of the injured area, bruising, not being able to put weight on it or the bone looking misshapen or out of place. Call 9-1-1 immediately if there&rsquo;s a suspected broken bone in the head, neck, back, hip, pelvis or upper leg, if there&rsquo;s severe bleeding or the bone is coming out of the skin.&nbsp;</li>
</ul>

Make a trip to urgent care when:

<ul>
	<li>You&rsquo;ve sprained your ankle. A twisted ankle is painful, but usually isn&rsquo;t severe enough to warrant a trip to ER. Physicians at your local urgent care clinic can examine your injury and determine your best course of treatment.</li>
	<li>You need an X-ray. For sprains, strains and less severe fractures (such as the hands, wrists or feet and ankles that do not have any of the warning signs listed above), an urgent care center can take X-rays and perform a physical exam to help you determine the severity of your injury.</li>
	<li>You&rsquo;ve got a bad cold or the flu. When you&rsquo;ve been sidetracked by a bad sore throat, cough or the flu over the weekend, it can be hard to wait until your doctor&rsquo;s office has an opening for an appointment the next week. Avoid the busy ER and visit urgent care when you&rsquo;ve got a severe sore throat, potential ear infection, bad cough or fever without a rash. Urgent care physicians can also administer <a href="https://www.sharecare.com/health/heart-disease/article/prevent-heart-problems-with-a-flu-shot">flu shots</a>.</li>
</ul>

Smart Patient Tip: Not every urgent care facility is the same &ndash; some can take X-rays, while others cannot. Check out the urgent care centers in your area to determine which one will work best for you and your family now, so you&rsquo;ll know where to go the next time you need help.

Call your doctor:&nbsp;If you&rsquo;re not dealing with a life-threatening situation, and you believe you can wait to receive care until the next day or after the weekend, your best bet will always be your doctor&rsquo;s office. They know your medical history, have records of your medications and past treatments and will likely cost you less out-of-pocket. It&rsquo;s usually safe to wait for your physician when you have or need:

<ul>
	<li>Common colds or illnesses</li>
	<li>Routine tests</li>
	<li>Shots and vaccinations</li>
	<li>Health exams</li>
</ul>

When it comes to medical emergencies, each case is different. But it&rsquo;s always better to be safe than sorry. If you ever have any doubts, don&rsquo;t wait -- head to the hospital immediately.

Medically reviewed in August 2019.

ER, Urgent Care or Physician -- Know Where to Go

As I helped pull my next patient off the EMS gurney onto the stretcher, he clutched his chest, disappointment heavy on his face as he confessed that his <a href="https://www.sharecare.com/health/healthy-new-years-resolutions">New Year&rsquo;s resolution</a> to quit smoking had failed yet again&mdash;as it had for the past four years. The 30-year-old guy a couple of doors down had planned to control his anger; his x-ray showed a broken hand from punching a wall. As ground zero for failed resolutions, the ER is also a great place to find ones that will work. What can be both manageable and impactful? Here are a few resolutions worth considering, based on what I&rsquo;ve learned from treating patients. They&rsquo;re not specific to any one condition &ndash; but when applied, they can give your overall health a big boost.

My suggestion?&nbsp;Choose just one for starters. We&#39;re all so overextended that too many goals can dilute the effort. So pick one and remind yourself of it each morning. Then take one action, no matter how small, that moves you closer to that goal. I&#39;ll be doing the same -- and I&#39;d love to hear how it&#39;s going in a few months!&nbsp;

1. Listen to your body. Whether it&rsquo;s the stomach ache you&rsquo;ve ignored for four weeks or the knee pain when you go biking, it pays to listen to your body. Maybe it&rsquo;s nothing. But talking to your doctor will a.) help give you an idea of what&rsquo;s causing the problem if there is one and b.) educate you on your options for addressing it. Sometimes good old physical therapy or minor lifestyle and diet changes can make a huge difference in how you feel.

2. Be in the moment. It may sound clich&eacute;d, but if working in the ER has taught me anything, it&rsquo;s that the time we have is short. So put down the phone and really focus on your child when you play with her. Stop thinking of what you&rsquo;ll say next in a conversation and just listen to the person who&rsquo;s talking. Every moment won&rsquo;t be filled with fireworks &ndash; but life is richer when you&rsquo;re focused on the here and now. &nbsp;

3. Get real about your resolutions. No, really. Don&rsquo;t tell me that your New Year&rsquo;s resolutions include <a href="https://www.sharecare.com/health/weight-loss">losing 20 pounds</a> and quitting smoking by February 1. I&rsquo;m not saying you shouldn&rsquo;t work toward those things if they&rsquo;re right for you (and I applaud you for it!), but be sure to make your goals realistic and manageable. How do you climb the Himalayas? One step at a time. So plan your steps. Anticipate whiteout weather or your sherpa going on strike. And bring some extra moleskin because&mdash;shoot&mdash;it&rsquo;s just a long climb. Take time to celebrate the view and each small victory. Nothing propels you better up and over that hill than the successes you&rsquo;ve experienced along the way.

4. Take responsibility for your health. No one else can -- and no one else should &mdash; be expected to do this for you. Not your doctor, your partner or your care coordinator. Every day I see patients who, when asked why they haven&rsquo;t followed up on something their doctor asked them to do, will say &ldquo;Well, my doctor didn&rsquo;t call me&rdquo; or &ldquo;I forgot to schedule with the physical therapist.&rdquo; Yes, doctors are increasingly busy. But patients lose critical time with their doctors by missing appointments, being late and not being organized about their own care. Don&rsquo;t tell me you &ldquo;take a green pill&rdquo; and then expect 20-Questions-While-I-Try-To-Guess to be a valuable use of our time together. You wouldn&rsquo;t depend on your bank to keep your finances in order, would you? You are your own Chief Medical Officer. Consider it a promotion and get to work.

5. Give thanks. Gratitude really is great medicine. Studies have shown that people who count their blessings (either by lists, journals or just awareness) have better health, fewer physical symptoms, lower depression and better life satisfaction. &nbsp;Double bonus? Not only does gratitude improve your day, you may even make someone else&rsquo;s a bit better. After a particularly frustrating shift in the ER one night, I went to speak to one of my patients &ndash; an elderly woman &ndash; before heading home. I was rushing to complete my charts, manage several very sick patients at once and place orders that a nurse needed. I hurried into the room and shared my treatment plan with the woman and her family. Then something happened. They smiled and her granddaughter, with tears in her eyes, said &ldquo;Thank you so much.&rdquo; They said that I didn&rsquo;t know how much the care I had given their grandmother meant to them. They&rsquo;re right&mdash;I didn&rsquo;t. I left that shift feeling uplifted and connected to my patients and my work. How many times during our day do we have opportunities like this to change our own and someone else&rsquo;s experience?

The ER is a lot like life &ndash; chaotic, unpredictable, with heartbreaking tragedy mixed in with heart-swelling joy and relief. Every next patient is a chance to learn from the prior ones and do better. New Year&rsquo;s resolutions are a lot the same. My patient with chest pain? After a heart catheterization, he&rsquo;s now on medication to help him <a href="https://www.sharecare.com/health/quit-smoking">quit smoking</a> and so far so good! The one with the broken hand? Well, let&rsquo;s just say that, like all of us, he&rsquo;s a work in progress.

What a blessing that every year, every month and every day is an opportunity to try again, to continue striving. Let&rsquo;s take some steps and work on resolutions that can help us boost our health and happiness this New Year and in those to come.

Medically reviewed in March 2020.

Five New Year's Resolutions from an ER Doc

As a frontline registered nurse and an administrative supervisor for clinical care in a Level I trauma center, I know about the power of communicating effectively with patients. Listening and speaking with empathy can calm patients&rsquo; anxiety, help them heal, and improve their outcomes.

And while I&rsquo;m committed to being there for my patients inside the hospital, I&rsquo;m equally devoted to helping people be well so they can stay out&nbsp;of the hospital.&nbsp;

Here are three of my top tips for taking charge of your preventive health. Note: These aren&rsquo;t the typical how-to items you may have seen before. Rather, they&rsquo;re intended to empower you by getting you more fully engaged in today&rsquo;s tech-forward healthcare space.

Get involved 
You are the biggest stakeholder in your health and therefore the most important member of your healthcare team. When you recognize that fact, you can feel empowered to take steps to live your healthiest life.

Start by becoming a more proactive healthcare consumer. Partner with your healthcare providers (HCPs) and be an active participant in the decision-making process. Remember to&nbsp;speak up and ask questions. When consulting with your doctor, nurse practitioner (NP), advance practice nurse (APN), or other HCPs, always ask the question: &ldquo;What are all the treatment options available to me?&rdquo;

Get tech-savvy 
Technology can help you progress along your wellness journey. Brilliant health apps continue to proliferate, and&nbsp;mobile technology&nbsp;is transforming health care. Imagine having a conversation with your doctor or other HCP that goes beyond simply what medications to take.

Don&rsquo;t get me wrong: Medications are very important for some patients. But once you understand all your treatment options, be sure to ask your HCP about technology. What are your treatment options that include technology?

Think about apps that can help you live healthier from a mind-body perspective. One great example is <a href="http://unwindingbysharecare.com/" style="color:blue; text-decoration:underline" target="_blank">Unwinding by Sharecare</a>. Designed by Jud Brewer, MD, PhD, an addiction psychiatrist and mindfulness expert, the app helps you change behaviors that may be getting in the way of your leading your best life. (Download the app for <a href="https://apps.apple.com/us/app/unwinding-by-sharecare/id1562169742" style="color:blue; text-decoration:underline" target="_blank">iOS</a> or <a href="https://play.google.com/store/apps/details?id=com.sharecare.Unwinding&amp;hl=en_US&amp;gl=US" style="color:blue; text-decoration:underline" target="_blank">Android</a>.)

Sharecare also has its own health app that can help people reach their health goals. Whether your focus is losing weight, managing stress, or sleeping better, Sharecare&rsquo;s health app (available for free for <a href="https://apps.apple.com/us/app/sharecare-health-well-being/id964313779" style="color:blue; text-decoration:underline" target="_blank">iOS</a> or <a href="https://play.google.com/store/apps/details?id=com.sharecare.realgreen&amp;hl=en_US&amp;gl=US" style="color:blue; text-decoration:underline" target="_blank">Android</a>) helps set you on a personalized path to total wellness.

The COVID-19 pandemic has also fast-tracked <a href="https://www.sharecare.com/health/online-health-care/article/how-telemedicine-work-you" style="color:blue; text-decoration:underline">telemedicine</a>, which can allow you to have appointments with your HCPs from the comfort and privacy of your own home. Not everything can be done via telemedicine, but for those issues that can be addressed, it can make seeking and receiving care especially efficient. Talk to your HCPs about establishing virtual communication.

Many HCP offices will send texts and/or emails for appointment reminders. Electronic Health Records (EHRs)&mdash;which enable you to view your health history, immunization records, and more, online&mdash;are also becoming more widespread. (We still have a ways to go to get all hospital computer systems interfaced and interconnected. If you&rsquo;re a patient in, say, Connecticut and you&rsquo;re traveling to another state and you happen to end up in the emergency department, your health records may not show up in their system.)

You may also find yourself using <a href="https://www.sharecareyou.com/" style="color:blue; text-decoration:underline" target="_blank">virtual reality</a> (VR) as part of your care, too. In certain settings, VR can be used to help minimize stress and anxiety in children and adults. For children, VR can be used to distract from uncomfortable procedures or treatments, and even to help minimize pain. For adults, it can be used for pain management, physical therapy, and rehabilitation.

If your HCP doesn&rsquo;t bring it up at your next visit, ask them about how technology can be part of your care.

Get social 
As the size and reach of social networks have exploded, so, too, has their potential to improve connectivity in the world of health care. If there are health experts who inspire you and offer trustworthy health information, connect with them online.

Important to remember: As you become an informed and connected healthcare consumer, it&rsquo;s vital that you question what you read and that you do your own research. Misinformation spreads like wildfire. Be cautious and make sure to speak with your HCP before making any changes to your health routine or your ongoing care.

There are many health experts engaging in social media networking to provide patients with valuable information. I&rsquo;ve been involved in a few of <a href="https://twitter.com/SharecareInc" style="color:blue; text-decoration:underline" target="_blank">Sharecare&rsquo;s Twitter</a> chats&mdash;powerful real-time question-and-answer sessions&mdash;and I&rsquo;ve found that two hours sharing, engaging, and interacting with the Twitter audience on topics like sleep and heart health is time well spent.

Platforms like Twitter offer nurses, doctors, and other HCPs the opportunity to help educate consumers. They also provide us with the ability to listen to the community, engage with consumers, collaborate, and hopefully inspire people to live a healthier life.

Are there ways you can lean in to be an even more engaged and empowered patient&mdash;and even help drive innovation in health care?

&nbsp;

A Nurse's Perspective: 3 Smart Ways to Take Charge of Your Health Care

Find out how much risk you're willing to take in search of higher returns.

What Type of Investor Are You?

A good working partnership with your doctor is key to getting the most appropriate care for your health needs. But the patient-doctor relationship isn&#39;t always what it could, or should, be.

People tend to go to the doctor when they&#39;re unwell and not at their physical or emotional best. Understandably, for many, having an intimate examination is an unnerving experience. So, it&#39;s no wonder the balance of power always seems to weigh in favor of the person wearing the white coat.

But remember: You&#39;re the expert on you. Be an active partner in your healthcare. Start with these simple steps:

Before your appointment 
Make the most of your time with your doctor by being prepared for your appointment. Beforehand, think about questions or concerns you&#39;d like to cover at your appointment and write them down. Also, jot down a list of:

<ul>
	<li>Symptoms you&#39;re experiencing or anything you&#39;ve noticed that&#39;s out of the ordinary for you</li>
	<li>Medications and supplements you&#39;re taking</li>
	<li>Alternative therapies you&#39;re using, such as herbal remedies or acupuncture</li>
</ul>

Take your lists with you and share them with your doctor.

During your appointment 
Take notes. Many people feel a little nervous at the doctor&#39;s office, and that&#39;s normal. But afterwards, you may find it difficult to remember exactly what was said. So, ask your doctor to recap at the end of the appointment, and take your notes then. If there are technical terms you don&#39;t understand, ask for an explanation.

Another option is to bring a close friend or relative with you. Some people find it helpful to have someone else hear and remember what the doctor says.

A friend can take notes, help you recall questions you intended to ask and offer support, should you need it. But remember: a doctor&#39;s appointment can be very personal, so choose your companion carefully.

After your appointment 
Follow up. Don&#39;t be shy about calling your doctor if you have questions between appointments or if you&#39;re waiting for test results.

And keep your own records. Make a note of the dates and results of health screenings, vaccinations, procedures, surgeries and regular checkups and keep them together for easy access when you need them.

Being actively involved in your healthcare is good for your health. It&#39;s that simple. Start now.

It's Your Health—Be an Expert

One of the most important decisions you will ever make&mdash;and you&#39;ll probably make it more than once&mdash;is choosing the right doctor.

YOU: The Smart Patient&nbsp;authors Mehmet Oz, MD, and Michael Roizen, MD, have a three-step approach to choosing wisely.

1. Take a survey.&nbsp;Ask your friends, your coworkers and your neighbors who they like, and look for these names in the packet of options you get from your insurance provider.

2. Take it online.&nbsp;Make sure your doctor of choice is included in at least a couple of doctor databases from reputable medical association websites. Good places to start looking: the American Medical Association, the American Board of Medical Specialties, the National Committee for Quality Assurance Physician Recognition Program, the American College of Surgeons and MedlinePlus.

3. Get on the horn.&nbsp;When you find a doc you like, call the office and ask key questions. At the very least, you want to find out that the doctor went to an accredited medical school and residency program and that he or she:

<ul>
	<li>Sees plenty of patients</li>
	<li>Has hospital privileges at a Joint Commission-accredited hospital</li>
	<li>Has been board certified for at least 3 years</li>
	<li>Practices with other doctors who have equally strong credentials and training</li>
</ul>

And if your top choice doesn&#39;t happen to accept your insurance? Don&#39;t throw in the towel just yet. Call your insurer to see if this doc could be added to the provider list.

How to Find Dr. Right

An old joke involves a patient asking the doctor, &ldquo;Have you been successful doing this surgery?&rdquo;If the doctor says, &ldquo;Yes, I&rsquo;ve been successful,&rdquo; that means he&rsquo;s done it once. If he says, &ldquo;I&rsquo;ve been successful in case after case,&rdquo; that means he&rsquo;s done it twice.

When you&rsquo;re faced with surgery, this may or may not strike you as funny. But studies have shown that the <a href="https://www.sharecare.com/health/health-care-basics/surgeon-skills" target="_blank" title="Surgeon skills">surgeon&rsquo;s experience</a> is the most important factor in having as safe and successful an operation as possible.

So how do you find out your surgeon&rsquo;s experience level? Ask. Be sure to do so in several different ways, and include the following questions:

<ul>
	<li>How many times have you done this surgery yourself?</li>
	<li>How many did you perform last month? Last year?</li>
	<li>When did you start performing this surgery?</li>
	<li>What have the outcomes been?</li>
	<li>What is your complication rate?</li>
</ul>

It&rsquo;s important to find out how many operations the surgeon has performed in the specifictype of surgery you&rsquo;re facing. It&rsquo;s a fair, reasonable question and the answer should be completely forthcoming. As with most things in life, avoid surgeons who make wild claims about their experience.

&ldquo;Quantity alone is not necessarily a guarantee of quality, but it is an indication of competency,&rdquo; says Joshua R. Sonett, MD, Chief, General Thoracic Surgery and Surgical Director, Lung Transplant Program, NewYork-Presbyterian Hospital/Columbia University Medical Center. Experience can be a tricky thing to evaluate, especially in the case of new procedures. If an operation is so innovative that no surgeon has performed it more than a handful of times, you might be willing to trade the lack of experience for the likely benefits. That said, if it&rsquo;s an established procedure, it makes sense to find a surgeon who has performed it often and well.

How do you define &ldquo;often&rdquo; when it comes to surgery? That depends entirely on what kind of surgery you&rsquo;re having. For example, surgeons who performed more than 30 routine shoulder replacements over a six-year period were considered &quot;high volume&quot; surgeons in a Maryland study. The same number, 30, also applied to hip replacement surgery.

On the other hand, James A. Lee, MD, Chief, Endocrine/Thyroid Surgery, NewYork-Presbyterian Hospital/Columbia University Medical Center, says, &ldquo;A surgeon should do more than 50 thyroid operations a year to be considered an expert. In addition, the overall number of parathyroid operations he or she has done matters. I would not consider thyroid surgeons experienced until they had done at least 500 operations.&rdquo;

If you can&rsquo;t find surgeon experience statistics on your surgery, one simple approach is to ask your surgeon, &ldquo;How many times should a surgeon have performed my operation to be considered experienced?&rdquo;

And beware of any surgeon who answers, &ldquo;I&rsquo;ve been successful in case after case.&rdquo;

Choosing a Surgeon: How Much Experience is Enough?

If you&rsquo;re dealing with debt, it might seem like the logical move to cut up your credit cards and walk away &ndash; but DON&#39;T. Here&#39;s why:

1. If the card still has a balance on it and you cancel the card, the credit bureaus won&rsquo;t find anything on your report for &ldquo;available credit&rdquo; and the &ldquo;credit limit.&rdquo; That&rsquo;s good, right? Wrong. Since you still have a balance on the card and no credit limit is listed (since you closed the account), it actually looks like you maxed it out. And that can&mdash;and likely will&mdash;<a href="https://www.sharecare.com/video/health-topics-a-z/financial-health/what-is-a-credit-score-and-how-do-i-improve-it">wreak havoc on your credit score</a>.

2. If you have paid off your balance, but cut up your card anyway, you&rsquo;re missing out on a valuable, steady payment history. Remember, you&rsquo;re going to need that credit down the road to take out a loan, buy a house or negotiate better deals on existing payments. Cutting your card is essentially taking you out of the game before you have a chance to play. And even if you do have a good reason to close a card (it charges exorbitant annual fees or stops offering the perks that made you sign on in the first place), cutting it up isn&rsquo;t all you have to do:

<ul>
	<li>You have to tell someone! If you cancel over the phone or online, follow up with a signed letter to your credit card company&rsquo;s customer service department stating that you wish the card to be canceled and a brief explanation of why you are canceling.</li>
	<li>Ask for a written confirmation in response from them, stating that the account has been closed. Monitor your credit reports to make sure the account is no longer active.</li>
</ul>

You can keep the card alive by leaving one recurring payment on it, like a utility bill, and using auto pay. That way, you don&rsquo;t have to think much about it, and it&rsquo;s still active. In the meantime, to help get your debt under control, start switching a majority of your daily spending to a debit card--that way you are spending money that&rsquo;s actually in your bank account. Studies show that people using credit cards spend 12% to 18% more when using credit rather than debit cards. If you are having trouble sticking to your spending plan or anticipate doing so, you&rsquo;re better off resisting temptation by <a href="https://www.sharecare.com/video/health-topics-a-z/financial-health/should-i-pay-with-debit-credit-or-cash">becoming a debit devotee.</a>

<a href="https://www.sharecare.com/health/financial-planning-health-care">Find Out: More Smart Tips for Managing Your Money</a>&nbsp;

Excerpted from: <a href="https://www.amazon.com/Rich-Bitch-12-Step-Financial-Together/dp/0373893175/189-0404368-7531317?ie=UTF8&amp;camp=1789&amp;creative=9325&amp;creativeASIN=0373893175&amp;linkCode=as2&amp;linkId=NXSNCOCJX7WL5SY5&amp;redirect=true&amp;ref_=as_li_qf_sp_asin_il_tl&amp;tag=sharecare-20" target="_blank">RICH BITCH,</a> by Nicole Lapin. Copyright &copy; 2015 Nicole Lapin. Rich Bitch is a trademark used under license from Nothing but Gold Productions. Inc. Published by Harlequin. Reprinted with permission.

Two Reasons Not to Cut Up Your Credit Cards

Learn tricks from the savviest savers to buy the things you really want&mdash;and still build your nest egg.

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Even though synonyms for the word &ldquo;primary&rdquo; include &ldquo;chief,&rdquo; &ldquo;key,&rdquo; &ldquo;crucial,&rdquo; and &ldquo;most important,&rdquo; 30 percent of American adults and nearly half of millennials don&rsquo;t have a primary care provider (PCP). Not only does access to primary care help you live longer and healthier, it may literally mean the difference between life and death.

In a nutshell, a PCP is the point person who guides your health and well-being. Unlike specialists who focus on a single organ, condition or age group, PCPs are Jacks or Jills of all trades: They are the doctors who do your checkups and treat any garden-variety nuisances like sore throats and rashes. These physicians&mdash;often internists, pediatricians or family practitioners&mdash;all receive at least three years of training after medical school focused on primary care.

But PCPs can also help you manage chronic conditions, such as high blood pressure, arthritis and diabetes. They can also treat injuries, perform minor surgery, conduct gynecological exams and sometimes even deliver babies.

&ldquo;Head to toe, from anxiety issues to joint issues, we&rsquo;re trained to see and treat practically everything,&rdquo; says Lauren Daniels, MD, a board-certified family physician at Southern Family Medical Center who also occasionally works with&nbsp;<a href="https://www.sharecare.com/group/doctors-hospital-of-augusta">Doctors Hospital of Augusta</a>, both in Augusta, Georgia. Hence the reason primary care should always be your first stop in non-emergency situations.

As impressive as their medical expertise can be, though, it&rsquo;s really the integral role PCPs play that has such a major impact on your health. These are the doctors with whom you get to develop long-term, sometimes even life-long, relationships and who get to know your health history better than anyone. &ldquo;As a caregiver, I want to know everything along the way,&rdquo; says Dr. Daniels.

According to the researchers behind a 2018 BMJ Open study, it&rsquo;s the accumulation of this type of knowledge that allows doctors to provide better-informed and personally tailored advice that likely keeps people ticking longer.

Even when a condition is beyond their scope and you do need to see a specialist, your PCP can make a referral to someone they have a working relationship with. They can then oversee your care with that doctor. Staying with a consistent office or practice gives patients a &ldquo;medical home&rdquo; which can be a welcome antidote to what can be a fragmented and depersonalized healthcare system. More importantly, this continuity provides tangible benefits that add up to better health.

So, whether you&rsquo;re looking to find a PCP or you have one but don&rsquo;t see him or her often enough, here are a few reasons you should visit a PCP on the regular.

You may receive more comprehensive care 
One of the key benefits of seeing a PCP is that they focus more on the whole person rather than just a specific problem, and that can translate into more holistic care for patients.

Indeed, research shows that women who choose an OBGYN as their primary physician may miss out on more comprehensive care. In a June 2014 analysis, PCPs were nearly 2.5 times as likely as OBGYNs to address such problems as mental health issues, metabolic conditions, and circulatory, respiratory, digestive, and skin diseases during a PCP visit compared to a preventive gynecologic visit.

Surprised to see mental health issues on that list? PCPs aren&rsquo;t exaggerating when they say they see it all. According to the Centers for Disease Control and Prevention, one-fifth of all primary care visits address mental health concerns.

When you&rsquo;ve been going to a PCP who knows your medical history inside and out, they can more easily recognize a change in your health as well. An 2018 BMJ study of primary care physician supply found that more PCPs were associated with improved health outcomes across areas including all-cause mortality, cancer, heart disease, stroke, and infant mortality, as well as low birth weight, life expectancy, and self-rated health.

&ldquo;When I&rsquo;ve been seeing patients for a long time, I can tell when something is off with them, that they&rsquo;re not their usual selves&mdash;even if they don&rsquo;t always know it themselves,&rdquo; says Daniels. &ldquo;It makes my sixth sense a little sharper and it signals me to dig a little deeper to figure out what might be wrong.&rdquo;

The reverse is also true: Monitoring changes through the years allow PCPs to know when something that might otherwise seem suspicious is actually fine and just a natural variant.

You may develop better health habits 
Your PCP can help you focus on achieving many healthy behaviors, including not smoking (or kicking the habit), <a href="https://www.sharecare.com/health/cold-and-flu/article/can-flu-shot-save-life">getting flu shots</a>, being physically active, eating healthier, even using seat belts&mdash;possibly because the primary focus of their practice is prevention.

&ldquo;First and foremost, my role is to make sure people are doing the right things to stay healthy,&rdquo; says Daniels. PCPs stay on top of things like whether you got your mammogram, colonoscopy, tetanus booster and skin check. But they often go beyond such measures in the interest of patient health. For instance, because obesity is significantly related to most chronic health problems, Daniels devotes about a quarter of her practice to weight management. These types of strategies seem to be working, as research shows people who have PCPs are healthier, regardless of their initial health.

You can find your way to the specialist you need 
A PCP can always provide a referral should you need one, but often they can address your health issues themselves and eliminate the need for additional appointments. In fact, having a relationship with a PCP can mean less use of specialists and visits to the emergency room. One 2006 study in Health Affairs found that people with a PCP rather than a specialist as a personal physician had 33 percent lower annual health care spending and a 19 percent lower mortality risk.

Other times, though, your PCP will want you to go see a specialist as soon as possible. When that happens, she can make the right connection and then coordinate your care.

&ldquo;I always tell my patients, &lsquo;I&rsquo;m not going to do your spinal surgery, but I want to be able to recognize when it&rsquo;s time for you to talk to a surgeon&rsquo;&mdash;and then find you two referrals if that&rsquo;s what it takes to make you comfortable with having the procedure,&rdquo; says Daniels.

Most specialists will do a thorough review of your history and look at all your medications, but sometimes they may be more focused on a specific system. &ldquo;You need someone who&rsquo;s looking at the whole picture,&rdquo; explains Daniels.

You can save money 
A lot of insurance companies provide incentives&mdash;lower premiums, contributions to your health savings account, gym memberships, even free fitness trackers&mdash;for having recommended check-ins and screening tests. But beyond that, a few studies show that coordinated care through your PCP can save you money and reduce your overall healthcare costs, likely because people tend to become healthier as a result of seeing their PCP.

It can be difficult to comprehend potential money lost due to health issues, but a good example is diabetes. <a href="https://www.sharecare.com/health/diabetes/article/screening-and-diagnosis-for-diabetes">People with diagnosed diabetes</a> incur about $17,000 a year in medical expenses. Sixty percent of those costs are estimated to be the result of hospital admissions and treatment of complications&mdash;and that&rsquo;s where regularly seeing a PCP comes in.

&ldquo;If I check your sugar and it&rsquo;s slightly elevated, I can do an intervention that gets you back to where your sugars are normal versus coming to me with full-blown diabetes that&rsquo;s already affecting your kidneys and causing numbness in your feet,&rdquo; says Daniels.

How to find a primary care physician 
Your PCP will hopefully be involved in your care for a long time, so it&rsquo;s important to choose someone you trust. &ldquo;As a physician, knowledge is power. The more I know about you, the better I&rsquo;m able to serve and care for you,&rdquo; says Daniels. &ldquo;If you&rsquo;re not comfortable telling me everything, I&rsquo;d rather you see someone you are comfortable with.&rdquo;

When looking for a PCP, start by asking friends, family and other health professionals for recommendations within your network. Rather than just getting a name, ask about the person&rsquo;s experience with the doctor: What do they like about their physician?

Does the doctor give her full attention and take time to answer questions?

It&rsquo;s worth noting that PCPs are in short supply&mdash;there are currently at least 18,000 too few PCPs for the number of people who need them, a gap that may increase to as many as 49,000 by 2030. Due to certain constraints, PCPs often don&rsquo;t get as much time with patients as they would like.

When investigating physicians, keep your unique health needs in mind. Some PCPs may have special areas of interest, say, in diabetes care. Though she practices full-spectrum family medicine, Daniels takes particular interest in women&rsquo;s health and adolescent care. Other PCPs may be specially trained to care for older adults, something that may be attractive if you&rsquo;re nearing the age of 60.

Of course, the best way to get a good feel for a physician is to schedule a visit. Ideally, you&rsquo;ll see the doctor when you&rsquo;re not sick. &ldquo;It&rsquo;s important to initially see your PCP when you&rsquo;re well and not dealing with a health crisis, so we have a baseline for you,&rdquo; says Daniels. If you don&rsquo;t click for some reason, trust your instincts and look for someone else.