Wednesday, August 17, 2005

Paying Cash for Surgery

As more of us use health savings accounts or have high deductible insurance, paying cash for health services has increased. Surgery is the most expensive of these services so ask your doctor to explain the charges that will be involved. Typically, there are three separate bills. One for the surgeon's fees, one for the anesthesiologist's fees and one for the surgery center or hospital where the procedure will be performed. Many of these fees are set in advance and cannot legally be changed by your doctor. It is still a good idea to ask for a cash discount. Look here for more later on this important and evolving topic.


Tuesday, August 09, 2005

Who is best at choosing a doc?

We all typically get a referral to a specialist from our primary care doc or a trusted friend. Do we ever question that referral? How do you decide if that doc is a good one? I think we need a better way of figuring out who the good docs are and who the bad ones are.

As previously stated in this blog, board certification is one way of sorting through your HMO/PPO book of docs. Dig a little deeper and find out where your doc went to medical school or did his/her residency. Also, when you are receiving a referral, ask the person why that particular doc?

Remember we all do to the "best docs". Who out there is going to a bad doctor on purpose?

Thursday, August 04, 2005

Tendinitis vs Tendinosis

It is important to know the difference betwteen Tendinitis and Tendinosis when trying to understand why you have pain around a joint. Tendinitis refers to an ACUTE inflammatory problem with a tendon. This can occur if you have used a specific muscle too much over a short period of time. The classic example is achilles tendinitis that occurs after a long or hilly run. It can also occur by playing too many sets of tennis or swimming excessively. Tendinosis, conversely, is CHRONIC problem with a tendon that usually has lasted at least 6-8 weeks. In this case, there isn't any direct inflammation but rather a poorly organized attempt at repair of the tendon by the body. This results in partial or complete tendon tears in some cases and manifests itself in pain and weakness when trying to use the muscle that is attached to the tendon.

The treatments for this two problems initially are the same. Rest from the activity that is causing the problem, anti-inflammatory medication and a stretching and strengthening program. For more information, go to


Wednesday, August 03, 2005

Knee Exercises for Arthritis

Knee Osteoarthritis is a common problem with a variety of moderately effective treatments. Exercise is one of these treatments that is often ignored. For my patients with mild to moderate knee osteoarthritis, I recommend using an exercise bike 3-4 times per week for 30 minutes at a time. If you are consistent about this simple regimen, you'll likely improve your walking ability, decrease you pain and burn enough calories to shrink your waistline. Adding in hamstring, quadriceps and achilles stretching and you have a simple yet effective program that should improve your quality of life without any medication.

Try it and let me know how it may work for you.

Always consult with your physician before beginning any exercise program. That is a disclaimer for all the lawyers out there.