How to Face a Costly Medical Procedure

Frank Lalli has chronicled his experience with the health care system in the New York Times op-ed piece “A Health Insurance Detective Story.” He has since become The Health Care Detective™ in a variety of publications and media outlets, including regular commentary on news and health for National Public Radio’s Robin Hood Radio. Throughout his thirty-plus years of experience in editorial and journalism, he has worked as an investigative reporter for Forbes, served as editor of Money and George magazines, appeared as a specialist on Today, Good Morning America, and Nightline, and is currently the special health correspondent for Parade. Lalli was named one of the top 100 business journalists of the twentieth century by TJFR, and has won the three most prestigious prizes for excellence in financial journalism: The John Hancock, the University of Missouri, and the Gerald Loeb awards.

DoctorSurgeryMoney_400When your doctor suggests a procedure that is not covered by insurance, your out-of-pocket cost may be shocking. What can you do to regain control of the situation? There are several steps to take, the first one being to get a second opinion. Read all about the others in Your Best Health Care Now: Get Doctor Discounts, Save With Better Health Insurance, Find Affordable Prescriptions.

Do not feel embarrassed about telling your doctor that you want another opinion. If he’s suggesting a costly procedure, he feels that you’re facing a serious concern, so neither of you want to make a mistake.

In my opinion, your doctor should volunteer to help you identify that second doctor—and a third one if you need a tiebreaker—just as Maggie Murphy’s doctor did when Maggie was considering whether to have a double mastectomy. (For Maggie’s story, see chapter 9 in my book, “Pink Confusion: When Should Women Get Screened for Breast Cancer?”)

If your doctor isn’t helpful, take that as a sign that you may not have the level of primary care physician you need. You want a quarterback, like I have. He should know you well enough to call the next play. But he also should give you time in the huddle with him to discuss his call and decide whether you want to run that route or not.

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