So I think I’m finally ready to delve into my multi-part series on self-medical care. Are you ready? This is a complicated & controversial topic and one I’ve been thinking of writing about for a while. Most of what I’ll be covering has to do with self-testing & preventative care. There is no way I will cover everything I want to, but I hope to give you guys some ideas and tools on why and how you might want to consider this for yourself.
My first part of this series is to address why you should consider self-education and self-testing, even if just for a portion of your health care:
1/ No-One Values Your Health More Than You
If there is one thing in life where you should be #1 it’s your own health. No-one and I mean no-one…not your specialist, not your family doctor, not your holistic provider has a more vested interest in your own health than you. Health is actually a passion of mine. There are many reasons for this, but primarily it stems from severe depression and eating disorders in my youth, as well as potentially hereditary health problems in my family. During my many years of depression and counselling no-one ever suggested a nutritional approach to my issues, despite the fact that nutrition was, ultimately, the #1 healing tool for me. Diabetes runs in my family yet no doctor has ever suggested any kind of long-term prevention for it except to “exercise and eat healthy”. Self-testing and self-experimentation has been critical to me over the years and I do not believe I would be here today without it. No-one is immune to sickness, but I read voraciously on health and constantly try to update and improve my own knowledge on the topic. Educating yourself and taking charge of your own health is something I recommend to everyone, no matter what your situation.
2/ Shouldn’t You Work With A Doctor On This?
The first question that everyone asks when I bring up self-medical care is doctors. Many consider self-testing to be dangerous or even irresponsible outside of professional involvement. My point of view is that there is no reason you can’t have the best of both worlds. By all means see your doctor and go for your annual check-ups, but this needn’t be the end of your personal health journey. In my experience there are many tests which a doctor will not prescribe unless you are showing obvious symptoms. Also, there are many nutritional details which are not part of regular medical care. This is very simply because most of modern medicine is focused on treatment rather than prevention. These tests may be incredibly simple and inexpensive yet deemed “unnecessary”. For someone like me who is truly interested in preventative care, I take the point of view that I would much rather explore & experiment with these tests on my own than ignore them. Should they show something I don’t understand then I can always take the next step and go to a professional. Self-testing is a compliment to my professional care, not a detriment.
3/ Isn’t Preventative Care Now Covered Under Obamacare?
This post will not cover all the implications of the ACA law (I have more on that coming in the future), but I do want to touch on this one particular aspect. I’m sure almost everyone in the US has heard that health insurance is now required to cover preventative care. Sounds great, right? Yes and no. Once you start reading into the law you quickly realize that the term “preventative care” is used in a very, very narrow way. There are only a limited list of items covered under the law and you can see them here:
If you’re the type of person who has never had any kind of check-up, then these benefits are a huge bonus, but for someone like me the list is woefully inadequate. For example blood tests for basic cholesterol levels (which is a flawed test IMHO) are covered, but kidney and liver values (which are important to monitor) are not. Also, free preventative care only applies to patients with no on-going risk or health issues in regards to the test being offered. If you are showing risk factors then the test is deemed “diagnostic” rather than preventative and is thus no longer included in your “free” benefits.
So, say you’re healthy and going in for an annual exam, then a basic cholesterol test would be considered “preventative” and thus totally paid for by your plan. However if you are given a cholesterol medication and need your cholesterol levels tested to see if the meds are working, this is considered “diagnostic” and therefore not part of the “free” benefits. You pay for these services out-of-pocket (until your deductable is reached).
This sets major limitations on the approach of “free” preventative care and simply doesn’t cut it for me. I’ll certainly be taking advantage of as many free services under my insurance as I can, but for anyone truly focused on preventative health I would not recommend relying on the ACA benefits to keep you fully covered.
4/ Self-Testing Can Be Inexpensive & Useful
Many younger (and pre-Medicare) nomads are on high-deductible insurance plans which means out-of-pocket $$ everytime you go see the doctor. Given how expensive health care is these days these visits can easily stack up and become overwhelming (to the point that you avoid docs altogether) . However there are many self-tests that you can do which cost less than a single visit to a primary doctor. Also, by on-going self-monitoring you get a much wider picture of your health than a simple yearly exam. In addition, there are a huge number of advanced (and very exciting) tests which are not really offered by doctors yet are simple to order on-line. I do not claim to have the definitive answer to self-testing…human health is simply too complicated and our understanding is constantly evolving. Plus, there are still many aspects (e.g. cancer) which are barely understood, but I do believe you can go a long way to helping yourself along by being educated & doing selective self-testing.
5/ Self-Testing Is The Ultimate Nomad-Friendly Tool
I’ve traveled a lot in my lifetime. In fact for much of my life I’ve traveled so much (and changed countries & insurance plans so often) I’ve barely had the time to establish a relationship with a primary care doctor. Since we’ve been RVing we’ve not had the chance at all. Many primary care doctors have long waiting lists to get on (especially if they are good), there is no way to know if you like them until you get established (which takes time) and they may not be “nomad-friendly”. There are ways to overcome this (e.g. travelling back to the same place every year), but for me self-testing has been my clutch during times where I was not able to get the level of preventative care I wanted. It’s the ultimate go-anywhere self-help tool, and we’ve relied on it as our primary care link since we started on the road. This approach may not be for everyone, but it sure has been useful for us, and until I find a primary care doctor I love it will continue to be a major part of our personal health care.
That about covers the intro. In my next post I’ll delve into what kind of self-testing we do and how to go about doing it.
P.S. Please NO politics in the comments section. I’m total open to discussing all practical aspects of healthcare on the road, but do not want this to devolve into a political argument.