Medical Lemmings: Peer Pressure and Medical Spending

Kitty PoP’s kill eyes… When this look is in his eyes, you don’t want to be on the receiving end.

My coworkers are the same people that convinced me to get allergy testing (they were right, I’m allergic to mold), and there was a weird two month period when 3 of us + the 1 dependent son of another employee all got MRIs done on our back.  They were all unrelated injuries, but when 3 other people related to this small office all get MRIs in the 8 weeks following yours, you start to wonder if we’re some kind of medical lemmings.

But beyond these examples, there were a couple of things that happened recently that have really got me thinking about medical spending and how we seem to encourage each other to do more and more of it all the time.

 

Squeeze In Another Mammogram?

The first event was when a coworker came into my office for her annual ritual of whining about a mammogram she had that morning.  Now, I’ve never had one before, so maybe I don’t truly understand the pain involved.  But when I said, “Maybe you don’t have to get as many of them?”, she did not react well.  I amended my statement, reminding her that the recommendations for breast cancer screening have changed in recent years, and that I was not planning on getting any mammograms any sooner than age 50 because of my risk profile.

Oh she did not like that one bit.

My coworker got super-defensive and started talking about all the women she knows who had breast cancer – mothers with breast cancer, dogs’ veterinarians’ sisters with breast cancer, etc.  Her stats and the risk factors associated with her genetics didn’t seem to be having any impact in her decision.  She felt that mammography screening saved their lives, and there was no way she was going to take a risk by skipping even one – no matter how much she hated getting them done.

We agreed to disagree and went on our merry ways, each thinking the other was nuts.

But then a couple of weeks later, she popped into my doorway again.  Her 87-year-old mother-in-law was diagnosed with very early stage breast cancer via a mammogram the day before.

Me:  “I’m so sorry… What are her treatment options?”

Co-Worker:  “Oh, they’re not planning on treating it.  Just watching it because she’s too sick from other things.”  

Me: “I’m so sorry, is your husband handling it okay?”

Co-Worker:  “It’s tough, but she was already so sick… So you can understand now why I will always get my yearly mammo, and you should too.  Even consider starting them early.  The earlier the better.”

I told her I’d definitely think about it, but all I was thinking was “WTH!?!”

  1. What is an 87-year-old doing getting a mammo if she’s too sick to be treated no matter what it says?
  2. A MIL may feel like a mom, but she has no genetic relation, so her MIL getting breast cancer has no clinical impact on my co-worker’s risk factors – and definitely no clinical impact on MY risk factors for breast cancer.

But it’s clear that my co-worker cares deeply about me getting a medical procedure that isn’t currently recommended for me for another 20 years.  Is this weird to anyone else?

 

 

Spotting Mono?

But then a couple weeks later I met up with a friend for lunch and found myself watching a similar scene unfold – but with a different view.

My friend looked  a little flushed, and when I asked if she was feeling okay she said she was fine now, just taking a bit of time to get over a horrible reaction to a medication and from strep throat.  “Oh no… mind if I ask what medication?”  “Amoxycillin.”  

I chewed on this for a little bit.  Meanwhile she talked a little bit more about how she and DH have just been SO EXHAUSTED with the kids (2 under three) lately and how they keep getting all these sore throats so she thought she had strep, hence the amoxycillin, and how bad the rash she got from the amoxycillin was.

Finally I spit it out.  “Have you been tested for mono?!?  Your symptoms sound like exactly what happened to me and it turned out I had mono.”  

[Fun medical fact of the day – 80-90% of people with active mono will get a terrible rash if they are misdiagnosed with strep and take amoxycillin.  If you don’t believe me, you should believe wikipedia.]

She hadn’t been tested for mono, so I told her about what had happened to me many moons ago… and by the end of my description, she was texting her husband telling him to get to the doctor to get some blood drawn for a mono test and to schedule her an appointment, too!

 

Did They Have Mono?  Does It Matter? 

Okay, so my friend and her DH did have mono.  But was I any more “right” in telling them to get tested than my co-worker was in telling me to get a mammo?  I was recommending a medical procedure (mono blood testing) that their doctor hadn’t felt was recommended at that point.  Same goes for my co-worker.  She was recommending a procedure that my doctor hadn’t recommended for me.

Neither of us are doctors.  If we want to be completely honest, I think the A I earned in Honors Bio my freshman year in high school was a little generous considering I never even dissected a worm.  I took my worm and set him free in the class garden to aerate the soil.  [Yeah, I was that kid!]

So my medical and biology knowledge qualifications are what  you could call “low”.  They’re based on reading summaries of studies (or even more often news articles about summaries of studies) and from my own personal experience.  That’s about as much as most of us who haven’t gone to medical school have to base these kinds of decisions on.

But we care about our friends and coworkers – they are part of our little communities – and we want them to be healthy and happy.

 

So How Do We Stop Being Medical Lemmings?

Honestly, I’m not sure.  But I think admitting that we can have that tendency can be a powerful step in the right direction.

I also think if I had the option through my work, I would switch to a HDHP (that’s high deductible health plan) with a HSA like Mr PoP has.  When the first dollars every year come out of your own pocket, it’s a pretty powerful incentive to do some price checking and make sure that procedures are really right for you before just going in for some allergy testing because your coworkers have you convinced you have allergies.  (Which the insurance company shelled out over $5K for….)

 

Is your health insurance generous enough that you, too, have developed some medical lemming tendencies?  Have you ever found yourself telling a friend that they really *should* go to the doctor for this or that?  Was it all necessary?  

37 comments to Medical Lemmings: Peer Pressure and Medical Spending

  • I had a super generous health plan at work and didn’t use it except for an emergency. I don’t like waste in general and France has such a good health system they spend a lot of money already and beg people not to waste it. I don’t do a mammo but have a visit once a year or so where the doctor checks everything is fine and I would have one upon his recommendation.
    Pauline recently posted..Being Outside of AverageMy Profile

  • That’s really weird. Your co-worker shouldn’t be pressuring you into getting anything medical done! She isn’t paying the bill. Very strange.
    Holly@ClubThrifty recently posted..Saving for Retirement: Don’t Make ExcusesMy Profile

    • Well, with our insurance it’s basically covered with your well-woman visit if your doc recommends it or you ask for it. So the insurance co sees the bill, not us… which I think is part of why this stuff can get so out of hand.

  • I do think we need to treat medical care and going to the doctors with more frugality and not running to see them when we have a minor cough. I think that’s a small part of the reason why health care costs are so high. I also don’t think you should feel pressured into anything if you don’t want to. While I feel sorry for your co-workers MIL, I am not certain why (if there were other issues already) they would get a mammo.

    That said, we’ve had two great friends, both young mothers in their early 30’s, get diagnosed with Stage 3 breast cancer over the last two years. It’s been a terrible trial (to say the least) for both of them. I think Obamacare added screening to the things covered at 100%. I know that might cause a number of things to inflate expenses, but think it’s well worth it.
    John S @ Frugal Rules recently posted..5 Frugal Ways to Start Investing NowMy Profile

  • PK

    Sounds like how I found out I had mono – ridiculous fatigue, the the point I was roughly chugging coffee at work (and re-evaluating my eating and sleeping habits). One day on the drive home I looked in the rearview and saw white dots in the back of my throat – and instantly turned around and drove to my doctor’s, only to be told it was strep (that is a pretty recognizable symptom of strep, to be fair. Not the fatigue though.).

    3 days later I was back, and left with a diagnosis of mono!
    PK recently posted..The Four Pillars of Personal FinanceMy Profile

  • I don’t understand why anyone would want to find out if they are allergic to mold… IT’S MOLD! GET IT OUT! LOL! Allergic or not, it’s not an option to keep it around as a house pet or something. Geeeez.
    Veronica @ Pelican on Money recently posted..Watch Out when Buying GoldMy Profile

    • Haha, we don’t have any mold inside – it was originally suspected that I was allergic to pollens or grasses since they got bad when I spent more time outside. But don’t worry – no mold in our house or in my office!

  • I can kind of see the correlation between the two stories but somehow I find them different. Number one was a preventative measure where as number two were syptoms that she was directly feeling that you recognized because of your own prior experience. I’m sure she was extremely grateful that you gave her the tip. I don’t think I’ll be getting mammograms anytime soon though because I’m not 50 and there is no history of breast cancer in my family.
    I think of it as more of a proactive approach to your health than lemmings. It’s not your doctor doesn’t have a million other patients and you may just slip through the cracks…everyone’s seen it happen to someone.

    • It’s nice that people are giving me the benefit of the doubt, but her symptoms could have easily fit things other than mono, too. I was definitely not qualified to make the recommendation, even if I did happen to guess right.

  • Medical Lemmings is an interesting term. I love that we have Universal Health Care in Canada, but people take advantage of it when they go to the emerg with a cold, just to be sure it isn’t Pneumonia
    Mandy @MoneyMasterMom recently posted..Are you a witch, wizard, or middle class?My Profile

  • I think the two situations are very different. You were recommending action to your friend out of an experience you had, where your co-worker was recommending your action because of an emotion. Emotions are what make medical lemmings.
    Derek @ Freeat33 recently posted..How to combat inflation on your retirement incomeMy Profile

    • I think you’re right that there’s definitely an element of emotional judgement going on – which isn’t always the best way to approach decisions like these.

  • CincyCat

    In my mind, the two situations with your co-workers were very different. In the first situation, your co-worker is recommending puely defensive testing with no risk factors, symptoms or even recommendations from the medical community at-large that would impact you. In the second situation, your co-worker was actively displaying symptoms that you had also personally experienced. As a result, you probably helped her (and her DH) get better faster. It’s not like you randomly suggested she get tested for mono. Apples and oranges.

    • Sadly with mono, knowing that you have it doesn’t necessarily mean you get better faster… =(

      It’s interesting that you guys seem to see the situations as very different. At the time, it was like I got smacked in the face with a “You just did what you were criticizing” pillow.

  • I feel like a lot of people, myself included, go to the doctor too often for far too many procedures and examinations. This is why health care is becoming so expensive; every year we Americans use so much more than the year before. I read a stat that Americans who make up less than 5% of the world population use more than half the world’s prescriptions. I believe it, too. We want treatments and pills for just about anything!
    Bill recently posted..Why You Should Refinance a Car Loan at a Lower RateMy Profile

    • Ah yes, a prescription for this and a prescription for that, and another one to take care of the messy side effects when the first two interact. Fabulous, right?

  • When you get checked out by your woman Dr. don’t they look for lumps by hand anyways? So long as a woman got a checkup on a regular basis it should be caught. This could prevent expensive unnecessary treatments that don’t need to be done
    On the other side, my grandfather passed away from colon cancer in his late 70’s, so I am at greater risk for it and will need to be checked earlier. Same thing with diabetes.
    I’m glad that my brother-in-law’s wife is a PA and has to read up on the latest medical information. Anytime I have a problem I can go to her free of charge to get an opinion.
    Justin@TheFrugalPath recently posted..Stockpile Smart: Hoarding Isn’t SavingMy Profile

  • I see both sides. We routinely check blood pressures for comprehensive eye exams and often find off the charts high readings. Patients often haven’t been to the doctor in years and refuse to go unless they are dying. Huge cost for having a stroke or heart attack that could have been prevented with regular care.

    I also have people who come in at the drop of a hat. Even the school is terrible about making a kid come in for any sort of eye redness. Conjunctivitis or “pink eye” is almost always viral, which needs no treatment, but if you don’t at least give the patient some sort of moisture or anti inflammatory drop, school and lots of work places won’t let them back in. People on state aid come in more often because there is no out of pocket cost to them. Private pay or those with high deductibles come in much less often.Not on the same level as breast cancer, but there should be a happy medium. Lots of the problem comes from how easy it is to sue someone. If you complain of a persistent headaches, you often get an MRI, even if it is obviously not a tumor. If you don’t rule that out, and the patient does have an unrelated problem even years down the road, they can come back and sue you.
    Kim@Eyesonthdollar recently posted..Reasons to Love Your Used CarMy Profile

    • I hadn’t considered the liability that doctors carry in the equation. You should write a post on that sometime, Kim. I’d love to hear what types of liability coverage you had to maintain as the owner of a medical business!

  • I find this interesting, especially as there is the whole cost aspect that is completely unfamiliar to me. I have had mono twice, so relate to those ones :-) I know several people who have had breast cancer, including 2 in their twenties, which has the worst survival rate (weird, no?). That said, there’s a reason for self checks, family history and physicals!
    Anne @ Unique Gifter recently posted..Guest Post: Health Care Gifts!My Profile

    • Mono twice? That sounds awful. (Not to trivialize the people with breast cancer, I just can relate as to how awful mono was to have just the once!)

  • Working from home I’m lucky: nobody to lemming….although my cat has been coughing a little lately and so have I, so I’m pretty sure I’m developing a hairball or something…..
    AverageJoe recently posted..How Much Should I Spend on the Holidays? My 4 Ironclad Gift-Buying RulesMy Profile

    • Haha, watch out for those hairballs!

      FWIW, Kitty PoP did a bit of a medical lemming himself when we had another cat (a long hair with a hairball problem) stay with us this summer. After that cat left, Kitty PoP hacked up a mega hairball like none he had ever done before or since.

  • I never get annoyed at people who diagnose me or tell me to go to the doctor, but it might be because of how I was raised. My mom *is* Dr. Google! She is constantly diagnosing people we barely know even. I’ve learned to just smile and reassure her that I’m going to the doctor regularly and that my doctor is VERY thorough. This pacifies her for the most part. :)
    Michelle recently posted..We Didn’t Win The Lottery….Thank God!My Profile

  • The NY Times recently ran an editorial about mammography.

    It suggests that very few lives were saved, while a very large number of women underwent painful, invasive procedures to treat a cancer that would not kill them.
    Kevin @ Employee Paid Benefits recently posted..My Baby Brother Was a Pre Existing Health ConditionMy Profile

    • Yeah, this post was mostly written before that came out – NPR also did a great review of the study – but that was part of the impetus to finally click “publish”.

  • Ivy

    I do believe in regular preventive visits, but it makes sense to consider the risk factors. I was going to a dermatologist annually for full skin check, but when he suggested a 2-year cycle I was happy to rely on exert opinion and reduce it. Maybe I am more diligent about this since I am adopted and don’t have family medical history, but a few years ago I did genetic testing with “23andme” and since then am much more comfortable that I don’t have high risk factors.
    I do have to say mammograms are one of the most unpleasant procedures I’ve had (almost beats being in labor) that I would be happy to run with the new recommendation

  • […] Medical Lemmings: Peer Pressure and Medical Spending at Planting Our Pennies. Please don’t ever be a medical lemming. Make choices that are right for you and don’t follow the crowd. […]

  • […] last, but not least, Kim at Eyes On The Dollar was kind enough to include our post Medical Lemmings – Peer Pressure and Medical Spending in her Can’t Take My Eyes Off These Blogs – Hacker Edition.  Glad you got your twitter […]

  • Health is the most important thing in life . if you are fit then you do your work with more effectively . so; according to me get the doctor recommendation each month and do medical checkup every month . please don’t wait for emergency because at emergency time may be disease crosses the peak level . so take care at starting level . eat healthy and stay healthy always .

  • […] Medical Lemmings: Peer Pressure and Medical Spending at Planting Our Pennies. Please don’t ever be a medical lemming. Make choices that are right for you and don’t follow the crowd. […]