Avoiding Urgent Care

photo credit: kenjonbro via photopin cc

photo credit: kenjonbro via photopin cc

When a health crisis occurs, urgent care clinics and emergentcy rooms will treat you (or your child, loved one, etc…). They can also put a serious dent in your bank account. During the crisis, it will seem like there’s no other option, that you just have to suck it up and pay the piper. It is a crisis, after all, not some gradually developing condition that can wait for your primary care physician to be available.

So how do you know if it’s a crisis? Is it’s best to err on the side of caution, even if it means takiing a chunk out of your savings? Ask anyone who has had a suddenly sick child what they think.

Nevertheless, back in 2013, the New York Times reported that “more than half the problems patients bring to emergency rooms either do not or would not require hospital-based care if an alternative source were readily available.” additionally proposing that “care in an emergency department for a routine medical problem can result in unnecessary hospitalization, tests and procedures that may even complicate a patient’s medical problem.”

Reduce the Chance of Crisis

The first step to avoiding an unnecessary trip to the ER is to get in the habit of routine check-ups with your primary care physician. Not only will your doctor montitor your health, but he or she is your best ally when getting educated about your own health.

This doesn’t have to be contained to their office either- many doctors are incorporating communication tech into their practice to increase their availability to their patients, which leads me to the next step in avoiding an unneccesary trip to the ER:

Call Your Doctor First

Or skype them, or use whatever method the two of you have worked out. Your doctor can tell you if the symptoms you report to them merit a trip to the ER, or if it’s something that can wait until they can see you. Often, a crisis occurs at an incovenient time. What are your doctor’s after hours policies? When do they take calls, and do they make house calls? If you aren’t sure, find out.

Direct Primary Care

Does your doctor take calls after hours? Do they make house calls? If the answer is no, you might want to consider finding a new primary care physician. The direct primary care model is growing in popularity with doctors across the nation because it allows them to see less patients, which opens up their availability for taking unscheduled calls or making a house call when needed. You can find doctors in San Antonio and Austin that practice direct primary care right here in our doctor directory.




photo credit: jmayer1129  cc

Sunscreen Alternatives

School’s out. Sunscreen’s in!

With summer here, everyone’s getting out of their respective caves, and out into the sun. Meaning sunburns. Growing up in the desert of Southern California, I’ve experienced some epic sunburns, mostly as a kid running in my BMX bike gang. After my mother had a chunk of her leg skin replaced due to malignant skin cancer, I started getting more careful.

But in the recent years, I’ve been slipping, and my skin becoming more sensitive. Falling asleep on a beach in France gifted me with an not-so-beautiful belly sunburn. Seriously. Just the belly. Then there was the upper ankle burn in Morocco. And the (now) bald head burn in the mountains of northern California. And the eyelid sunburn passed out on a boat in Lake Union Seattle.

And my excuse for not sunscreening it up? I hate sunscreen. The smell. The color. The fact it make my palms all girly and soft. The cost. Then some research declared that sunscreen *increases* the risk of cancer. All of it.

So how do I dodge the inevitable sun burn and probably skin cancer bullet? Well I’m going a natural – and I don’t mean nudist in the shade. That’s just gross. I’m talking natural sunscreens.

Here’s some alternatives.



photo credit: Phú Thịnh Co  cc

photo credit: Phú Thịnh Co cc

Wellness Mama has some great recipes. Notable is the list of oils used as a optional bases in the lotion have natural SPF all by themselves. The short list:

  • Almond Oil- SPF around 5
  • Coconut Oil- SPF 4-6
  • Zinc Oxide SPF 2-20 depending on how much used
  • Red Raspberry Seed Oil SPF 25-50
  • Carrot Seed Oil –  SPF 35-40
  • Shea Butter – SPF 4-6



DIY Natural makes the case for just protecting yourself the old-fashioned way. Wide-brimmed hats, find shade during the hottest parts of the day, wear light, loose clothing to cover skin and even rocking an umbrella. When hiking a (tiny) section of the Pacific Crest Trail, the thru-hikers inevitably had sunscreen on the bridge of their nose and ears and wore light long sleeve shirts, and some great big hats. One dude even rocked an umbrella – apparently it’s a growing trend.


photo credit: the camera is a toy. cc

photo credit: the camera is a toy. cc

For those super-susceptible to sunburn, a tweak in your diet can actually reduce your risk. Specifically cutting Omega 6 fatty acids (which coincidentally are the cause of a bunch of other negative health effects) and increasing intake of lycopene (tomatoes, red peppers and watermelon). Vegetable oils are the most common culprit – from fried foods, margarine, etc…

Another reason to start using coconut oil, and adding watermelon to your super-foods diet regimen.


Finally, if you prefer the ritual of slathering yourself and your kids with suntan lotion, you can try out this natural recipe for the traditional stuff. Pay special attention to the notes about zinc oxide (that’s the chemical that does the actual ‘blocking’) – some natural remedy proponents have put it on the ‘good to go’ list, and other have lambasted at it as trading one problem for another (the fine powder is un-safe if inhaled, and the finest powders can be absorbed into your skin which is also unsafe).

As for me, I’m sticking with my big hat and long sleeve linen shirt.

What about you?

Blog Digest – June 2014

Photo Credit: Nytimes.comGet your monthly dose of the latest health care news right here on budgetdoc.com. This month we’re jamming on the theme of personal accountability, aka taking yourself and your health seriously.

States Can Shed Light on Health Care Costs

This article from Forbes criticizes Obamacare’s failure to lower the cost of health care, but offers up some insights into how individual states can champion the health care consumer (read: living breathing human beings) through proactively pursuing price transparency.

Forbes further advocates personal accountability in the matter, encouraging consumers to price shop more aggressively, while admitting that under current law, it can be difficult to impossible to learn what price your insurer pays for your care, or learn the actual cost of care from hospitals. So what can your state, and you, do to become better informed on how your health care dollars are being spent? Find out here.

Adventures in Urgent Care

From the BudgetDoc.com blog, Nate shares his experiences when his daughter’s condition went from “everything is hunky-dory” to “what the *bleep* is wring with my daughter?” You don’t want to get caught in a situation where you need urgent care, but sometimes you can’t help it. Nate’s story outlines the process, the consequences, and the lessons he has learned though the experience.

Adventures in Caring and Acting Affordable

I’m sensing a theme developing: labelling mildly traumatic experiences as adventures. Dr. Rob Lambert’s adventure involves giving the old healthcare.gov a whirl and what happened after. With his usual level of humor, he shares his epic quest to enroll his family, in particularly his 18 year old son, in the health care plans provided by Obamacare. This case study exposes a few particular quirks in the system that you may have encountered, and what to do about them. Learn more about Dr. Rob’s experience over on more-distractable.org, and while you’re there, take some time to read up on his further adventures as a direct primary care physician.

Skeptical Medicine: Refuted Studies and Herbal Supplements

Dr. Larson of Austin OFM shares the philosophy and reasoning behind practicing skeptical medicine. If you want a good picture of how medical studies can prove one idea one year and discredit it another, this article delivers. As a health care consumer, are you a skeptical patient? Whether that’s price shopping for the right doctor, or talking over your health with a doctor you trust, Dr. Larson invites us to take a closer look at something it’s too easy to take for granted: our health.

Dealing with Pain

back painWhen should I call my primary care physician?

Pain is a part of everyday life. In some cases, you can pop an aspirin or two and feel better. Sometimes you can’t. When should you call your doctor?

One of the most common types of pain is back pain. If you work sitting down, odds are you’re no stranger to it. The culprit may be as simple as your lifestyle.

For simple aches, one of the best remedies is to get active! Take time from sitting at your desk to activate the muscles in your core and strengthen them. Even a two-minute “standing break” every so often is better than nothing, though it’s amazing what good posture and physical activity can relieve when it comes to back pain.

Pain in your back or other parts of your body may be soothed with the simple application of ice or heat, applied 15 minutes at a time.

Naturally, ibuprofen or acetaminophen are also options for managing pain, though if you find they aren’t helpful, it may be worth calling your doctor. Self-medicating with alcohol, while practiced by some, is a bad idea. Alcohol opens the door to other health problems and reduces the quality of the sleep you get, leading to more time in bed, which can lead to further pain, particularly back pain.

Call your doctor if you experience sudden, severe pain, pain that gets worse over several weeks, pain that wakes you from sleep, numbness or weakness in your legs, or develop a fever.

Loss of bowel control and difficulty urinating are symptoms that may require immediate treatment, so call your doctor right away!

Chronic pain should also be discussed with your doctor, as well as arthritis related pain.

Many of the doctors here on budgetdoc.com practice the direct primary care model, which may include free phone consults. Find your doctor here.





photo credit: tamaramarabobara cc

Adventures in Urgent Care

After leaving the Air Force in 2006, I experienced a fairly cliche journey of transitional ups and downs.

  • No more shaving – Awesome!
  • No more uniforms – OK, except when I realized shopping was involved.
  • No more secure, steady paycheck – Kind of a bummer.
  • No more moving every two years – Super Duper!
  • No more being called Sir – Was odd for a barely man in his 20′s.
  • No more deployments hanging over my head – Priceless.
  • No more health benefits – AAAAAAAAAAAGGGGGGGGGGGHHHHHHHHHHH!!!!!!!!

As a full-time single dad, my daughter is tougher than most. But when she does get hurt, it’s usually serious. In the Air Force, a quick trip to the emergency room, and a follow-up appointment to her primary care physician, and everything was swell.

An Adventure in Urgent Care

But now when she was experiencing some erratic abdominal pain, and with me in a job with zero health insurance, I didn’t know what to do.  At first I just started calling pediatricians only to be confused by their ridiculously low availability to see my little girl.

Finally I got in touch with an ‘on-call nurse’ at Childrens Hospital in Seattle. She patiently heard my long-winded tirade, and responded simply.

“Go to the urgent care clinic. Bring your checkbook.”
“Urgent care clinic? What’s that?”
“They are for all of the ‘in-between’ stuff that’s not quite an emergency, but can’t wait till tomorrow.”

So I hustled down there, and after a short wait my daughter was seen by a dynamite doctor who immediately ordered an MRI, found the issue, prescribed me with some generic meds, an sent us on our way. She was feeling better by the end of the week. They even worked up a discount for the care (MRI’s are *not* cheap) and setup a simple payment plan for me. Granted, it would have been easier if I had some standard PPO plan, but it all worked out.

Lesson Learned

  1. Know the location / contact info for all of the urgent care clinics in your region. Even if they don’t take your insurance, make sure you’ve got their number stashed away in your wallet.
  2. When shopping for a doctor, make sure you understand their policies on after-hours help. If they don’t offer it, they should have a good referral to an urgent care facility.
  3. Don’t be a cheapskate. If I had waited even a few more days, an urgent care visit that cost a little less than $1,000 could have turned into a $10,000 ambulance ride.
  4. If money is an issue, explore alternatives such as cash-pay osteopaths. After interviewing Dr. Zain Hakeem, D.O. about my daughter’s medical history, he nailed the exact issue in about 15-minutes. Calling someone like him earlier on may have helped me avoid getting to the urgent care stage to begin with.
  5. Ask lots of questions. The more knowledge you have about prevention, the more you’ll know when to spot when something is wrong. Some of the docs in our directory even offer free workshops.

Stay well.

Blog Digest – May 2014

presentIn this month’s blog digest, BudgetDoc takes a look the past, present, and future of health. Guess which one looks the brightest? Hint: It’s not the past.

Reflections Of A Fourth Year Med-Student

Over at Scientific American, Ilana Yurkiewicz reflects on her experiences at med-school so far, including her thoughts on efficiency, the grooves her patients carve into her psyche, and what poetry has to do with it.

Medical Students Should Get Excited About Direct Primary Care

Physician Brian Lanier shares his story about discovering direct primary care and the optimism for the future of his practice it provides.  Outlining provisions in the Affordable Care Act for direct primary care practices, Brian calls on new doctors and med-students to turn to a practice that “harkens back to the glory days of the family doctor.”

Why Is Nutrition So Confusing?

Perennial myth-buster LifeHacker asks and answers it’s own question in this article that addresses annual flip flopping on nutrition issues (e.g. “Eggs are bad! No wait, they’re good!”) as well as fitness fads. The short answer is: there is no short answer. It’s a complex issue, but this article breaks it down into great detail.

Good And Bad Ideas From “City Of Health”

The Public Library Of Science posted this fascinating blog that looks back at health ideals from 1875. Not exactly the most up to date source material, but it’s reassuring to know that we’ve progressed in our understanding of health since then. If you need a palate cleanser after that LifeHacker article, this is it.


Physical Well-Being and Mental Wellness Go Hand in Hand

Four ways to foster physical and mental well-being, and be happy about it!

Money doesn’t buy happiness – but it can buy peace of mind

Start saving money! Easier said than done, sure. Having an extra bit of padding in your bank account can help you to avoid panic during the tough times.

Perhaps it isn’t a surprise that a healthier lifestyle is less expensive. Cooking fresh produce at home vs. eating out or managing health risks through exercise, for example.

There’s a host of money-saving advice all over the internet. Some tips may be useful for your situation, some may not.

If you’re looking to save money on doctor visits in Texas though, you know where to start.

Get out of the house

Exercise isn’t just good for the body, but the mind as well. You don’t have to push yourself to the limit to get that rush of endorphins to the brain, you don’t have to exhaust your last reserves of energy each day. A short workout during the day will give your mind a little time off while improving blood flow to your whole body.

If you find going to the gym a punishing experience, get out into nature. Stretch. Go on a jog, do some push-ups, crunches, jumping jacks, whatever. Stretch again.

You’ll start to notice you feel better during the day and sleep better at night.

Add value to your life – what does your time mean to you?

Are you spending too much time on “grunt work”? Perhaps you like to decompress at the end of the day with some TV.

According to the A.C. Nielsen Co., the average american watches more than 4 hours of TV each day. Clearly, there’s a lot of wiggle room in that little statistic. Maybe one day you watch an hour, another day you don’t watch any, and the next day you binge watch an entire season of House of Cards.

Which of those days felt the most satisfying to you?

Not to knock Kevin Spacey’s political drama. The point is that there’s wiggle room. Spending less time vegging out and more time participating in activities that grant satisfaction, that you feel accomplish something, either for your personal gain or the gain of your neighbor, will help you feel happier with how you spend your time.

Don’t be so hard on yourself

There’s no right way to handle happiness. If you’re lying awake at night wondering “why am I not happier?”, perhaps you’re doing it wrong. Or perhaps you’ll wake up in the morning with some ideas to add value to your life, and take action on those ideas.

It’s your life. Only you can define what happiness is to you (cue Pharrell Williams)

Bacon or Blueberries? The Questionable Practicality of Heart-Healthy Foods

Credit: ccavinesscc

Credit: ccavinesscc

After working directly with a few of BudgetDoc’s osteopaths, I’ve become seriously motivated to start eating better. In the past I avoided fad dieting, calorie counting, cholesterol monitoring and sugar measuring with great intensity.

But a perfect storm of discomfort physical (belly: 1, top-button of jeans: 0), emotional (best friend died of a heart attack at 45) and mental (my lack of focus had become appalling) was enough to push me over the edge.

I started slow … canned foods were kidnapped from my cupboard at an alarming rate. Cheap sandwich bread was replaced with Dave’s Killer Bread. And push-ups weaseled their way onto my scheduling tool thrice weekly.

And its been working. But now that the low-hanging fruit has been harvested, it’s time to grab a ladder and start tackling the harder stuff: like eating food that better for my heart. Which brings me back to my original question: Bacon or Blueberries?

Harvard breaks it down by category.

“Avoid the following:

  1. Processed Meats (bacon, hot dogs, sausages, lunch meat, etc…)
  2. Highly refined and processed grains and carbohydrates (Wonder Bread anyone?)
  3. Soft drinks and other sugary drinks (basically every drink other than bottled water for sale in 7-11)

Eating Well magazine takes a different approach, with their “avoid these foods” list:

  1. Trans Fat – packaged snacks (potato chips)
  2. Saturated Fat – butter, sour cream
  3. Salt
  4. Added sugars

So my longtime culinary affair with bacon is in danger of being exposed …. it’s processed and packed with salt, all sorts of glorious fat, and a bit of sugar if I’m feeling Maple-y. The basic tenet of overcoming any addiction is to focus more on replacement then removal.

So what are the heart healthy foods?

Credit: Martin LaBar (going on hiatus) cc

Credit: Martin LaBar (going on hiatus) cc

Health magazine and WebMD’s lists are very similar, and jam-packed with fruits, vegetables, and some super foods such as flax seeds or coffee. After digging into several more lists, blueberries kept popping up. So I picked up some Quaker Old Fashioned Oats and some dried bulk blueberries, and dove head-first into my much-improved breakfast routine.

Now I crave oatmeal and blueberries fortnightly – but I daydream about bacon, that heart assassin daily. I’ve already added / increased my intake of the so-called superfoods (which I’m convinced is just a covert way for the grocery store to triple their price). Here’s a mash-up of the super hero foods, in no particular order

  • Tofu - uhhh, yeah, that ain’t gonna happen
  • Soy Milk – have you tasted that stuff?
  • Blueberries - nearly 10 bucks a pound. Yup.
  • Carrots – I can handle that
  • Spinach – last time I bought a huge bundle of this stuff, it reduced down to something like that looked like a used wad of chew … tasty, but … yeah.
  • Broccoli – awesome … with its super un-healthy nemesis – ranch dressing
  • Peppers - my stomach lining would likely tell the heart to piss off
  • Sweet Potato - baby food … except when in a pie form laden with heart murdering brown sugar
  • Asparagus - I love the stuff, but hate the price
  • Oatmeal - my old standby … poor student’s food at best, especially with a hunk of butter (evil) and brown sugar (super-villian)
  • Brown Rice - no sure if the $1.49 a pound Basmati rice counts as ‘whole grain’ but brown rice always tastes like undercooked cheap fast food rice.
  • Red Wine - sorry, but I’m a vodka guy.
  • Coffee - really?!?! these same experts have been crying about the over-caffeination of Americans for a decade-plus now. Lesser of the evils perhaps?

The Verdict

So in the superfood / supervillian death match, who will reign victorious: bacon or blueberries? I call it a draw.

I’ll give oatmeal and blueberries Mondays and Wednesdays, bacon and eggs Tuesdays and Thursdays, and Fridays a coffee and flaxseed muffin (I *think* those exist).

And Saturday and Sundays? Whatever cures my hangover from drinking a week’s worth of wine in one night.

That’s okay right?

Heh, heh, anyways, you should consult your doc before taking any advice from a superfluous man with poor self control and a public addiction to beer, bacon and butter. 

April 2014 Blog Digest

arthritis 2What’s The Deal With Cracking My Knuckles?  Is It Harmful?

Lifehacker provides this Q&A which says “usually not” in response to rumors of knuckle cracking causing arthritis.  When is your paranoia justified?  Read the article to find out.


Diary Of A Healthcare Spy

A collection of stories that seeks to establish a dialogue based on the themes and problems of healthcare reform.  Join the dialogue, read the stories, and leave your comments.

Activity Tracker Smackdown!

As activity and sleep tracker wristbands become more popular, who else but the NYT well blog would take it upon themselves to test and rate all of them? In this article, they compare Nike Fuel-bands, Fitbit Trackers, BodyMedia Armbands, the Jawbone UP and a few others.  Which has the features you want at the price you want?  You know where to go to find out.

Physician Responds to Obama Care Holistically

Dr. Larson of Austin OFM opened a subscription based practice earlier this year.  Find out more about direct primary care and osteopathic treatments right here on BudgetDoc.com.


Last week I had the challenge of preparing a meal without dairy. The menu: mashed potatoes, surf & turf, and asparagus. Initially, I didn’t think much of it. Except when I instinctively grabbed butter, whole milk and sour cream for the potatoes, melted down butter and garlic for a dipping sauce, and added butter to the asparagus to keep it from sticking. Needless to say, we made two separate meals. And it got me to thinking about milk, and it’s controversial role in the health and wellness space.

Here’s a recap of recent opinions and findings on the classic white food.

You’re Drinking the Wrong Kind of Milk

A slew of new evidence on the cause for milk and lactose allergies has popped up recently. The core topic of the discussion hinges on the difference between A1 and A2 milk. In layman’s terms, milk from regular Holstein cows in Europe and America create the A1 protein which is though to be the driving force behind the colossal increase in milk allergies in the US. Other cows produce the A2 protein which . Proponents of A2 milk claim that A1 milk can cause (or worsen) diabetes, arthritis and even autism. Regardless of the lack of mind-altering evidence, numerous dairies in the US have stopped breeding A1 milk cows, in favor of A2 cows. One company in Australia has been mass-producing A2 milk after extensive testing in rats showed that it didn’t trigger lactose intolerance.

I’m guessing this will put a different spin on our attitudes towards the popular steak sauce as well, but we’ll save the off-flavor jokes for a different post. 

(Source: Mother Jones

Milk Allergy? Now What?

Milk now top the list as the most common allergy in the US. As a child I was incorrectly diagnosed with a milk allergy and suffered under Mocha Mix for cereal. As a teenager I caved, and guzzle cow’s milk down like booze at an open bar. Today’s alternatives are much more appealing:

  • Soy Milk
  • Almond Milk
  • Coconut Milk
  • Hemp Milk
  • … and a bunch of others (this article cites alternatives such as quinoa milk, oat milk, and potato milk, 7-Grain milk (from oats, rice, wheat, barley, triticale, spelt and millet) and sunflower milk.

PERSONALLY: Soy milk, though the most common, isn’t appearing en masse on store shelves (yet) – not a fan. I’ve tried almond milk, but only enjoy it in coffee or sweet baked goods. My sister swears by the stuff though. Coconut milk (the cheap canned variety) has been a constant companion in Indian and Thai cooking but seems a bit strange in a bowl of cereal.

The most cutting insight culled from the article: none of the milk alternatives packs the nutrition punch that cow’s milk boasts

(Source: Medical News Today)

 California: The Land of Milk & Honey No More

As a native to California, dealing with drought sits right down there with ignoring (most) earthquakes. An occasional annoyance. However, the recent drought here has had devastating effects on milk and honey production. The growing demand for milk from organic, grass-fed cows is difficult to meet when the grass is crunchy. Less rain means less nectar production. An less nectar production means bees start dying.

Be on the lookout for increased prices on organic milk and honey, especially if you’re in the western U.S.

Source (TwinCities.com)