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Chronic Disease Care

It’s tough and time-consuming to try to be your own doctor. Of course, it’s best to feel connected to your body and educate yourself regarding its ins and outs. But when it comes to chronic disease care, it’s good to have someone else involved.

Common Chronic Diseases

The top chronic diseases we deal with are mental health issues, metabolic problems, and pain-related medical problems.

Hypertension, high cholesterol, osteoarthritis, and depression are the most common issues I deal with. Not all of these require medications. In fact, many are better managed through lifestyle changes.

Saving Money on Care

In the traditional insurance model income is generated when the patient is seen by the doctor. And the more complex the case the more money is earned.

This is likely why we call the US healthcare system a disease-based model. Of course, it has incredible upsides as well. If you suffer major trauma or anything acute, a US hospital is likely going to do quite well.

In my practice, I sell my expertise on an hourly basis. The patient is who pays me and that’s who my customer is. They can discuss any topic with me at length – such as when to use antibiotics for a diverticulitis flare and when to manage it conservatively.

I save my patients money because we think about chronic disease care from all aspects, not just which treatment to offer but how to prevent it. It’s also important to factor in how a particular medical condition affects your long-term health outcome.

Cash-Based Healthcare

I charge a flat hourly rate for my expertise. I answer directly to my patients and not an insurance company. This incentivizes me to keep my patients healthy instead of generating profits from developing new ICD-10 codes for chronic medical conditions.

This isn’t the perfect solution for everyone. If you need expensive IV infusions or specialist care, the cost can rapidly get out of hand when you pay cash.

However, 90% of chronic diseases can be managed through a simple conversation with your doctor and the occasional prescription medication. With the ultimate goal of using the least number of interventions possible.

1. Hypertension

Instead of immediately starting anti-hypertensive medications, chronic diseases like high blood pressure benefit from breathing exercises, stress management, a functional approach to nutrition, and some natural remedies.

I love the work of Dr. Weil and Dr. Low Dog regarding natural remedies for common chronic medical conditions. It’s rarely dangerous to try these options first.

If necessary, I prescribe medications such as ACE-Inhibitors or Calcium Channel Blockers to control high blood pressure, always with the goal of stopping these eventually once the blood pressure is controlled naturally.

2. High Cholesterol

Your cholesterol may be high but if your diet, stress, and inflammation is controlled and you do not have a strong family history of cardiovascular disease, the question is whether you’d benefit from a statin or PCSK9 inhibitor.

The ever-popular atorvastatin drug can be paid for cash for as little as $15 for a 1-month supply through GoodRx. But, again, just because it’s cheap, it doesn’t mean you need it.

A lipid panel test needs to be done but every few years won’t cost more than $60 through Quest Direct.

3. Osteoarthritis

My main concern with osteoarthritis isn’t to wait until my patient needs a joint replacement. Rather, how can I prevent them from ever needing surgery?

Joint injections and prescription medications will only expedite the time of surgery. Instead, my patients benefit from a change in their diet and meeting with movement specialists and physical or occupational therapists.

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