Important warning signs you should always discuss with your doctor.
Common sense tells us that symptoms like acute chest pain and abdominal pain or persistent fevers and headaches are important reasons to seek medical attention. Yet some patients, because they lack access to a physician or are simply too distracted or stubborn to make the phone call, disregard such symptoms until it's too late.
Dr. Joseph W. Stubbs, president of the American College of Physicians and an internist in Albany, Ga., has treated both types.
Recently, he saw a diabetic patient who quit taking blood thinner and blood pressure medications after losing her job. By the time she contacted his office for help, four of her toes had turned gangrenous--a common risk for diabetics who experience poor circulation.
Today this kind of behavior is common; the recession has forced many to postpone routine health care. A Kaiser Family Foundation telephone poll of 1,200 people conducted in April found that 60% of respondents were delaying care in some way, including skipping a recommended medical test, using home or over-the-counter remedies instead of seeing a physician, or failing to fill a prescription.
The ability to pay for health care, however, does not always mean a patient will seek needed treatment. Stubbs has also cared for work-obsessed patients who neglect their health because of perceived time constraints.
Either way, Stubbs says, "I would urge people to not be pound foolish and penny wise."
Though it can be difficult to separate critical from typical aches and pains, Dr. Stubbs says that emergent symptoms should be considered on a continuum from acute to moderate to mild. Chest pains, fevers above 101 degrees and severe abdominal pain, for example, should be examined immediately.
A patient may diagnose new chest pain as indigestion, but it can instead indicate a heart attack. A high fever combined with shortness of breath, mental changes or lower back pain could be signs of pneumonia, meningitis or a kidney infection, respectively.
Unusual skin rashes should be examined quickly, since they can indicate an underlying infection, lupus, shingles or the measles. Changes in skin pigmentation or new growths, however, don't need to be seen in the emergency room; scheduling a visit with a physician soon after noticing the issue is sufficient.
Other symptoms that require urgent medical attention include sudden trouble with mental faculties--a sign of stroke--and fainting, a rare but deadly sign of an irregular heart rhythm.
Planning for Health
Dr. Ron O'Quin, a physician in Bellevue, Wash., agrees that such symptoms should be considered urgent or high-priority and encourages his patients to contact him at any time with any concern.
His patients do pay for that privilege, however, since he practices with MD2 (pronounced MD squared), a network of providers who offer a so-called concierge style of medicine in which individuals pay an annual fee of $15,000 for unlimited access to a physician. MD2 physicians treat only 50 families, which allows them to develop close relationships with patients.
O'Quin recognizes the unique advantage of his practice, but says patients with varying levels of insurance coverage and access can try to achieve a similar level of attention by developing short- and long-term plans for their health. That should include scheduling the annual battery of tests, monitoring any chronic health conditions and asking for reminders about starting and adhering to new medication regimens.
Those plans may not prevent an emergency, but they can help a patient take control of his or her health and feel more comfortable about communicating with a health care professional about an emergent problem.
With some things, "you only get one chance," O'Quin says. "Ignoring that is a serious mistake."