Shows
Friendly Neighborhood PatientEpisode #42: Why Investors Love Buying Medical ClinicsYou might look out to the ocean and see the tiny lip of what becomes a massive wave by the time it hits the shore. In the world of healthcare, that phenomenon would be like investors buying up hospitals and clinics of all kinds. Corporations are joining the fray as well—they, like anyone else, want to cut their medical expenses. Mainstream press focuses on the “greedy corporate overlord” narrative whenever a nonmedical business buys a clinic. Under this theme, such moves could be anticompetitive and kill the care patients get. There’s some truth to those outcomes. Yet the real...2022-10-1311 min
Friendly Neighborhood PatientEpisode #41: How the Gov't Tries to Make Healthcare CheaperThere’s no doubt that our medical system’s expensive to a point of comedic tragedy. No shortage of private and public entities have tried to make medicine cheaper. Ironically, the federal government tries to spend money to save you money in healthcare. Enter the subsidy, an economic instrument both loved and detested by many. Subsidies are used in many parts of the economy, but with medical care in particular, the feds tackle drug development and health insurance among other sectors. Today’s episode tells you why assistance with medical funding makes healthcare both cheaper and pricier for you. 2022-10-0610 min
Friendly Neighborhood PatientEpisode #40: Who are the Doctors Without MDs? Enter the DO!You’ve heard of doctors and nurses. Physician assistants have been on the scene as well. But not all medical doctors have the same degree. Sometimes you might see doctors the letters DO following their names instead of MD. The DO, or Doctor of Osteopathic medicine, has similar base training to an MD, but with more emphasis on treating someone within context of the entire person. Don’t be ashamed if you haven’t heard of such a doctor—according to the American Osteopathic Association (AOA), about one in five Americans don’t even know that DOs exist. Patients who know t...2022-09-2908 min
Friendly Neighborhood PatientEpisode #39: Where Do Your Drugs Come From?It’s totally normal for people to ask where their food comes from but we don’t always do this for prescription drugs. Every medication has to get from a lab to your pill bottle somehow. Ever since the Covid pandemic and the quick approval of its vaccines, patients became more aware of how modern medicine comes about. Our drug approval system has more nuance than just expensive 10-year challenges and quick 12-month emergencies. Let today’s episode be a simple crash course about how our country approves drugs and the first steps to untangle that messy, twisted process for th...2022-09-2210 min
Friendly Neighborhood PatientEpisode #38: The Messy World of Drug DiscountsNever blame a patient for wanting to save money. Especially for meds. Insurance companies also would like to nickel-and-dime manufacturers when possible. High drug prices are a mainstay in the news. That said, a whole world of prescription discounts is right around the corner. Medication discount cards and coupons are everywhere, but patients still need to be careful with using those savings. Episode 38's dedicated to helping you wade through the swamp of a drug discount world we have. This is a public episode. If you would like to discuss this with other subscribers or get...2022-09-1509 min
Friendly Neighborhood PatientEpisode #37: How to (Kind of) Fix Interstate HealthcareYour phone might stick around wherever you go, but your medical care may not follow suit. When the time comes for you to move to a new state, change jobs, or both, your health plans and doctors would need to change as well. Insurance plans and medicine are (mostly) locked within state lines. Closed-loop healthcare built in the 20th century is part of why our current medical system gets expensive. Yet we live in a connected world where it’s perfectly normal to work from anywhere and move state-to-state like we’re crossing the street. In this pod, I’ll mak...2022-09-0809 min
Friendly Neighborhood PatientEpisode #36: When Your Watch Tells You to See the DoctorYour smartwatch talks a lot but may not say much about your health. Constant data collection from wearables claims to improve medicine at large. Is the ‘quantified self’ the next step for patients or is it just a gimmick? Does healthcare improve when doctors access your live data on a whim? After today’s episode, you’ll learn to trust your wearables at the right time rather than all the time. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit rushinagalla.substack.com2022-08-3108 min
Friendly Neighborhood PatientEpisode #35: Does it Matter if Your Doctor's Board-Certified?Learning never stops—that goes double for medicine.Doctors have vast knowledge but they need to remain sharp. Every year we find new diseases, innovations, and drugs. The physicians keeping up with their craft among other requirements are “board-certified.” Why should patients care for that title? After this pod, you’ll know what a board-certified doctor means as well as helpful tools to find a solid one. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit rushinagalla.substack.com2022-08-2508 min
Friendly Neighborhood PatientEpisode #34: How to Use and Not Despise Your PharmacyUnless you happen to be lucky, you’re probably getting prescribed something in your lifetime. It could be one medication. Or you might need a pill calendar. In any case, you’ll have to deal with a pharmacy. Your doctor’s passing the ball and setting you up for success whether that be through a treatment plan, medication regimen, or a combination. Hearing today’s episode will help you deal with the local pharmacies and pharmacists to ensure you get in the end-zone for your healthcare. This is a public episode. If you would like to discuss...2022-08-1808 min
Friendly Neighborhood PatientEpisode #33: The House Call's ComebackWho remembers the good old house call days? Some may imagine a doctor strolling into their home with a well-worn briefcase and curled-up stethoscope. Newer technologies are making the house call a thing again. See Episode #33 of Friendly Neighborhood Patient to know the uses and limits of home health. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit rushinagalla.substack.com2022-08-1109 min
Friendly Neighborhood PatientEpisode #32: Why Your Doctor's Burned Out--And How You Can HelpSome people are tired and others are permanently drained. No matter the profession, if you have no energy, your abilities suffer. Medicine is a demanding field, no doubt, and we should expect our providers to be resolute and intelligent. Why should patients care about their doctor’s well-being? Doctors also happen to be human beings—they too can feel the vice-grip of burnout. A burned-out physician hurts your care and threatens any chance of having a great medical relationship. Patients need to recognize when their doctor isn’t fully present or just going through motions. In today’s episode, you’ll learn h...2022-08-0408 min
Friendly Neighborhood PatientEpisode #31: The Rise of PAs, NPs, and Non-MDsIn the old days, we called them doctors. Now everyone sees a “provider.” Many other professionals from the scribe to the physician assistant complement the doctor. These positions are supposed to make the clinic experience better for all patients. You might have a choice to see a nurse practitioner now or wait longer for your physician. In some places, you may not ever see a doctor again unless your medical condition is complicated or severe. Given how quickly norms change, patients need to ask two questions. Should nurses and physician assistants play a bigger role in medicine? And more...2022-07-2808 min
Friendly Neighborhood PatientEpisode #30: Medicare's Butterfly EffectsHave you ever heard something nice about Medicare in the last few years? It’s the behemoth among our country’s fragmented medical systems. We also pay for it with taxes. So why is it always close to running out of money? Today you’ll learn what insolvency means, how our national coverage actually works, and what we should do about their unintended consequences.Patients have a right to know what they’re paying for. Medicare, our national insurance for seniors, is no exception. Knowing that an entitlement will be weaker by the time you age into it...2022-07-2109 min
Friendly Neighborhood PatientEpisode #29: How to Pick Healthcare Brokers and Deal with IncentivesSailing your own ship is harder than it looks. The world of medical insurance can feel like an unending ocean of choice and complexity, especially when you get a new job, age into Medicare, or turn 26 and thus can’t stay on your parent’s coverage. Every ship captain needs a helmsman, so I want to pass along learnings from my own search about how a broker can be a major help and hindrance for picking the best possible health plan. After today’s pod you’ll know why (and why not) to use a broker.The point of an in...2022-07-1407 min
Friendly Neighborhood PatientEpisode #28: Planning for the Worst With a Healthcare ProxyYou’re awake most of the time when getting medical care. But the future is a funny thing. It’s not a given that you’ll be able to speak or even write your healthcare desires tomorrow or in 20 years. Advocating for yourself is difficult when you get incapacitated or can’t think and act clearly. If you’re in a coma or become unable to make decisions, someone else has to act on your behalf for many items like money, last wishes, and health. On the medical side of things, patients can avoid these confusing and traumatic situations by picking a...2022-07-0706 min
Friendly Neighborhood PatientEpisode #27: How to Prepare for a Hospital StaySometimes patients need to see the doctor more than once a year or even for more than a few days in a row. When a hospital trip comes around, you’ll need to pack more than just your clothes and a toothbrush. After this episode you’ll know the differences between inpatient and outpatient care as well as how to prepare for any long or short healthcare journey.When thinking of how to get medical care, you’re probably imagining a visit to the doctor’s office or a telemedicine app. In any case you’re in and out the sa...2022-06-3008 min
Friendly Neighborhood PatientEpisode #26: When Bedside Manners Matter in MedicineTwo doctors in the same field have equal years of experience with similar expertise about your condition. Assume you can choose either without needing to wait longer for the other. Does it matter if one of them cares a bit more about you as a person? The answer might surprise you. After this episode you’ll know how much emotional intelligence your physicians have on top of their medical intelligence.It’s easier to judge a doctor’s abilities over a long period of time. If an orthopedic surgeon has done a few thousand knee replacements or if a derm...2022-06-2307 min
Friendly Neighborhood PatientEpisode #25: The Myths of Doctor Supply and DemandAmerica has severe doctor supply and demand issues, but the truth is we actually do have enough doctors. How is this possible? After today’s episode you’ll know how our medical system’s resources are misused and what our country must do to improve long-term medical capacity. The patients who understand this will be able to hold the necessary players accountable to make lasting change.If the US healthcare system is a chessboard, and providers are the game pieces, America is playing those pieces with just one column and row instead of using the whole space! Several journa...2022-06-1609 min
Friendly Neighborhood PatientEpisode #24: How Doctors Choose Their PricesYou might be wondering: how can a doctor charge several hundred dollars for a ten-minute office visit? Why can the hospital bill $100k for a three-day stay? Who makes up these numbers besides me? Today’s episode is going to answer those questions so patients can get closer to what price transparency in healthcare should become.One hilarious irony of medicine is that you won’t always know how much you need to pay for a visit and providers themselves don’t know how much they’ll get paid for the same visit until long after the fact. The doll...2022-06-0908 min
Friendly Neighborhood PatientEpisode #23: Paying Cash For Medical CareHealth insurance is a privilege, but not everyone is so lucky. Even if you have a health plan, you may still get a better deal paying out-of-pocket for routine care. For those who don’t have insurance and need to navigate self-pay medicine, this episode is for them.Since 2014, patients have been able to sign up for health plans via the Affordable Care Act (ACA), and the overall number of uninsured Americans fell. However, US adults without insurance remain persistent at between 10-11% the population. Analysis from the Kaiser Family Foundation also covers the reasons uninsured people claim to...2022-06-0208 min
Friendly Neighborhood PatientEpisode #22: When to Get a Second OpinionJust as you would likely review multiple cars or houses before making a final choice, there are moments in healthcare to find another resource for your medical issues. Second opinions in medicine are more common than you think—once we’re done with this pod, you’ll be able to request for the right kind of additional expertise on time and on target.Even if you’ve seen the same doctors for long enough that both your and their hair are turning gray, you can and should be comfortable asking for a second opinion in a variety of situatio...2022-05-2607 min
Friendly Neighborhood PatientEpisode #21: Tackling Medical Bills With ConfidenceObscene medical bills are just insult to injury when you’ve already paid a lot of money to fix the injury. After this pod, you’ll be able to handle medical invoices with more confidence.You’re not the only person who might have a major doctor or hospital bill. Data from a previous review by the Survey of Income and Program Participation suggest that 9% of Americans in 2019 owed “significant” medical debt. In this case, significant was defined as $250 or more. Of those 28-29 million adults who owe that much, 53% owe between $1001 and $10000 in healthcare debt and 13% owe more than...2022-05-1908 min
Friendly Neighborhood PatientEpisode #20: Should I Go to the ER or Urgent Care?One day you could wake up and your body isn’t just having a bad time—all you know is that you have an issue that needs to be dealt with fast. In the US, we have urgent care and emergency rooms made to help for this purpose. Once you know the pros and cons between urgent care and the ER, you’ll be able to make better choices when sudden health problems arise.How can patients walk the fine line between urgencies and emergencies? Like I’ve stated in past episodes, Friendly Neighborhood Patient is not a medical...2022-05-1206 min
Friendly Neighborhood PatientEpisode #19: How to Pick the Right Mental HealthcareThere’s no doubt that mental health matters but not everyone knows how go about seeking help or even how prevalent these issues are for patients. Soon you’ll have more confidence in picking the mental health option working best for your situation.The fact of the matter is that no basic lab or blood tests exist for mental issues. Mental health conditions are primarily diagnosed upon having an exam or long-term study of your health. Even though we don’t know all the answers about why our lovely brains can get depressed or schizophrenic, we do know that s...2022-05-0507 min
Friendly Neighborhood PatientEpisode #18: Precision Medicine's Irony, Promise, and Price TagImagine for a second if you could have treatment which fits you better than a tailored suit. In some cases, biostatistics tools and custom medicines like gene therapy open new doors for patients. After today’s pod, you’ll know all the practical and impractical uses of precision medicine for patients.So what is precision medicine? Aren’t doctors already supposed to customize treatments for each given patient’s situation? The short answer is yes but the longer answer leaves a key gap I want to talk about. What the majority of doctors follow is evidence-based medicine. This is a tim...2022-04-2707 min
Friendly Neighborhood PatientEpisode #17: What Do You Mean by Out-of-Network?!It might seem wild that a doctor or hospital won’t take your insurance, especially since more than 91% of Americans have at least some form of coverage. After this pod, you’ll know what “out-of-network” really means as well as the choices you have when health insurance doesn’t go too far.In strictly financial terms, it’s wiser to seek a provider who takes your insurance. You’re already paying a king’s ransom for the insurance you have so why pay more? In any other context, a doctor accepting your insurance won’t be necessarily better than a provider wh...2022-04-2108 min
Friendly Neighborhood PatientEpisode #16: Prior Authorizations and How to Deal With ThemAs a patient, you’re beyond ready to get started on whatever treatment you need to heal or prevent other issues. Sometimes though, you get hit with a prior authorization, which is, without a doubt, healthcare’s most annoying rug pull. Thankfully, we have simple ways to deal with it.Healthcare is a field where you may consume a given product or service at your leisure but at the same time find yourself stopped by gatekeepers preventing you from getting other routine medical work done. Let’s say you go to the doctor’s office and get an order fo...2022-04-1407 min
Friendly Neighborhood PatientEpisode #15: Drug Inflation--The BasicsOne quick way to start arguing with a politician is to mention prescription drug pricing changes. This issue affects everyone, so I’m going to give you the brief story for how drugs get from the manufacturer to your front door as well as go over the underlying reasons for why they cost a ton.We’re probably better at tracking drug pricing than remembering to get rid of the trash. For example, if you’re taking blood pressure meds that cost $2 per pill per day now and next year each pill costs $2.10 daily, you might have the diffic...2022-04-0708 min
Friendly Neighborhood PatientEpisode #14: How Your Medical Record Should Be ProtectedYou should treat your medical records with care just like with your keys, wallet, and phone. Hopefully, medical providers are treating your data even better. By the time we’re done today, you’ll know about health record protection as well as how to use those records properly.When you see your doctor and their scribe typing furiously on their devices in the exam room, they’re trying to update your medical record, which includes things like your basic family health history, surgeries, meds, lab results, visit notes and more. It’s a great idea to keep an electron...2022-03-3108 min
Friendly Neighborhood PatientEpisode #13: The Good, Bad, and Ugly of Medical OfficesA great doctor might be what brings you into a clinic but you won’t stay there too long if that clinic and its staff treat you like crap. Once we’re done with this episode, you’ll be able to tell apart the good, bad, and straight-up dysfunctional clinics or hospitals.Obviously, the skill and location of whatever doctor you see matters the most in your choice for what clinic you join. Every great team needs its stars, but the reality is that in most places, the doctor is one major cog in a grand machine. The mid-le...2022-03-2407 min
Friendly Neighborhood PatientEpisode #12: The Benefits of HSAs and FSAsHealth savings and flexible spending accounts make for a nice crossover between money and medicine. This is not a personal finance podcast at all, but when I’m done with today’s theme, you’ll be able to take advantage of benefits good for your health and maybe even your pocketbook.The main concept here is that health savings accounts, or HSAs, and flexible spending accounts, or FSAs, have pre-tax money that you can spend on various healthcare items. I’m not here to give you tax or investment advice but I do want to point out a bunch of...2022-03-1706 min
Friendly Neighborhood PatientEpisode #11: Telemedicine Pros & ConsTelehealth and telemedicine offer so many benefits you should take advantage of. But just like how you might take whey protein, telemedicine should be a supplement and not a replacement for your health needs.The one thing we should clear up right off the bat is that telehealth and telemedicine are not exactly the same. Telehealth options tend to be more public-facing and include things like mental health or education tools. Telemedicine is more along the lines of getting official medical care through an app or software interface. Telemedicine can however, be considered a part of telehealth, just...2022-03-1007 min
Friendly Neighborhood PatientEpisode #10: Why Doctor's Schedules Get CloggedSaying a doctor is busy is like calling the sky blue. You still might be asking though, why are clinic schedules so damn packed? After we take a trip behind the scenes for why the doctor’s waiting room earns its title, you’ll be prepared to handle any reasonable wait time.There are really two boxes to unpack for talking about how doctors get heavily booked: 1) the day-to-day operations (when the doctor is quick or slow to get you at any given time) and 2) the big picture trends and seasons explaining the congestion in the first place. This...2022-03-0307 min
Friendly Neighborhood PatientEpisode #9: How to Refill Your MedicationsYou could say that medical advice and prescriptions are the salt and pepper of healthcare. Unfortunately, there will be times when you run out of prescriptions that you need to continue and you are worried about what needs to be done next. After this episode, you’ll be able to handle prescription refills, no sweat.Let’s say you’re leaving the clinic with a treatment plan in mind and your doctor either gave you a physical prescription or sent an electronic one to your pharmacy. Now you fill the prescription either at the pharmacy or in the mail a...2022-02-2306 min
Friendly Neighborhood PatientEpisode #8: Handling Medical Office AnxietyI can tell you for sure more people feel concerned rather than excited to visit the doctor. Some patients get anxious if not terrified of medical offices. All that being said, there are simple tips which can help you approach your doctor with confidence; no liquid courage required.Just like how we can be vulnerable during intimacy, discussing sensitive items with the doctor, to no one’s surprise, makes for a lot of apprehension and worry. In the exam room, there are a zillion things you don’t want to hear from the doctor that can stress you out...2022-02-1706 min
Friendly Neighborhood PatientEpisode #7: Medical Referrals--Unpacking the Black BoxSuperman may be great at pretty much everything but the other heroes use their own particular skills for a reason. When it comes to medicine there are issues that even general practitioners can’t handle, so when the time comes they will refer you to a specialist. Once we break down how referrals work you will improve your follow-up care with simple insights.When any given doctor sends you to another provider, the primary intent to get medical opinions, surgical work done, or diagnostic help to support the best possible treatment for you. Picture a scenario where you’re i...2022-02-1009 min
Friendly Neighborhood PatientEpisode #6: HMOs, PPOs, and POS's... Oh My!Whether individuals or employers pick your health coverage, you can still make sense of insurance choices to match up with your lifestyle and current medical situation. Knowing the relationships between various insurance components makes each plan type digestible.Before we even talk about insurance plan types, we need proper self-awareness. If we know ourselves and our health tendencies, we’ll find a better insurance plan fit. This logic applies both to individual patients picking health plans from online marketplaces and businesses purchasing health plans for their employees’ best possible coverage.The major tradeoffs for any health plan...2022-02-0308 min
Friendly Neighborhood PatientEpisode #5: Medical Practices and... Ice Cream?!It’s hard to pick the flavor of ice cream you want at the shop unless you know yourself well. I know I’m that guy who takes forever to pick something when I’m in line. Choosing to get your healthcare in a private or public setting can make you feel the same way. Once we go over the major types of medical practices, you can rest easy with finding an office that’s a great fit for your needs.You should have a say on what kind of medical practice works best for your situation, but there ar...2022-01-2707 min
Friendly Neighborhood PatientEpisode #4: Demystifying Health Insurance BasicsYou might think your insurance will be a gentleman and pay for dinner, but the company will probably split the bill or make you pay the whole thing instead. After this episode though, you’ll be able to tackle the basics of health insurance like deductibles and copays without a problem.Understanding your medical insurance might feel like scaling a sheer cliff. Once we cover the basic concepts you’ll have enough hand- and foot-holds to do that climb. Before we start that let’s check out the big picture. The concept of insurance should matter to you becaus...2022-01-2007 min
Friendly Neighborhood PatientEpisode #3: Turning EOB and Medical Codes into Plain EnglishHere you are opening mail to find that your insurance sent a letter which is apparently not a bill, yet it says you owe money for your recent doctor’s visit. Once we translate this letter into English, you’ll have nothing to worry about.This letter I’m talking about usually arrives in the coming weeks after any given medical visit or service. This document states, in bold lettering, that it’s not a bill, yet the number of dollar figures on there raises your blood pressure anyway. This letter is an explanation of benefits (EOB). It’s supposed...2022-01-1309 min
Friendly Neighborhood PatientEpisode #2: Take Advantage of Your Routine CheckupYou’re at the doctor’s office, the visit is just about over, and you completely forgot why you’re there in the first place. Trust me, I’ve been there before too. But fear not! Getting ready for a routine visit is as easy as walking the dog or minting an NFT.You can prepare yourself well for a regular physical before you even set foot in the exam room. Besides reviewing everything I’ve noticed from my own experience running a clinic, I checked out a few sources including the government’s Agency for Healthcare Research and Quality...2022-01-0608 min
Friendly Neighborhood PatientEpisode #1: Finding a New Primary DoctorWhat is a primary care provider, why do I need one, and how the hell do I find one?Contacting a primary care provider (PCP) or a primary medical doctor (PMD) is a great first move when you need a new health issue addressed or if you want preventative care and guidance. These are the professionals you want to have a great relationship with. You should not settle for seeing an absolute jerk of a doctor, regardless of how great he or she may be. Getting effective medical care from a professional should not be like a fast-food...2022-01-0508 min
Friendly Neighborhood PatientEpisode #0: What Do Bikes and Medicine Have in Common?Calling all patients,Think of your healthcare like your bike. A bike suiting someone who’s 6’3” and 280lbs wouldn’t work for someone who’s 5’5” and 140. The purpose of a bike or a car of course is to take you from point a to b—that doesn’t change. But not everyone should ride the same bike, the same car, or have one-size-fits-all medical care. The problem is that various companies and governments are trying to replace and reinvent healthcare when the equivalent of applying some WD-40 and switching the chains is a better solution for most people.Patients...2022-01-0502 min