How to nd

Doctor Right
3 Contest: Lean Team Challenge 7 Tests that could save your life
March 2008











C
elebrating 30 Yea
rs o
f H
e
lp
in
g
P
eople Stay Healthy
did you know?
Sleep helps your brain process
and store recent memories.
Neuroscience
depression
and early
retirement
Depression is associated
with early retirement
among late-middle-aged
workers. During an eight-
year study, researchers
traced 2,853 workers
between ages 53 and 58.
Of the men and women
who retired, nearly 20
percent reported symptoms
associated with depression.
As many as 9 percent
of all U.S. workers have
depressiona treatable
con dition. Yet, many dont
know theyre depressed,
nor do they have their
de pression diagnosed and
treated by a professional.
Health Services Research
quick takes
Questions are answered by Phyllis D. Cross, M.D., M.P.H., in conjunction
with the Taking Care medical advisory board and medical contributors.
This publication provides general information and isnt a substitute for professional health care. Be sure to discuss with your doctor any health strategies or medical treatments.
Im pregnant. Could my cat cause health problems?
CATS THAT eat rodents, birds and other small animals can
become infected with a parasite called Toxoplasma gondii, which
can be passed to humans who are exposed to the cats feces.
Millions of people carry the Toxoplasma parasite without
any negative health consequences. However, toxoplasmosis can
cause serious problems. Moms-to-be, for example, can spread
the infection to their unborn babies. In rare cases, babies with
toxoplasmosis are born with serious eye or brain damage.
Te parasite also can come from sources other than cats.
You can become infected by eating contaminated raw or
partially cooked meat. Te bug also can be present in drinking
water or soil. But, cats commonly play a major role in spreading
the infection. Fortunately, blood tests can detect the parasite.
And, medications can be used to treat the infection.
With precautions, pregnant women and cats can live safely
in the same household. To help lower your risk of infection:
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Have someone else clean the cats litter box. If you must clean
the box, wear disposable gloves and wash your hands aferward.
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Change the litter box daily.
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Dont feed your cat raw meat.
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Keep your cat indoors.
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Avoid personal contact with stray cats or kittens.
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Dont eat raw or poorly cooked meat
at home or in restaurants. Also,
wash hands and utensils afer
handling raw meat.
Ask your doctor for
other tips to reduce your
risk. Te Centers for Disease
Control and Prevention
also encourages pregnant
women to discuss their risk of
toxoplasmosisand possible testing
for itwith their doctors.
3 steps to take if laryngitis steals your voice
Viral laryngitis, a contagious infection, can temporarily
steal your voice. To help prevent laryngitis, try to stay
away from anyone who has it, and remember to
wash your hands frequently to help avoid the spread
of germs.
If you do lose your voice:
1. Take a break from talking for a while. Talking may
lead to further irritation.
2. Drink plenty of water and avoid caffeinated beverages.
3. Gargle with salt water. This may soothe a sore throat.
American Academy of Otolaryngology Head and Neck Surgery
2 FEBRUARY 2008
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TAKI NG CARE
contest
YOU KNOW that buying generic laundry detergent or
other products can mean savings at the supermarket. But,
is it wise to buy generic drugs at the pharmacy? Granted,
generics cost less. But, are they as efective and safe as
brand-name medications?
Yes, according to the Food and Drug Administration (FDA),
which regulates these products. Generic drugs must be the
same quality, strength and purity as brand-name drugs. And,
they must contain the same active ingredients as brand-name
drugs, so both provide the same benefts and come with the
same risks.
But, for all their similarities, there are subtle diferences. For
example, according to trademark laws, a generic drug cant look
exactly like the brand-name drug. Certain inactive ingredients,
such as colors or favors, also may be diferent.
Still, if theyre largely the same, why are generics cheaper?
It comes down to investment costs. Lots of money goes into
the research, development, marketing and promotion of new
drugs. Patent protection helps drug makers recoup these costs
by giving them exclusive rights to sell the product for a set
number of years. But, when the patent expires, FDA-approved
companies can make generic versions.
Today, nearly half of all prescriptions are flled with generic
drugs, according to the FDA. If youre taking a prescription
drug, your doctor will help you decide whether a generic is
appropriate for you.
ON YOUR mark, get set, go! Its time once again for Taking Cares Lean
Team Challengea great way to get in shape, have some fun and put you
in the running to win fabulous prizes. First, team up with three other
people. Ten, for the next 10 weeks, keep track of your exercise and weight
loss. For complete information, rules and contest entry forms, go to
www.takingcarenews.com/ltc.
Havent exercised for a while, or not sure how much weight loss is
appropriate for your health? Be sure to talk with your doctor to fnd out
whats right for you.
2008 Lean Team
Challenge
GENERIC DRUGS
Are they safe and effective?
Each winning team
member receives a gift
certicate to Amazon.com.
Grand Prize
gift certicate
Second Place
gift certicate
Third Place
gift certicate
$100
$50
$25
TAKI NG CARE
|
MARCH 2008 3
OF THE countless decisions youll make about your health,
choosing a doctor is defnitely one of the most important.
Finding the right one for you can take some time and efort.
But, the reward will be reliable health care and a doctor who
can help you stay healthy for years to come.
Make a list
As you begin to create a short list of possibilities, consider your
personal preferences and any special health needs you have.
Would you like your doctor to be male or female, younger or
older? What ofce locations are convenient for you? Do you
need a specialist to manage any specifc health conditions
you have? Also:
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Find out if your health plan has a list of preferred providers
rated by the quality of care they give.
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Ask family, friends and co-workers for referrals. For this
approach to be efective, make sure to ask people whose
opinions you value. Be sure the person has visited the doctor
under consideration several times. Ask why the doctor is
being recommended.
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Call a hospital, medical center or medical school and
ask for recommendations.
How to nd Doctor Right
To nd professional information about specic doctors, try
the online tool from the American Medical Association.
Visit www.ama-assn.org and click on DoctorFinder.
4 MARCH 2008
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TAKI NG CARE
7 ways to build a strong
doctor-patient relationship
Once youve found the right doctor, do your part to nurture the relationship. These
tips can help you partner with your doctor:
1. Speak up. If you dont understand something, ask your doctor to explain it until
its clear.
2. Prioritize your questions. Before each visit, write down your questions or concerns.
List the most important ones at the top. If you need more time to discuss concerns,
say so.
3. Be honest. This is the best policy if you want to protect your health. Mention
anything that might be important about your health history or symptomseven if its
difcult or you feel embarrassed. Your doctor needs to be aware of any special risks you
face in order to recommend necessary screening tests and give good advice.
4. Keep your doctor up-to-date. Be sure your doctor knows about other doctors you
are seeing, other treatments youre having and all of the medicines you take, including
over-the-counter drugs and supplements.
5. Take notes. Write down instructions, or ask if its OK to use a tape recorder. Feel free
to ask for written instructions as well as brochures to take home.
6. Pay attention to symptoms. Do your best to explain any symptoms youre having.
7. Follow up. Call the ofce if you have questions after an appointment or if youre
having trouble with medicines or symptoms.
Sources: Agency for Healthcare Research and Quality; American Academy of Family Physicians
Make initial contact
When you have two or three candidates in mind, call their
ofces and fnd out if theyre taking new patients. Also, ask to
speak with someone who can help answer questions like:
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How long has the doctor been in practice, and what are his or
her medical credentials?
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What are the ofce hours? What if I need to see a doctor
right away?
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Where would I be referred afer hours?
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Do I need to pay upfront, or can I be billed for anything not
covered by my insurance?
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How long does it typically take to get an appointment, and
how long is a usual ofce wait?
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Are reminders sent out about screening tests?
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Can I get routine medical advice over the phone?
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Which hospital is the doctor afliated with? Or, do other
doctors called hospitalists typically provide hospital
inpatient care?
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Who covers for the doctor when he or she is out of town?
Be sure to ask anything of importance to you. If the staf
is helpful and youre satisfed with the responses, its time to
make an appointment.
Meet the doctor
Consider this a get-acquainted session. As you talk, do you fnd
yourself liking and trusting this doctor? Does he or she:
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Give you a chance to ask questions?
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Answer your questions in a way you understand?
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Make you feel comfortable?
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Ask about your treatment preferences?
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Address any health conditions you have?
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Spend enough time with you?
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Suggest ways to reduce your risk of illness, such as by
exercising more or losing weight?
Tese qualities are helpful, but it may take some time to
establish a working relationship. However, the reward of having
a health partnership with a doctor you trust will be well worth
the efort.
TAKI NG CARE
|
MARCH 2008 5
on your mind
QUIT WHILE youre ahead. Tats
great advice for anyone who gambles.
But, what if you cant quit?
Tats the case for an estimated
6 to 8 million people in the United
States who have become increasingly
addicted to gambling, including those
who gamble online or place bets on
sporting events. Now, its disrupting or
even destroying their lives, according
to the National Council on Problem
Gambling (NCPG).
Fortunately, problem gambling can
be prevented and treated.
Beyond money
Problem gambling may cost you more
than money, says Keith Whyte, executive
director of the NCPG. Even if you pay
of your debts, you can lose the trust
of your family and friends, he says.
A gambling problem can hurt your
reputation and performance at work. It
can afect nearly every part of your life.
People with the disorder may:
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Lie and argue about the extent of
their gambling
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Continually borrow money or
constantly rely on help to get out of debt
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Steal or embezzle money to fund
their habit
Problem gamblers may neglect their
families and jobs because they spend so
PROBLEM GAMBLING
Betting your
life away
is gambling a problem for you?
You may have a problem with gambling if youve:
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Often gambled longer than you planned
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Lost sleep due to thoughts of gambling
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Frequently gambled until your last dollar was gone
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Let bills go unpaid because of gambling
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Gambled to escape from personal problems
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Lied to your friends or family members about gambling
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Made repeated, unsuccessful attempts to stop gambling
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Felt irritable when trying to stop, cut down or control your gambling
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Broken the law or considered breaking the law in order to nance
your gambling
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Borrowed money because of gambling
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Felt depressed about gambling losses
If you can identify with any of these statements, consider calling the
National Problem Gambling HelpLine Network at 1-800-522-4700 for
condential assistance.
Source: National Council on Problem Gambling
much time gambling or thinking about
gambling. And, research shows they also
are more likely to abuse their spouses
and children and to become depressed
and suicidal.
Prevention and treatment
Like a drug or alcohol addiction, problem
gambling is a medical disorder. Being
afected doesnt mean youre weakonly
that you need help.
If youre worried you could develop
a gambling problem, its a good idea
to stay away from casinos, lotteries,
ofce betting pools, online betting sites,
and other situations and places where
gambling occurs.
And, if gambling is already a concern,
see your doctor. Support groups and
individual counseling can help you quit
and stay away from gambling.
Te sooner you address it, the better
of youll be, Whyte says.
Support groups and individual counseling can help
you quit and stay away from gambling.
6 MARCH 2008
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TAKI NG CARE
youre in charge
ITS HARD to mention good news and cancer in the same
breath. But, there are a few things you could say about
colorectal cancer that are hopeful. For example, if you fnd
it early enough, your chances for successful treatment are
excellent. Even better, removing precancerous intestinal
growths can stop colorectal cancer before it starts.
Colorectal cancer ofen begins as small growths called
polyps. But, polyps and early colorectal cancer may not cause
symptoms, according to Durado Brooks, M.D., director of
prostate and colorectal cancer for the American Cancer Society.
Tats why screening tests are so important. Ask your doctor
which tests he or she recommends. Options may include one or
more of the following:
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Yearly fecal occult (hidden) blood test. At home, you place
several small samples of stool on cards and send them to a
lab. If this screening fnds blood in your stool, you will need
further tests.
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Fecal immunochemical test. Tis is similar to the fecal occult
blood test but may be more accurate.
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Flexible sigmoidoscopy every fve years. Using a slender,
lighted tube called a sigmoidoscope, a doctor examines the
lower third of your large intestine. Te test takes about
10 minutes and can be done in the doctors of ce. If a polyp
is found, in some cases, it can be removed right away.
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Colonoscopy every 10 years. Tis is the gold standard
when it comes to colorectal cancer screening. Colonoscopy
is similar to a sigmoidoscopy but uses a longer tube, called
a colonoscope, to view the entire large intestine. You will be
sedated for this test, which takes about 20 minutes. Polyps can
be removed at the same time.
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Virtual colonoscopy. Tis test checks the entire colon with
x-rays. It shows promise but still is being studied and isnt
commonly used yet.
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Barium enema every fve years. A chalky liquid, called
barium, is temporarily placed in the colon. Ten, x-rays are
taken. Te barium helps improve the detail of the images.
Some form of colorectal cancer screening should begin at age
50 for people with an average risk of the disease. If you have a
higher risk, your doctor may recommend that you start having
screening tests at an earlier age and at more frequent intervals.
Screening is the most important tool for
preventing colorectal cancer. And, fnding
[cancer] early gives you a tremendous
advantage, Dr. Brooks says.
Polyps: An early warning sign
Polyps are grapelike growths of tissue on the inside walls of the
intestines. Most arent cancerous, but doctors remove them for
testingjust to be on the safe side.
Polyps are very common, and they usually dont cause
symptoms. However, you should tell your doctor if you have:
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Blood in your stool or on toilet paper after a bowel movement
even if you think its only hemorrhoids
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Constipation or diarrhea for more than four or ve days
Routine screening for colorectal cancer often nds polyps.
Most can be painlessly removed during a colonoscopy, but larger
growths may require surgery. If polyps are found, your doctor
may advise having a colonoscopy every three to ve years to
check for new growths.
Even precancerous polyps or ones that cause symptoms can
almost always be treated successfully.
COLORECTAL CANCER
Age 50 or older? Its test time
For more info
American Cancer Society. Visit www.cancer.org.
American Gastroenterological Association. Visit www.gastro.org.
TAKI NG CARE
|
MARCH 2008 7
Michael W. Rosen, M.D.
National Medical Executive,
Health Solutions Group
Joseph R. Carcione Jr., D.O.,
M.B.A.
Medical Director, Healthcare
Services, Oxford Health Plansa
UnitedHealthcare Company
Gail Borgatti Croall, M.D.
National Medical Director, Health
Care Decision Support, Optum
Phyllis D. Cross, M.D., M.P.H.
Medical Consultant, Optum
Tanise Edwards, M.D.
Medical Consultant, Optum
Cheryl Lewis, R.N.
Medical Consultant, Optum
Virginia Lund, M.A., L.P.,
C.E.A.P.
Mental Health Consultant, Optum
Richard A. Zabinski,
Pharm.D.
Vice President, Pharmaceutical
Solutions, Health Solutions Group
Taking Care adheres to stringent clinical standards and
is reviewed by the following medical professionals:
Taking Care

Helping People Stay Healthy Since 1978

Taking Care

March 2008 | Vol. 30, No. 3

E-mail: takingcare@uhc.com
If you have an address change, send
it directly to the entity through which
you receive the newslettersuch as
your employer or health plan.
Taking Care is dedicated to helping
people have healthier lives. However,
this publication does not replace
the necessary and individualized
medical care offered by a health
care professional. Not all treatments
mentioned in Taking Care are covered
by your health plan. Please check
with your health plan regarding
covered services.
Unless otherwise noted, all models are
used for illustrative purposes only.
2008 Optum

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answer your questions and provide health information.
This page of your Taking Care newsletter features
examples of the kinds of questions people askas
well as the kinds of helpful answers they receive.
What can I do to help keep my child from
trying cigarettes?
BILLIONS OF advertising dollars are spent enticing people to
smoke. But, behind the glossy images lurks a smelly, expensive
andabove alldangerous habit. So, its important to steer
your kids away from tobaccos false promises.
Start by arming your child with the facts about tobaccos
dangers, but do this in a way your child will understand.
Stressing long-term riskssuch as cancer, heart disease and
strokeis important but perhaps too abstract for kids. Make
those dangers real by pointing to family members or friends who
may have sufered or even died of tobacco-related ailments.
But, keep in mind that it may be more efective to emphasize
some of tobaccos short-term efects, such as bad breath, yellow
teeth and smelly clothes. Point out that tobacco also can limit
athletic performance, make asthma worse, cost a lot of money and
be extremely dif cult to stop once you start.
Clear, consistent rules with consequences also are important.
Make sure your kids understand that youre setting no-smoking
Keep your kids tobacco-free
rules to keep them safe. Help your kids follow the rules by
discussing ways to overcome peer pressure.
If just saying no isnt enough, ofer alternate responses,
such as I dont like the way smoking makes me look or I
dont like the smell.
Rules and facts arent your only tools. Your child is more
likely to make good decisions if he or she fnds it easy to
discuss sensitive topics with you. Forge a strong bond with
your child by listening closely, asking opinions and praising
good behavior.
Its also important to set a good example. If you use tobacco,
quit. If youre having trouble quitting, talk with your doctor.