5 Cheap-ish Ways to Take Charge of Your Health

One quick note before we start this episode.

We mention a few specific labs, services, and healthcare resources by name. None of them sponsored this episode, paid us, or gave us anything.

They're simply options we found while researching lower-cost care, and we've included some links on our website to make them easier for you to find.

Welcome to Please, Health Me!? I'm Tristin, and each week, I bring real health questions from around the internet to my mom, Rebecca, a board-certified family nurse practitioner with 45 years of experience. We're here to help you better understand your health, not diagnose or treat medical conditions.

Everything we discuss is for educational purposes only and should never replace the advice from your own healthcare provider. I wanted to talk about the clinic that you started 15 years ago in our community, which was a low-cost clinic, very accessible for people. It was something you did yourself, and it was a really important and valuable asset to the community, for sure. Can you talk about what that was, why you started it, and why it was important?

I can. I started a clinic for people without insurance. It was very apparent that hardworking people who just didn't make enough to have health insurance had no place to go. I mean, if you had just a UTI or a sore throat, you had the urgent care, which cost a fortune, and the ER, which cost a fortune, and there just wasn't any place in our community to have that addressed.

So that's kind of how we opened up. We wanted to be there for acute problems like sore throats and UTIs and all the various little things, as a quick and affordable place to go. But we quickly realized that these people who were coming in for these things had no preventive care.

They might have come in for a sore throat and found out they had screaming-high blood pressure or other problems. They just hadn't seen anyone, or it hadn't been addressed, and they would say, "Well, I don't have money for that." It was kind of anxiety-inducing for me. It was like, "Well, we have to do something here."

We got dragged into primary care, really, when we just wanted to be there for acute care. So I decided that I had to find some way to diagnose and treat these people affordably—something they could afford—and take care of them.

We ended up making a plan sometimes: "Can you do this today? Can you do this test today?" Or, "Let's do this, and then when you get paid next week, we can do some more." So we worked things out so that they could get some care.

If someone came in and basically said, "I can't afford all of this," how did you decide what actually mattered first?

It really did depend on the problem. Many times, they would come there for an acute problem, so we would take care of that that day. Maybe it was a strep throat. They had to come in for the visit, and we had to give them meds. We also had a little pharmacy with a lot of low-cost antibiotics and things like that.

We could actually diagnose them and hand them the bottle to take. We would take care of the acute problem, and then—especially if it was high blood pressure—I would address that, too. Because people get freaked when they come in and they're sick, I would give them a sheet where they could start recording their blood pressures and say, "You know, this is important. You need to record your blood pressure."

A lot of people had access to a relative's blood pressure cuff, or I would say, "You can get one pretty affordably at the drugstore." I would have them take their blood pressure at different times of day for a week and say, "Come back and let me see what you have. Do you really have high blood pressure? Because if you have it like it is today, you need to take blood pressure meds."

Then, of course, it was, "Oh, I can't afford that." But I said, "No, there are very affordable meds now. You can get 30 days of blood pressure medication for $4 at Walmart."

So they could afford it. When they came back the next week, I would start them on a blood pressure medication if needed, and we would get some basic labs done and go on from there. It was a process, but they were able to get some care.

In the office, I had a sign in the waiting room that said, "Five cheap-ish things you can do for your health." That was something people were interested in. It listed things that could be done fairly affordably and help you check the status of your health.

Okay. Well, I like "cheap-ish." What made the list?

There are some basic things that everyone maybe should do if they're trying to keep on top of things. You don't have to do everything; you just have to do a few things. To me, a physical exam is one. My clinic was really affordable, so that was easy.

But you can check in your area for health departments or clinics that give affordable cash-pay prices. I've always believed in the physical exam, and I know that, in recent years, everyone relies on testing rather than a decent history and an exam. I'm kind of old-school that way. I think it's important.

You find things and see things on exams. Just how a patient walks into the room, how they breathe, and what their color is—meaning normal color for them or pale lips—all those kinds of things give you a sense just from observing. Then you add the history to the exam, and you have a lot of information.

This is why I'm not a big fan of online health when you really need a hands-on exam. There are some things that can be done online. You just need to talk to someone who knows something. But there are a lot of things where you need to examine the person.

I had this woman who came in who had gone online complaining of a cough, and the provider had given her medicine. It wasn't working, but the provider online told her she had terrible lungs. I was blown away. I mean, how did she know that? She didn't listen to her lungs. What the hell?

Then the patient was anxious about her terrible lungs, and she didn't have terrible lungs. I listened to her. That's crazy.

Yeah, and I think it's easy to underestimate just how much you can learn from actually seeing someone in person.

Think of the things you've ordered online, and you get them and go, "That's not that same color," or, "That's not what I thought." Even if you're face-to-face with a provider on your screen, they can't tell as much as they can when you're in front of them.

That's a really good analogy. When you order clothing online, it might not feel the same, look the same, or the color's wrong. You could apply the same sort of mantra to a person walking into a room. The lung example is perfect. How could someone even know if your lungs were—

You have to listen to lungs with a stethoscope to know what's going on there.

Yeah, those types of things—not just say, "Oh, you have terrible lungs." So the physical part is really important, but you were saying numbers are also important in addition to the physical piece?

Yeah, some basic labs, and it doesn't have to be a lot.

We would start with what we call a chem panel, lipid panel, and CBC. A chem panel will give you glucose, liver and kidney function, and electrolytes such as sodium and potassium. The lipid panel will tell you all about your cholesterol—the good, the bad, and all the rest. A CBC will tell you all about your blood: the red cells, white cells, platelets, and other parameters.

These three panels give you a nice overview of your health. There are all sorts of panels you can order, but if cost is an issue, these will give you more bang for your buck and a nice overview.

If you haven't done blood work in years and have no idea where to start, those are basically the three you'd look at first?

Yeah, that's what we did because, like I said, it gives you a lot of information. If something is drastically out of range, then that leads you to further testing, so you might want to see a provider. There are national labs such as Sonora Quest or Labcorp where you can go online, make an appointment, and get these labs at a cash-pay price, which can be much more affordable than getting an order and going into the same lab.

You just search these labs. They have online websites, and you can search for tests such as CBC, CMP, lipid panel, or PSA. I checked recently, and these tests at cash-pay prices are around $30, $50, $60, and $70, respectively. So, affordable. Remember, other than the PSA, these tests contain many tests within the panel.

It's not just one test. It gives you a lot of different things with a lot of numbers. You should have your blood drawn fasting—either overnight or eight hours. I understand it can be difficult when you get results. You go, "If something is out of whack," and then you get concerned.

On any given day when we do labs, some things will be slightly elevated above the range or slightly below the range. This is totally normal.

This happened to me with my pre-op blood work for my ankle. I remember getting the results. I was going through them and saw a little bar showing my LDL was out of range, so, of course, it showed a little red icon highlighting that.

I texted you, but you didn't answer right away, so I decided I was going to put it into AI. It told me, "Yeah, it's a little high, but it's nothing extreme to be worried about." Then you texted me back and basically said the same thing. Is this something people could do for some of those little variances?

Yeah. As a provider, I was a little wary of this, of course, but I know things have changed rapidly, and I now feel it may be more trustworthy. As a tech person, what do you think?

I still have a cautious take on this use case. I know that OpenAI, Anthropic, and Google have their specialized health AI tools built in, and they're really pumping that. I think it's definitely improved, but I still always want to validate with you, of course.

Sometimes I'll put it into all three and see what each one says—check everyone. But, again, I think it's really important that you have a professional look at it, especially if it's something serious.

Obviously, you must be comfortable with what you were told by AI. If you're not, then it's time to run it by a provider as well. Or if AI tells you to see a provider, then yes. I did a brisk business in the clinic going over people's lab results. They had gone to the lab on their own, and then they'd say, "I don't know what to do with this."

They would make an appointment, and we'd go over the labs and reassure them or check anything we might need to do in addition. Obviously, AI isn't perfect, but a rule of thumb is that something should be well out of the normal range before panicking. Also, if you have a panel—a lipid panel like you did—and one thing is a little bit out of range out of the four or five lipids they give you, then no, it's not a big concern.

You may also be able to easily find an online provider to review your labs. That's another way to go. As an example, Costco partners with a healthcare marketplace called Sesame. You need to be a Costco member, but they offer $29 online primary care visits. That's a super-affordable way to say, "Hey, these are my labs. Can you tell me if there's anything to worry about?"

I recently found out that they offer $79 labs, which include the CBC, CMP, and lipid panel, plus a urinalysis. I was blown away by that. It's done at Sonora Quest, the same lab that would serve your walk-in cash-pay people. This is amazing. That's a great find.

For males, in addition to those lab tests, I would say, depending on your age, of course, a PSA lab test. As I said, you can get a cash-pay price of around $70 for that.

Certainly, if you have a family history of prostate cancer, you must do this. If you can't see a provider, you can get this test done at the lab, and the lab will tell you the normal range. Again, it's better than doing nothing. Obviously, if it's not in the normal range, you better go somewhere.

But if it is, then you go, "Okay. Wow, I'm all right. I'm okay." This is a test that determines prostate cancer. It can also be elevated in other conditions, like if you have an enlarged prostate or a prostate infection or inflammation called prostatitis.

If you're having symptoms, then you can't say, "Oh my gosh, if it's elevated, I have prostate cancer." You need to see somebody.

If you go to see a provider, they may do a rectal exam. The rectal exam gives us an idea of the size of the prostate, and we feel for any nodules on the prostate.

You cannot palpate all of the prostate on a rectal exam, but you can reach some of it, which can help determine some cancer or nodule risk. The PSA can also help with that—the two together.

My experience is that most men don't want that, and they have refused to let me do one if I say that's what we should do, since I'm a woman. So at least do the blood test. That's something you can do.

If that's a hard no for you, at least get the blood test. What age do men actually need to start thinking about this?

There are different guidelines about what age to start screening with a PSA.

The National Comprehensive Cancer Network states average-risk men should start screening at 45, while the American Urological Association states screening should start at 55. African Americans are considered at higher risk for prostate cancer. Studies suggest that Black men reach cancer-risk levels three to nine years earlier than average-risk men.

Be aware of that. The NCCN recommends starting screening at age 40 for Black men, and the AUA starts at 40 to 45, so they're close to the same. Obviously, for both categories, family history matters. If you have a first-degree relative diagnosed before age 65, that needs to be addressed.

You need to go at the recommended age to get a PSA.

It's interesting that you have two very legitimate medical groups—the National Comprehensive Cancer Network and the American Urological Association—and one says 45 while one says 55. That's a pretty big gap. What are you supposed to do with that?

I know. It's confusing. Almost all conditions we talk about have different guidelines from different associations. It's not ideal, but that's the way it is. They're based on research, but there's not always a consensus on the age groups. Some over-worry as opposed to others. At least use one of the guidelines instead of not screening at all.

If you're a nervous person, you err on the lower age group rather than the higher. So it is a little bit up to you which one you follow, but get one.

If you've had a PSA already, you're in that age group, and it's been over five years or so, then do another one. The number matters because if your result has increased a lot within that time, even if it's in the normal range, it needs to be investigated. Say the first result was 0.9 and the next was 4.0.

That's a fairly fast increase. That would tell me you've got to follow it more closely. You need to get another one a year later. What is it? If it's gone up, then that needs to be investigated. We have a worksheet where you can see some of the normal ranges for more information.

And what about for women?

For women, a Pap smear. With a history of normal Paps, the guideline is every three years—not once a year, every three years. There's also an additional test called HPV DNA, which can be done at the same time as your Pap. If both of those are normal, you will be allowed to go five years before your next screening.

It costs extra, but it allows you to go five years if it's normal. More affordable places for screening include your local health department, which usually has clinics for that, or Planned Parenthood. I've seen women who have not had a Pap in 20 years, and they say, "Well, I have no family history." I say, "The biggest risk factor for cervical cancer is being female."

I also say, "It would be embarrassing to die from cervical cancer when early detection is 100% curable."

Oh, wow. Okay, that's definitely a way to make a point. But what if someone's biggest hurdle is actually getting to the clinic?

There are people who obviously don't want to do Pap tests. They put it off forever. They just don't want to do it. Now, believe it or not, there are home tests.

They are approved by the FDA. The test obviously isn't a Pap smear as you know it. It's a vaginal swab to test for HPV, which causes 95 to 99% of cervical cancers. It's something you can do at home on your own. The test costs anywhere from $49 to $179. It depends.

I was checking that out online at the various prices.

Wow. That's actually really cool, and it gives women another option for cervical cancer screening. That's really convenient. What about mammograms? I know that's a big one. When you go for your yearly exam, they generally guide you toward getting a mammogram if you haven't had one. That's another one people tend to put off, right?

Yeah. I know it squishes your breast. I know it doesn't feel good. But, come on, you have to do one once in a while. I don't know that I've seen a lot of people in my clinic who do it per the guidelines.

The U.S. guidelines mostly recommend the first one at age 40. The frequency differs, though, depending on the guideline, whether it be annual or every two years. I definitely have gone every two years myself. I don't do it every year. But some people, depending on their history, maybe should be doing it every year.

I've had women in the clinic who never had one or haven't had one in years.

I've heard everything from, "I know my body," to, "I have no risk factors," as an excuse. But if you get a mammogram every five years, that's better than never getting one. Even every 10 years, that's better than never getting one.

Even if you're not doing it perfectly on schedule, something is better than nothing. But are there women who should be doing more than the standard mammogram because of their family history?

Yeah. If you have a strong family history, now we can do genetic testing.

That should be done on women at high risk. High risk would include a family or personal history of breast cancer under 50 years old. The younger you are, the more aggressive the cancer is. A family history of ovarian or pancreatic cancer, male breast cancer, or high-risk prostate cancer—these are all cases where you are considered higher-risk.

There are genetic testing centers, and there's also cash-pay testing at a lab now.

Many imaging centers and some hospitals will perform a screening mammogram without an order now. Just check around. Many imaging centers also run specials, especially in October, which is Breast Cancer Awareness Month, so that's a good time to check around.

If you have felt something in your breast or are having breast symptoms like burning or discharge from a nipple, you would then need what is called a diagnostic mammogram.

I didn't realize a screening mammogram and a diagnostic mammogram were two different things. So if you're having an actual symptom, you would say that upfront?

Yeah, you should. Diagnostics are more expensive, and they do require an order. But be upfront about it if you are self-ordering and you have symptoms, because it allows them to carefully scrutinize the area of concern. If you try to get by with a screening mammogram—and I have been guilty of sending someone with no money for a screening mammogram—and they find something, then you will have paid for the screening mammogram and have to pay for a diagnostic mammogram.

If you've had worrisome symptoms for a time, please just go ahead and see someone. Many states have a fund where, if it's found that you have breast cancer, you will be enrolled temporarily in Medicaid to pay for that expense—the testing and the treatment. So don't be afraid.

Breast cancer is not a death sentence. There are really good treatments now, and there's no reason to be afraid to pursue diagnosis.

The earlier, the better, I'm sure. All right, we're at number five now. What's the last thing on your cheap-ish list?

Definitely colon cancer screening. People say, "Colonoscopy? I'm not doing that," or, "I can't afford that." And it's true: many people cannot afford a colonoscopy. They vary in price, but the least expensive I found in my area is $1,500, and they range up to $6,000.

It's an expensive thing. But we have testing that we can do that isn't a colonoscopy. There are tests you can do at home, really: the FOBT or the Cologuard test. The FOBT looks for hidden blood in your stool, which can be a sign of colon cancer. It's blood you can't see, and you can do this test at home. These are affordable tests you can buy online.

Cologuard is a little more expensive, and that's also something you can get online. The difference is that, to be effective screening, the FOBT should be done once a year. Cologuard is done every three years. Cologuard looks for hidden blood, but it also looks for the shedding of DNA from precancerous or cancerous lesions.

So you've got a couple of tests with Cologuard. It's a little more specific. You can order those two tests online if you want. Europe has been using these tests for years for colon cancer screening. They don't do screening colonoscopies in Europe, and they feel confident—there are studies to prove that the results are good.

They're high. Especially if you say, "Well, I can't afford a Cologuard; I can only afford the FOBT," well, shoot, once a year, every year, I think that's doing a lot to screen for cancer risk. If you have a colonoscopy and it's normal, they don't even have you come back for 10 years.

Down the line, when they have really studied all three of these methods, they all come out pretty close to the same for screening cancer.

That's great. It's nice that you can do those at home on your own. Between those two, it sounds like there are at least some options if a colonoscopy is just not happening.

If it's not on the table, doing these tests is certainly way better than doing nothing. If you have a family history and you can't afford or do a colonoscopy, do these. It could save your life. Obviously, if you have a positive test, you need to see a provider, and you are going to need to have a colonoscopy.

One thing that's available nationwide is called ColonoscopyAssist. This is a facility. They have certified providers, and they are private. The last price I saw—I don't know if it's current—was $1,500, which is really the cheapest I've ever seen.

I've sent patients there, and they've had really good experiences. They come back with a whole chart full of pictures and all kinds of information. Also, for that price, if they see something like a polyp, they will take care of it at the same time.

That's a good place to check into if you find that you're getting positive tests and need to go somewhere.

These are the five types of tests, or cheap-ish things, that I would recommend to people. You can truly do some preventive health for yourself. It'll give you peace of mind, and, as I said, doing some care is way better than no care at all.

You don't want to feel hopeless because you don't have insurance or you're low on funds. You really can do some things and be proactive. You can also do what we did in the clinic. You can plan to do these things a little at a time if money is an issue. Preventive health is all about catching a problem early, when it's treatable, and not waiting for that problem to become expensive or life-threatening.

I think that's really the point. You don't have to do all of this at once or do it perfectly.

It's just about starting somewhere and looking at what you can do to prevent a big, major event from happening. You can be proactive about it and catch it earlier.

That's the way to go, right?

You don't want to wait. We need to do a better job in this country with preventive health. Preventive health is the way to go. It's what prevents big, bad things—and expensive things. So if we can't do it through our government, we can try to do something on our own.

You can. I know this is a lot of information, and that's why we felt there should be a worksheet for you. You can download that at our site. You can even check things off as you do them. I have felt people's anxiety when they feel like they can't do it, but I think you can do it.

If we make it easy, maybe they'll do it. Maybe we'll prevent some things from happening for people in the future.

You can prevent a lot of things if you do a little preventive care.

Cool. We'll add it to the website, and hopefully people will find it valuable and take control of their—

Take charge.

Yeah. Take charge of your healthcare.

Thanks for listening to Please, Health Me!? If you found this helpful, share it with someone who might need it. We're here to help you better understand your health, not diagnose or treat medical conditions. Everything we discuss is for educational purposes only and should never replace advice from your own healthcare provider.

If you have a topic you would like us to cover, send one to us by visiting our website at pleasehealthme.com.

And if you have a kid heading off to college, our next episode is for you. Mom spent years running a health clinic on a college campus, and now that we're getting ready to drop our own son off, we're talking about what parents and students should actually know before move-in day: health centers, drinking, drugs, sex, safety, mental health, homesickness, and, yes, some truly questionable student-athlete decisions.

Look for “Before You Drop Them Off: The College Health and Safety Talk” next.