This Issue

Patient power

The root of the problem

Making every dollar count

ABC's of health insurance

Q & A

Inherited risks

Who’s in charge here?
You are

It is your responsibility to get the appropriate screenings at the appropriate time based on your age, gender, race, risk factors and family history. If your doctor does not offer the tests, ask for them. You’re the one who ultimately pays — in poor health.

Starting age*
High blood pressure
High cholesterol
Every five years
Type 2 diabetes
Every three years
Breast cancer
Prostate cancer
Colorectal cancer
Every one to ten
Cervical cancer
Every one to three years

*Frequency and starting age will differ by risk factors. For instance, if you have prostate cancer in your family, you will probably start screening at age 40 or 45.

For more information, click here.

A detailed list of screening tests

Sources: American Cancer Society, American Heart Association,
American Congress of Obstetricians and Gynecologists

Ask the question

Looking for reliable sources of
health information?
Here are a few...
Government Agencies

• National Cancer Institute

• MedlinePlus

• Centers for Disease Control and Prevention

• U.S. Department of Health & Human Services

Non–profit Organizations/HMOs

• American Cancer Society

• American Heart Association

• American Diabetes Association

• Blue Cross Blue Shield of Massachusetts

For a tutorial on evaluating health information on the Internet, click here.

Inherited risks

There are several diseases that run in families and are passed down from generation to generation. A family history does not guarantee an illness; it raises the odds. Examples of inherited diseases are:

• Prostate cancer

• Ovarian and breast cancer

• Colorectal and uterine cancer

• Diabetes

• Heart disease

• Stroke

• High blood pressure

• High cholesterol

• Kidney disease

• Depression and dementia

• Alcoholism and other substance abuse

• Miscarriage and stillbirth

• Birth defects and infertility

• Asthma

• Alzheimer’s disease

Reliable health information

Family history medical tree

Who's in charge here?

Risk factors
• Tobacco use

• Heavy alcohol use

• Combined tobacco and
alcohol use

• HPV infection
• Sun (cancer of the lip)

• Exposure to chemicals,
such as asbestos

• Poor diet — lacking in
fruits and vegetables
Another good reason to visit the dentist

“All you have to do is open your mouth.”

— The Head and Neck Cancer Alliance

The oral cancer examination is painless and quick … and life-saving. When cancers of the head and neck are found early, the cure rate is high. Annual screenings by a doctor or dentist should be a part of your regular physical or dental checkup. The provider:

• Inspects your face, neck, lips and mouth.

• Feels the area under your jaw and the sides of your neck, checking for unusual lumps.

• Asks you to stick out your tongue to check for swelling, color and texture.

• Using gauze, lifts your tongue and pulls it from one side, then the other.

• Checks the roof and floor of your mouth and the back of your throat.

• Feels and examines the insides of your lips and cheeks for red or white patches.

• Places one finger on the floor of your mouth and, with the other hand under your chin, presses down to check for unusual lumps or sensitivity.

Source: National Institute of Dental and Craniofacial Research

Oral, Head and Neck Cancer
Awareness Week is May 8 – 14.

Photo by Vannessa Carrington/Mass. Eye and Ear

Get screened for head and neck
cancer. It’s free, quick and painless.

Boston Medical Center
Moakley Building Lobby
830 Harrison Avenue
Date: April 2
Time: 8 a.m. - noon

Tufts Medical Center
860 Washington Street
Date: May 12
Time: 2:30 – 4:30 p.m.
Mass Eye and Ear
243 Charles Street
Date: May 13
Time: TBA
Dedham Family Dental
Dr. Helaine Smith
30 Milton Street, Dedham
Date: May 11
Time: 9 a.m. – 1 p.m.

Mass General Hospital
Voice Center

One Bowdoin Square,
11th Floor
Date: May 13
Time: 9 a.m. – 1 p.m.
Remember to call ahead to confirm
time and date
of screenings.

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The ABC’s of health insurance

HMO, PCP, PPO, POS — feel like you’re wading through alphabet soup? Read on for translations of common terms.

• Health maintenance organizations (HMO) require you to choose a primary care physician (PCP), who coordinates all of your care, including visits to specialists.

• Preferred provider organizations (PPO) let you make your own choices from a network of preferred providers (in some plans, you can pay a higher fee for out-of-network care) and may not require you to have a primary care physician.

• Point-of-service plans (POS) let you choose between receiving care from participating providers (you’ll be reimbursed more for this), or non-participating providers(you’ll be reimbursed less for this).

Some plans offer lower premiums (monthly payments) in exchange for a higher yearly deductible (the amount you must pay personally before insurance provides any coverage). Some plans require co-pays, a set fee you pay for health care visits or medications. Others ask you to pay co-insurance, which means you’re responsible for a portion (20 percent, for example) of eligible expenses charged by a provider or the amount the insurer agrees to pay for specific services.

Many plans require preauthorization or precertification for certain services, such as surgery or visits to a specialist. Some pick up the tab on preventive care services, such as flu shots, cholesterol tests, or colonoscopy. Most have formularies that list pre-approved, commonly prescribed drugs.

Tips for completing a family history medical tree:

  • Include at least three generations if possible

  • Note the relative’s age at diagnosis and the age and cause of death

  • Watch for a disease that occurs in more than one relative

  • Look for diseases that occur at an earlier age than expected

  • View death certificates, family bibles and family medical histories

  • Get input from as many relatives as you can

  • Continue to update & correct the tree as new information becomes available

  • Share the information with your doctor and relatives

Keep in mind that your family history does not guarantee an illness — it indicates risk. You can reduce your risk by adopting lifestyle changes — not smoking, healthy diet and exercise. You can also often detect a potential problem by timely screenings or genetic testing.

To develop your family
history online, visit


Stroke runs in Susan’s family and strikes young, as noted in her younger brother. Ovarian and breast cancers — which are linked — are also found.
Susan will probably be advised to have regular mammograms, which can catch breast cancer in the early stages.