The office visit allows the physician to objectively assess the current status of your asthma by reviewing:
The physician can then appropriately adjust your treatments in order to maximize asthma control with the minimum amount of medication. He or she also can recommend further diagnostic studies or consultations with other specialists. If your asthma appears to be under excellent control, the asthma specialist may make no changes at all. In addition, The Asthma Center physicians try to gauge your understanding and participation in your asthma treatment, which is a critical building block in the foundation of optimum management.
In The Asthma Center specialists' opinion, which is consistent with national guidelines, maintenance or follow-up office visits need to occur regularly, usually every few months, because control of chronic asthma can easily change, even if you feel fine. When you are taking daily medication, infrequent evaluation (every 6 - 12 months) is simply inadequate for optimum treatment and places you at increased risk for a poor outcome. The Asthma Center specialists recommend that you be evaluated every 3 - 4 months if you are taking daily medications for asthma control. If you have recurrent acute symptoms, or sudden worsening of symptoms, contact your physician frequently and have an in-office review following each major episode of asthma or whenever your asthmatic symptoms are not resolving with phone consultation.
Having a prescription refilled without a timely physician review of your asthmatic condition as outlined above puts your treatment on "auto-pilot" and does not represent a competent way to manage a potentially dangerous and disabling chronic disease.
In general, following the initial evaluation, costs for doctors’ visits for outpatient care are relatively modest compared to the costs of medications. It is not unusual for the entire annual outpatient cost for the asthma specialist (excluding tests, allergy shots, etc.) to be less than the cost of a few months' medications.
The cost of office visits represents a small fraction of the overall cost of asthma treatment, while the benefit of controlling asthma optimally has an immeasurable intrinsic value. Optimum control of asthma ultimately saves you money because of decreased emergency room visits, hospitalizations and unnecessary costs of managing flares of asthma on an outpatient basis. Of course, optimum care for you cannot be evaluated primarily in dollars and cents with so much of your future well-being hanging in the balance.
You will need to check your insurance directories to see which physician(s) are in your plan. A good asthma specialist can be found in most insurance plans. However, when your medical needs are not met, consider seeing a specialist outside of your plan after you have exhausted the resources of your insurance plan's options. In this case, your insurance may cover your medications and laboratory tests while you pay for office visits. If you are in an HMO, check your directory for participating specialists. You will need an initial referral from your HMO primary care physician for a work up. If you are unhappy with your asthma management and your primary care physician will not give you a referral, speak to your insurance company. If you cannot resolve the problem, consider changing your primary care physician, your insurance, or seek an asthma specialist outside your plan.
Finally, your busy life may lead you to overlook your medical needs, particularly when you feel well. It takes a certain amount of discipline to ensure that a chronic medical condition such as asthma receives optimum treatment continually-- not just after you suffer an adverse event. Remember, undertreatment can lead to permanent lung damage, and some damage can occur with or without significant asthmatic symptoms being present.