March 12, 2009 -- It's 2009, not 1909, but more people are willing to do their own health care and dentistry these days.
"It's one of my front teeth, I had just been supergluing it in," said September Williamson of Grand Junction, Colo.
The mortgage is due, the kids have needs, and the dental insurance doesn't cover a ninth of the cost of your dental work. At that point, applying superglue to your crowns didn't seem too unreasonable for Williams.
But, the superglue was just one of a whole set of tooth troubles. Unable to pay for more expensive treatments, Williamson said she's resorted to just pulling out the problem teeth.
"I've had five teeth total pulled, one of them was a wisdom tooth," said Williamson. "A couple of months ago, I was just frustrated with the whole thing -- I'm not the only person out there."
Emergency room physicians, social workers and advocates for the uninsured or underinsured agree.
Although the poor have always employed questionable home treatments, some health care workers have noticed a recent increase in desperate attempts by people to play doctor out of economic desperation.
Pulling Out Bad Teeth
"They'll pull rather than try to fix; that's a huge, huge issue," said Joan Whitaker, director of health services at the Action for Boston Community Development Center in Massachusetts.
While dental insurance rarely covers the cost of more expensive treatment, health insurance doesn't always cut it either, Whitaker said.
"Even if people have health insurance right now it doesn't mean that they have money for their co-payments," she said.
Whitaker works with many low income families in the Boston area. She said that recently time, rather than money can be an issue for patients.
"What's happening with a lot of people is they are putting off finding out about problems, because if they're in low paying jobs, and if they take time off they're afraid they won't have a job when they get back," she said. "They're out here working one or two jobs but they are still marginalized, because one thing could happen to them and they can lose it all."
As Williamson knows, delaying medical and dental care can land someone with bigger bills than preventive care would.
Woman Superglued Teeth Because of High Dental Care Costs
"For a few years we didn't have any health or dental insurance," said Williamson. Now what could have been a few fillings will turn into partial dentures.
"This is really the first that that we've even had dental insurance for a long time," said Williamson. Despite the $1,000 coverage each year, Williamson said she'd have to pay an additional $8,000 out of pocket for new dental care.
Williams tried a local community clinic, but said she didn't qualify for assistance because she had insurance. She even tried calling the closest dental school 250 miles away in Denver, but they weren't looking for new patients.
"I was so frustrated, I knew other people were out there," she said.
A spokesperson American College of Emergency Physicians (ACEP) said there are no current statistics or data tracking self-care in recent months. However, the ACEP has heard anecdotal reports from members that the age-old attempts to save on health care are on the rise.
One ACEP member had a patient who refused an ambulance after a car crash, but decided later to drive himself to a free clinic for neck pain. Unfamiliar with car crashes, the clinic ordered a series of tests and exams, only to have the man end up back in the emergency room with pain all over again.
Taking Leftover Medication
"I am personally seeing an increase in the number of people who are taking other people's medications," said Dr. Richard O'Brien, spokesman for American College of Emergency Physicians and a doctor at the Moses Taylor Hospital in Scranton, Penn.
Whether it's a family member's old pain pills or someone's leftover antibiotics, O'Brien has seen an increase in the number of people who are willing to risk problems instead of seeing their doctors.
"The antibiotics thing I see all the time," he said.
In the case of antibiotics, O'Brien said leftovers from a full course rarely suffice. "It's almost never enough to treat a legitimate infection," he said.
Moreover, antibiotics actually have side effects patients may not know about. O'Brien said patients could be allergic, or have interactions with blood clotting medication, or have interactions with birth control pills and end up with an unwanted pregnancy.
In many cases, ACEP doctors said that improvised medical care is a delay tactic until a person can save up enough money for a doctor's visit.
Buying Street Drugs for Pain
"I hear more and more people buying drugs on the street and not just for the people who are addicted," said Ellen Hadaway, a clinical social worker at the University of Michigan Health System in Ann Arbor.
Hadaway said often teetotaling, middle-aged people can find black market oxycontin with a few phone calls.
Although expensive, the cost nowhere nears the bill from an emergency room visit to diagnose the pain.
"They'll do that to try and stop the pain that they're going through rather than try and access a public clinic or anything that would be available for them," she said.
Aside from the pain pills, Hadaway has seen more people who've waited days after an injury or a problem before finally seeking treatment. After such a wait, Hadaway said some people leave the hospital before doctor's orders to avoid additional health costs.
"I see 5-10 people who are here uninsured every day," said Hadaway. "But more of them now are the folks who have been doing their level best now for years."
"Unfortunately every day I have to tell people that I don't have anything to offer to help them," she said.