He got it for free: A decision by Mariano Rivera on elective shoulder surgery

Mariano Rivera stepped out of the visitors' clubhouse in Boston's Fenway Park on Friday to get a soft serve ice cream cone. It cost $4.25, but he got it for free. At 38, after a long career, he is well known, and being the greatest closing pitcher in baseball history has its perks.

He is weighing the merits of shoulder surgery for inflammation caused by a calcification in his right shoulder. It causes him periodic irritation and pain, intensifying when he pitches frequently, but has not prevented him from having 38 saves in 39 chances this season, with 76 strikeouts and only six walks.

He had an MRI (magnetic resonance imaging) test, and saw two doctors this week, who have given him the options of cortisone injections to dull the inflammation, or surgery. The surgical procedure would be a minor one, requiring only a few weeks of rehabilitation.

He is weighing his dislike of needles against the low risks of surgery, and is leaning toward surgery.

Advice to athletes considering surgery: Keep in mind that the team physician and other employees of the team have the team’s best interests at heart, not necessarily yours.

Read another story on a baseball pitcher.

Thanks to Tyler Kepner for the source story in today's New York Times.

After three surgeries: Health advocates

After three surgeries, 63-year-old Judy Sherer of Norcross, Georgia still had chronic pain in her left shoulder. She'd lost faith in her doctors, and in despair, tried a new health benefit offered by her employer.

The service, Health Advocate, is a call-in center that helps customers find the right doctor, haggle over insurance coverage and manage other medical systems headaches.

An advocate helped Judy find a new surgeon, one who found metal shavings left in her shoulder in error by a previous doctor. The advocate also negotiated the charge for her physical therapy down to $40 per visit from the $200 charge she was told of initially.

"It saved me a ton of money," she said. “I’m very, very pleased.”

The largest customers of health advocacy services are companies, not individuals. "The employers are interested because it means their employees are not on the phone taking care of doctor's visits during work hours, says Carol Fischer, a spokeswoman for Pennsylvania-based health Advocate.

Advice to frustrated consumers: Consider using a health advocate.

Read another patient advocate story.

Thanks to Mike Stobbe for the source article in the July 27 issue of the Atlanta Journal-Constitution.