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When the economy sputters and the cost of living spikes, people inevitably look for ways to cut financial corners -- even on basics like health care.

A poll released this week by the National Association of Insurance Commissioners found that 22 percent of people who responded said they were cutting back on doctor visits. Eleven percent said they were reducing the number of prescription drugs they take or lowering the dosage to make the medications last longer.

But deferring potentially life-saving screening tests or throttling back on medications is a risky, pennywise-pound-foolish way to save money, doctors at Duke Medical Center say.

"You can more effectively manage health care costs and stay healthy at the same time by taking control in other ways," says Lloyd Michener, MD, chairman of Duke's Department of Community and Family Medicine.

Options include:

• Adopting a healthy diet and exercising regularly
• Getting regular preventive care, including immunizations and screening tests
• Seeking care when you need it, before you wind up in the emergency room
• Asking for less expensive but good medicines
• Knowing when to see a specialist

"These are always good ideas, not just when money is tight," says William E. Kraus, MD, professor of medicine and research director at the Center for Living at Duke Medical Center. "Lifestyle changes can be very economical and save the individual and system money."

Insured people feel the pinch, too. Many say they no longer can afford the $15-$25 co-payment to see a primary care doctor, says Devdutta Sangvai, MD, MBA, assistant professor of family medicine and pediatrics.

"And some folks, especially seniors, are known to ration their medications because of financial hardship -- by taking a daily medication every other day to make it 'last longer,' " Sangvai says. "I would suspect that this is even more the case with milk at $5 a gallon and gas at $4 a gallon."

He encourages patients to save money via comprehensive visits to their doctor.

"Encourage your doctor to take care of several related issues at the same time," Sangvai says. "For example, get your vaccines, medications, and screening tests all at the same visit."

Another way to save money, he says, is focusing more on generic drugs, particularly the $4 to $5 lists at Kroger, Wal-Mart, and other places that offer such lists.