Monday, October 21, 2013

Patient Encounter

Vascular Surgery Clinic: I have already seen and examined the patient, presented to the attending, and we are going back into the exam room to speak to the patient together. The patient is 16 years old, so her mother is with her. The patient is status post embolectomy (an embolus was removed from her thigh area) in the catheterization lab.

Attending: " I think some compression stockings would be good for your daughter as her thigh is still very swollen."
Patient's Mother: "Medicaid won't pay for them."
Attending: "Well, you could pay for them."
Patient's mother: "They are very expensive!"
Attending (looking at the take-out bag of donuts and Starbucks coffee the mother is drinking): "They are not that expensive, and if you saved a little every day, you could buy them. Do you think your daughter's leg is worth it? I think your daughter's leg is worth it, and if you stopped spending your money on things like donuts, you could save up the money in a few days. You may also lose a little weight, so it would be healthier for you too."
Patient's mother: "What are you saying?"
Attending: "I am saying that you are carrying a lot of extra weight and if you stop eating donuts, you could lose some and save the money you need."
Patient's mother: "I don't need you to stand here and tell me that- who do you think you are? Get out of this room."

We step outside...........
Attending: "People have this great sense of entitlement and do not want to pay for anything. I have had patients ask me for gauze to change their dressings because they do not want to pay for them, but they have enough money to buy themselves cigarettes to CAUSE these wounds. And they think it's other people's responsibility to pay for their actions. Now I understand that this lady was upset, but she has to face the facts. Donuts are not as important as saving her child's leg, and Medicaid does not OWE them compression stockings. They already paid for her embolectomy and doctor's visits."

Now.............I completely agree with the attending, I am just surprised he verbalized his thoughts to the patient. I also find it surprising that a physician who feels this way has worked so many years at this particular city hospital because the majority of the patients there have the same beliefs as this particular patient's mother. I will not even get into a Medicare/Medicaid/Obamacare discussion right now. Not enough energy....I am on night float.............this is what I need:

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