Sunday, January 13, 2008

Patient hatred

Ten out of Ten wrote a great post about the truth behind how physicians feel about patients.

The love, or lack thereof, flows both ways.

Last week I had the love rolling in.

Three years ago I met her for the first time. The pus was literally dripping off of her foot onto the floor. Her ankle and foot were extremely red and swollen, and her blood sugar was 450. She hadn't seen a doctor in years, and had no idea she was diabetic. (For some fun pictures, google 'diabetic foot' and hit image.)

Not much of a diagnostic dilemma. I sent her to a local hospital, where she had extensive debridement and was admitted for several days of antibiotics.

She kept her foot. I've followed her since. She's done wonderfully. Her HgbA1C (an indicator of diabetic control) went from 14% to under 6.5%, where it's remained. I think of her as a Federally Qualified Health Center success story.

Recently, she's run into some unrelated problems, and the last time I saw her I recommended some imaging. The problem? You guessed insurance.

She works full time, and tho I don't know how much she money she makes it's unlikely to be much more than minimum wage.

And so, just like the fifth drug seeker in a row suffers for the anger of a doctor at the previous four, I became the official representative of the broken US healthcare system.

She was shaking with anger, and shook her finger in my face. "YOU put me in the hospital three years ago and I'm still paying on $17,000 of hospital bills. I'm not going to have ANY testing done. I'm never coming back."

I think I got her to agree to see me again next month. She was still pretty ticked. I can't imagine what $17,000 looks like to someone who might barely make that in a year. Hopefully I'll keep her engaged enough to continue to keep her diabetes under control.

Sometimes we hate them. Sometimes they hate us. The goal is to continue working together toward health.


rlbates said...

Very well said.

Anonymous said...

I work in an ER on the admitting side...My last 2 week paycheck I had to pay $450 to cover my family for insurance...this toenail pain/headache/pinky pain, etc, Medicaid patient (whom is also a frequent flier) come in to have me come out and look at his NEW Hummer that he paid $30K in cash for...HE IS ON State assistance!! I am struggling with the choice to take on a second job to cover my family's insurance plan...The health care system is abused, it is broke and I know why sooo many doctors hate their patients...he comes out with his script pain meds for his "back pain" and takes off in his Hummer...SOOO glad that we are paying for these idiots to abuse the system...ARGHHH!!!

SOCKS said...

Very insightful - very sensitive - the struggle is ongoing, where it will stop "no one knows."

Ten out of Ten said...

Thanks for the link! Your last paragraph says it all.