The poor get rotten medical care

[Harriet Vane]

My heart is breaking over the way poor people are treated by the medical establishment.

 

It is a fact that when you are a Medicaid patient you have to fight for access to doctors and medical services, and the services your receive are often sub-par. And you have to make do without. A lot.

 

A friend of mine is in a terrible situation tonight. She lives in poverty. She lives alone. She has complicated health issues. She has mental health issues. She's also a very, very sweet, kind, gentle person.

 

Most of the time she manages passably well. 

 

Today, however, my friend had what appeared to be a stroke. The hospital says it is not a stroke. They did some big tests like MRI and others, so it's possible the hospital is correct. But they have not actually diagnosed my friend with anything. And even though my friend has a raging headache, cannot walk a straight line, and has slurred speech and a brand-new, overwhelming stutter (can hardly string two words together!), the hospital released her.

 

!!!!!

 

She is supposed to call a neurologist in the morning to get an appointment. Assuming she can make them understand through the stutter and the garbled, wandering speech.

 

I am hundreds of miles away. 

 

A mutual friend is with her tonight and will try to get the neurologist set up. 

 

I am not sure what the options are other than to dump her at the ER and tell her to refuse to leave. But I am not sure she has the resources internally to stand her ground right now.

 

And this wouldn't even be a discussion if she had insurance. 

 

 

 

 

 

 

 

 

 

Disclaimer: I have dear friends who are doctors and who are nurses. One of my doctor friends works full-time in an inner-city clinic, giving his life to the poor. I am not demonizing the entire profession, though I am angry at the system and at those who choose to discriminate against the poor.

[Carol in Cal.]

Oh that is horrible. 

And I agree, the system is waaaay broken.

[Χά�ων]

Oh my. I am sorry

[SKL]

I am not so sure it wouldn't happen if she had insurance.

 

I'm very sorry for your friend.  I hope she gets the help she needs.

[redsquirrel]

I am so sorry.  But, this might happen even if she had different health insurance.  It's really not that uncommon, I am sad to say.  But, your point stands that people without access to resources have a much more difficult time in any kind of system. Money makes everything so much easier

 

But mostly I am so sorry. I hope she is able to get some care that is useful for her.

[Ottakee]

Ask neurologist to check for migra-seizure.

 

My daughter had one at 9 and had a terrible head ache, very slurred speech, etc....very stroke like. Turns out it was a seizure that triggered a migraine.

[kroe1]

It most likely has nothing to do with your friend's insurance. All hospital admissions must meet government guidelines irrespective of insurance status. If the hospital was not going to do anything over night that could not be done at a home, then your friend would not meet admission criteria. Blame the government, not the healthcare industry.

 

Finally, admissions should not be considered without risks. There is always the risk of contracting an infection in hospitals. I certainly would not want to be admitted unless the admission was going to benefit my health more than my risk of contracting a disease or becoming a victim of a medical error.

[creekland]

It seems that as soon as one get outside of what is "common," decent medical care is more of a luck deal than anything else.

 

Be prepared for her to need up front cash to get to see anyone.  That seems super common too, even with insurance (folks have to pay for what insurance won't cover), but even moreso if there is no coverage of any sort.

 

If there is any sort of patient advocate service around, it could be useful for her to talk with them as they often know what is possible and what isn't.  (These can be free if associated with a local hospital or medical group.)

 

Best wishes.

[JFSinIL]

Taking ds, almost 25, in for a sleep study tonight just to make sure we are not missing anything that might be the cause of his terrible insomnia before we assume it is med-related. Poor young man in on SIX different pills now for various mental issues etc. and need to get him figured out before he ages off our insurance. His fraternal twin brother (my dude with autism) has been on Medicaid for a few years now and at least it covers his frequent trips to ER (non-verbal dude can't tell what hurts or where, so need scans/x-rays, or just a trained professional to figure him out sometimes. Our Urgent Care kinda blows him off so ER it is.)

[Katy]

I'm sorry, but this would have happened even if she had insurance.  If she didn't have a stroke, she had any number of other non-emergency conditions, most of which would be best managed by a neurologist. Some hospitals make those referrals for you, and schedule appointments before you leave.  Others don't.  It has more to do with local medical networks than quality of care.

 

If she doesn't have someone locally available to help her now, and she cannot manage on her own, it might be time for her to move into a nursing home.

[Anne in CA]

I am sorry about your friend, but in the right area I think it absolutely could happen to someone who has insurance. Almost the same thing happened to my MIL at Duke, which is a teaching hospital and she had great insurance. Eventually she recovered. Her issue was that she was having seizures induced by prescribed medicine that was having a bad reaction with other medicine she shouldn't have been taking. But they said she hadn't had a stroke and just sent her home still having seizures and stuttering. A relative who is a nurse went through her list of medications and figured it out a few days later.

[TechWife]

 

 

If there is any sort of patient advocate service around, it could be useful for her to talk with them as they often know what is possible and what isn't.  (These can be free if associated with a local hospital or medical group.)

 

 

All accredited hospitals must have patient advocates. There is no charge to contact them or have them work on your behalf on matters pertaining to the hospital. They do not address outside matters. 

[Murphy101]

All accredited hospitals must have patient advocates. There is no charge to contact them or have them work on your behalf on matters pertaining to the hospital. They do not address outside matters.

That and in my experience they are nothing more than mouth pieces for the hospital they are employed by.

[Murphy101]

I have a dear friend who has developed seizures and her symptoms are a lot like the OP describes. She has insurance and it went basicly the same way. If she didn't have someone to go with her to appts and wasn't married and therefore have a dh to wake up to her episodes and help - she'd be screwed. And even with that, it's really hard and really time consuming and really expensive to get her care.

 

Medical just sucks in general in the states.

[TechWife]

That and in my experience they are nothing more than mouth pieces for the hospital they are employed by.

 

 

They are required to take certain specific actions, such as passing complaints to appropriate departments for follow up. They are also often called upon to act as intermediaries between departments within the hospital to make sure that the patients needs are being met. Their records are part of the audit procedure and they have to demonstrate follow through and a resolution to the problem. Not all resolutions are satisfactory from a patient's point of view, but if they are medically sound resolutions, then the advocate has done the job. Yes, they are employed by the hospital and they act accordingly - their job is largely customer service. 

[Reefgazer]

Most of the Catholic hospitals have a sign in their emergency room stating that they accept patients regardless of ability to pay.  Can she seek out a Catholic hospital?  Barring that, I agree with the suggestion of a patient advocate.  I agree this is an awful situation; I feel for your friend.

Edited September 1, 2016 by reefgazer

[Harriet Vane]

Thanks to all who posted compassionate responses.

 

My friend will see a neurologist this afternoon. A mutual friend was able to arrange for it. She had to call around quite a bit, though, as the doctor originally referred to refused to take her and several other doctors refused a new Medicaid client.

 

I find it difficult to believe that there is no poverty discrimination here. When they released my friend, she could not walk a straight line or speak intelligibly. They knew she lives alone. They released her in that condition expecting her to get through the night, use a phone, and set up a neurology appointment. !!!

 

I have had a ton of experience with Medicaid. I was poor once, and the difference in medical care was astounding when I finally got a job with decent insurance. I also spent many years working with an inner-city population. And another friend, the inner-city doctor, could also tell you some sad stories about how difficult it can be to get meaningful medical care for poor clients.

 

Several years ago, my husband had what appeared to be a seizure. He fell, and after he fell he lay there shaking for at least a minute or more. He was unresponsive. When he stopped shaking, he had no memory of the incident. It looked like a seizure. At the hospital not only did they run all the big tests, they also admitted him without question.

 

His issue turned out to be vasovagal syncope, which is a fancy term for a drop in blood pressure causing fainting. It is a benign event, and people who are prone to this can usually avoid further vs episodes by careful behavior changes to avoid the blood pressure drop. In other words, vasovagal syncope is not a big deal.

 

Not only did my husband have good insurance, he also appears to be upper middle class--his clothing, his pretty blonde hair and preppy hair cut, his speech and vocabulary. His treatment was both much kinder than what my friend experienced as well as much, much more comprehensive. This is the norm I experienced when I was poor, and this is the norm I have observed many times in my years living in a poor urban neighborhood.

 

If you have never been this poor, you may have no context for understanding just how substandard care can be. 

 

Thank you, though, for your sympathy for my friend and for your suggestions. She is terribly frightened. Not only is she terrified of her own condition right now, she is also terrified at the possible loss of her job (child care) and how this could affect her custody of her own child (child's father is a real bully).Any prayers for her are greatly appreciated.

[FaithManor]

I have seen people with good income and private medical insurance released under similar circumstances. Most insurance will not pay for hospitalization due to ER visit for neuro symptoms unless a diagnosis that fits their guidelines can be made quickly or the patient is unconscious/cannot maintain reasonable cital signs.

 

Our entire system is catastrophically beoken and hospitals have to abide by insurance dictates or they will not be able to keep their doors open.

 

Sigh....

[Murphy101]

Oh no. I completely agree the poor get the worst care. Btdt. I totally agree.

 

But since care over all sucks here, having insurance does not necessarily mean all that wonderful of care either.

 

I understand the problem your friend is having. It's a common problem. Bc our system is not set up to meet the needs of such people. The hospitals are often not equiped financially or facility wise to accommodate them.

[ktgrok]

I know what you mean. a friend had a baby at the local hospital. Because she gave birth while still in triage, the paperwork didn't get completed, and for the rest of her stay they thought she had no insurance. When they figured out she did, the care changed drastically. Stuff like, they would only give her one diaper at a time for the baby, none in the room, when she was poor and paying out of pocket. Once they knew she had insurance, she got diapers in the room. stuff like that. 

[Murphy101]

I know what you mean. a friend had a baby at the local hospital. Because she gave birth while still in triage, the paperwork didn't get completed, and for the rest of her stay they thought she had no insurance. When they figured out she did, the care changed drastically. Stuff like, they would only give her one diaper at a time for the baby, none in the room, when she was poor and paying out of pocket. Once they knew she had insurance, she got diapers in the room. stuff like that.

Ugh. I had a delivery like that, but it wasn't even in triage. They automaticly presumed that bc I was young, and not even that young really - I was 22, that I was a poor single dumb girl who got pregnant AGAIN (my second baby) and I got the distinct impression the nurses thought they were going to teach that young girl some life lesson by making the delivery and newborn recovery as difficult as possible. They completely changed their attitude when I had a husband show up with my insurance card.

 

ETA: oh and that reminds me of the time when I needed more pads after a delivery in hospital and the nurse was reluctant to bring them to the room. Because "if we open a package, you know you have to pay for that whole package, right?" Uh? This isn't my first postpartum rodeo lady. I know how paying for pads works. I can either bleed all over your hospital room or you can bring me another package. Weird. I'd never had that problem before or since, insurance or not.

 

And there was that one nurse who told me I could fold the baby wipe and wipe again. Those wipes at the hospital are right up there was those useless Kleenex they offer. There's no fold and reuse option. If you try you end up with a mess on your hands.

 

The only thing I could think was the nurses were somehow getting in trouble for going through inventory too fast? Idk. Again. Weird.

Edited September 1, 2016 by Murphy101

[Guest]

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Edited September 2, 2016 by Heigh Ho

[ktgrok]

If she wasn't well enough to care for herself a social worker should have gotten involved. I'm so sorry. 

[AmandaVT]

I'm so sorry your friend isn't getting good care! :-( 

 

The way Medicaid patients are treated must vary by location. Here, so many people are on Medicaid due to how much our state has expanded the program that pretty much all Dr's take it. I believe 50% off all children in VT have Medicaid due to Gov. Dean's Dr. Dynasaur initiative he rolled out when he was governor. 

 

They pay quicker than any other insurance company and pay more than all but 1 insurance company around here (I do mental health billing for two different practices). People aren't looked down upon or treated differently here for having Medicaid, thankfully. 

[Anne in CA]

Oh no. I completely agree the poor get the worst care. Btdt. I totally agree.

 

But since care over all sucks here, having insurance does not necessarily mean all that wonderful of care either.

 

I understand the problem your friend is having. It's a common problem. Bc our system is not set up to meet the needs of such people. The hospitals are often not equiped financially or facility wise to accommodate them.

Absolutely. I do know for certain that being poor means you will not get the same quality of care across the board. As far as some issues go, however, there is a limit to what medical care will do even if you have money and means.

[Ravin]

My heart is breaking over the way poor people are treated by the medical establishment.

 

It is a fact that when you are a Medicaid patient you have to fight for access to doctors and medical services, and the services your receive are often sub-par. And you have to make do without. A lot.

 

A friend of mine is in a terrible situation tonight. She lives in poverty. She lives alone. She has complicated health issues. She has mental health issues. She's also a very, very sweet, kind, gentle person.

 

Most of the time she manages passably well. 

 

Today, however, my friend had what appeared to be a stroke. The hospital says it is not a stroke. They did some big tests like MRI and others, so it's possible the hospital is correct. But they have not actually diagnosed my friend with anything. And even though my friend has a raging headache, cannot walk a straight line, and has slurred speech and a brand-new, overwhelming stutter (can hardly string two words together!), the hospital released her.

 

!!!!!

 

She is supposed to call a neurologist in the morning to get an appointment. Assuming she can make them understand through the stutter and the garbled, wandering speech.

 

I am hundreds of miles away. 

 

A mutual friend is with her tonight and will try to get the neurologist set up. 

 

I am not sure what the options are other than to dump her at the ER and tell her to refuse to leave. But I am not sure she has the resources internally to stand her ground right now.

 

And this wouldn't even be a discussion if she had insurance. 

 

 

 

 

 

 

 

 

 

Disclaimer: I have dear friends who are doctors and who are nurses. One of my doctor friends works full-time in an inner-city clinic, giving his life to the poor. I am not demonizing the entire profession, though I am angry at the system and at those who choose to discriminate against the poor.

 

I will say, this varies a lot from state to state. Arizona does a pretty decent job for people on medicaid; we had better access to services then than we do now on my employer insurance (because I can't afford the out of pocket expenses, we have to pick and choose and prioritize in a way we didn't when we had medicaid. For example, no more OT for my DD.)

 

Just don't get me started on the shifting-target hoop-jumping involved to get on and stay on medicaid here.

[hjffkj]

I'm so sorry your friend isn't getting good care! :-(

 

The way Medicaid patients are treated must vary by location. Here, so many people are on Medicaid due to how much our state has expanded the program that pretty much all Dr's take it. I believe 50% off all children in VT have Medicaid due to Gov. Dean's Dr. Dynasaur initiative he rolled out when he was governor.

 

They pay quicker than any other insurance company and pay more than all but 1 insurance company around here (I do mental health billing for two different practices). People aren't looked down upon or treated differently here for having Medicaid, thankfully.

Yeah, this is how it is for me in DE. We've had Medicaid on and off for the last 8 years. We have never been treated poorly because of it and have never had any issue finding doctors who accept new Medicaid patients. However, I know this is not how it is in every state.

[Harriet Vane]

Your experience depends on what providers you deal with. Workman's comp and medicare/medicaid is where I see the professional difference....some providers will do the minimum and move you on, others deliver professional care either way.Others are horrible and even the best insurance wont get you good care.

Workman's Comp has so much delay built in as cost containment that people are likely not to get the care they need in order to recover. Your friend is getting in the next day. That is hardly substandard.

 

 

My friend is seeing a doctor today specifically because she had a friend who was willing to work the phone and all her contacts to find someone who would take her. Friend was turned down by multiple doctors--many would not see her at all and many would not see her for several months. This is an emergent situation that needs attention now. 

 

Having a willing advocate does make a difference. My inner-city doctor friend has had to go to bat for clients often. And I have played the phone roulette game many a time myself, trying to get care for the poor.

 

But it shouldn't have to be that way. 

Edited September 1, 2016 by Harriet Vane

[Guest]

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Edited September 2, 2016 by Heigh Ho

[lexi]

I am so sorry. But, this might happen even if she had different health insurance. It's really not that uncommon, I am sad to say. But, your point stands that people without access to resources have a much more difficult time in any kind of system. Money makes everything so much easier

 

But mostly I am so sorry. I hope she is able to get some care that is useful for her.

This. Even with private insurance you can still get rotten care.

 

healthcare in America is below what you would receive in many other countries. Medical care in general is pretty rotten here.

 

I'm so sorry for your friend. I hope she can get some answers. She needs someone to advocate for her.

[Crimson Wife]

My child with special needs has Medicaid secondary to our private insurance. Kaiser Permanente (the state's largest HMO) accepts Medicaid and they get the same exact same treatment (for good or for bad) as regular Kaiser patients. Now that we've switched to Cigna PPO as primary, we do have to be more cognizant of which providers accept Medicaid and can bill them for the co-pays & cost-shares. Most do, including the highly regarded children's hospital in the area that did my daughter's cochlear implant surgery. I doubt that the surgeon even was aware that we had Medicaid coverage since he doesn't handle billing.

[Crimson Wife]

This. Even with private insurance you can still get rotten care.

 

healthcare in America is below what you would receive in many other countries. Medical care in general is pretty rotten here.

 

I'm so sorry for your friend. I hope she can get some answers. She needs someone to advocate for her.

 

I disagree. Our healthcare system is far more variable in quality, just like our higher education system. We have some of the best hospitals and universities in the world, but we also have some dreadful ones and plenty so-so ones.

 

[SparklyUnicorn]

This is actually pretty normal even if you have insurance.  Sorry she is going through that!

 

 

[SparklyUnicorn]

I disagree. Our healthcare system is far more variable in quality, just like our higher education system. We have some of the best hospitals and universities in the world, but we also have some dreadful ones and plenty so-so ones.

 

 

Yeah this has been my experience.  Sometimes I've gotten awesome care or known someone who has and then sometimes it's really really bad.  I don't know what to make of that.  Money isn't the only factor either because it's expensive everywhere.

[creekland]

I disagree. Our healthcare system is far more variable in quality, just like our higher education system. We have some of the best hospitals and universities in the world, but we also have some dreadful ones and plenty so-so ones.

 

 

:iagree:  There are plenty of people from all over the world coming to the US for care and I doubt it's because it's poor care.

 

I have my own issues medically, and have more or less given up hope that they will get fixed, but honestly?  A huge part of that is because my body does not respond typically (to anything really) and whatever it is that's going wrong with it is not common.

 

My step-mom came here from Canada to get two procedures done because they could be done in a shorter time period and with more advanced procedures than she would have gotten there.  This was at a "basic" hospital here.

 

When I was in the waiting room at Hopkins there were plenty of others from far and wide also there.  They could have chosen anywhere.

 

And in some countries we've traveled to... no money = NO medical care.  Period.

 

Our (insurance) system is cruddy.  Many places are overworked and understaffed.  To a large extent that's due to the sad state of our (collective) health.  One WILL (almost always) get better medical care if the place knows they are getting paid for it.  (There's only so much anyone can do for free - see my first point in this paragraph that our insurance system is cruddy.)

 

But from what I've seen... I'd take the medical personnel (and procedures) here either just as quickly or more quickly than those elsewhere.  

[kbutton]

If she wasn't well enough to care for herself a social worker should have gotten involved. I'm so sorry. 

 

:iagree:

 

Lots of medicaid families in our area--it can be hard to find a family doc to take you because they are SWAMPED already, but hospital care and emergency care here is handled VERY well. 

 

Medicaid aside for the moment, most docs will not take a new patient that has an acute problem unless they have a family doctor and a well-documented medical history. It's a huge undertaking, and they can't play both family doc and specialist at the same time. They also are usually booked well out and save their emergency bookings for current patients. (More on Medicaid and family docs later.)

 

While it's true that in an emergency department, docs are not going to diagnose all underlying things before sending you home, they should be hooking a person up with social services and/or making referrals for the patient. Our local hospital and/or ER docs can sometimes get a person into a new setting who would not be seen if that patient made a cold call on their own. This goes for insured patients as well as Medicaid.  With Medicaid patients, this is where getting a social worker involved is key because it's hard to find a new family doc that will take Medicaid.

 

I know that practitioners sometimes have greater leeway in treating a Medicaid patient than they do someone with different insurance--it varies widely. It's also almost impossible for a practitioner to know all the ins and outs of insurance and such--that is why advocates, social workers, etc. exist. Practitioners will keep up on the most common things they see for the most common insurance types in their area, which is going to vary by their geographic region, specialty, etc. You will, at times, have to educate your practitioner on the options available because it's always shifting.  

 

Many practitioners go above and beyond for all their patients, including the Medicaid patients. Others couldn't care less or are personally resentful that the job falls to them to do all this extra work to write scripts just so, make referrals just so, know all the ins and out of insurance, etc. when they are already doing the diagnosing, treatments, etc., and unfortunately, they pass on that attitude to the patient at times. 

 

Also, some hospitalists are tougher on admitting patients than others--the patient will not know this is how things go down (you can get in trouble for libel if you aren't careful about what you say about another clinician), but there are times the family doc, ER doc, etc. want a patient admitted, and no hospitalist will do it. Not to cast hospitalists in a bad light (some are amazing!), but the buck doesn't stop in just one place, and what goes on behind the scenes is not going to be discussed in front of or told to the patient. 

[Tammyla]

Family member had a stroke last month transported via ambulance (has insurance and is over 65 so medicare?) she was sent home after 6 hours or so in the ER.  (She had slurred speech and mild weakness in the left arm, crazy high BP as well as being very disorientated.  She had two immediate trips back to the ER via ambulance; one was the next night; she passed out and didn't wake (Medication fail/allergic reaction) and then 48 hours later was in for a BP check and immediately transported again due to the BP  Each time she was stabilized, and sent home to follow up with her doctor.

 

It took three weeks to get a MRI and Check of her arteries.  

 

Tragic and sad that someone in need of monitoring was sent home over and over again.

 

BTW it was a frontal lobe stoke and unnumbered mini stokes.  She never wants to return to the ER at that hospital again.

 

 

[goldberry]

My brother, who was homeless and on Medcaid, actually received excellent care in his area.  I'm sure it varies by region, but in some areas the treatment is good.

[pinkmint]

Haven't read all responses. Just wanted to say that I wonder if you are right. 

 

My kids have never had normal health insurance, only medicaid, and I've been on medicaid during every pregnancy. I've had some good and bad experiences and sometimes I really have to wonder if being a medicaid patient requires you to put up with things that "regular" people don't have to. And once when I was foolish enough to vent about some medicaid related frustrations, a formerly close friend basically told me I have no right to complain since I am leeching off the taxes she pays. Guess I'm leeching off my husband too who works full time and has taxes taken out of his pay. Some of us work as hard as we can and still can't afford to not "leech" the government. I don't like it and hope it changes but I'm glad it's there for now. 

 

In the meantime, I try really hard, because of my Christian faith to assume the best intentions of people, and medical staff (there is a nurse at my kids' clinic who seriously tests my ability to do this). 

 

Edited September 2, 2016 by pinkmint

[kbutton]

And once when I was foolish enough to vent about some medicaid related frustrations, a formerly close friend basically told me I have no right to complain since I am leeching off the taxes she pays. 

 

:grouphug:  :grouphug:  :grouphug:

 

Nope, not a leech. 

[Harriet Vane]

Haven't read all responses. Just wanted to say that I wonder if you are right. 

 

My kids have never had normal health insurance, only medicaid, and I've been on medicaid during every pregnancy. I've had some good and bad experiences and sometimes I really have to wonder if being a medicaid patient requires you to put up with things that "regular" people don't have to. And once when I was foolish enough to vent about some medicaid related frustrations, a formerly close friend basically told me I have no right to complain since I am leeching off the taxes she pays. Guess I'm leeching off my husband too who works full time and has taxes taken out of his pay. Some of us work as hard as we can and still can't afford to not "leech" the government. I don't like it and hope it changes but I'm glad it's there for now. 

 

In the meantime, I try really hard, because of my Christian faith to assume the best intentions of people, and medical staff (there is a nurse at my kids' clinic who seriously tests my ability to do this). 

 

Not a leech.  :grouphug:

[Um_2_4]

I actually experienced this from the other side. We are blessed to have AWESOME insurance and it got put to the test the year I needed 3 surgeries. I went to the ER with what I suspected was a gallbladder attack. I knew that it was going to have to be dealt with sooner rather than later. My twins were 5 months. My dear friend met me in the ER at 5 am at a local small hospital that was in network (the same place I had had my appendix out earlier that year). I had excellent "service" and the staff was great. I ended up in surgery that same day and went home the next afternoon.

My friend and neighbor, on medicaid, had similar attacks about 2 months later. Hers seemed to be much worse than mine from just the symptoms. She decided to go to the same ER and ended up being given some pain med and referred out for an appointment. She finally got surgery 2 months later after waiting for referrals.

I think it was due to my insurance authorizing the surgery immediately that I got it resolved in less than 24 hours, while due to paperwork she suffered another 8 weeks.

I know from her also that getting appointments with any kind of specialist is really hard for kids on medicaid. Too many patients and not enough Drs who will take it. My OB told me she stopped taking it as she was losing money on those patients when she factored in time for billing and the lower reimbursement rates.

[Anne in CA]

Not a leech. It will be sad when this person needs something someday. And I hope that she does. Nor for revenge for her dumb words, but so she can learn something and grow as a person.

[Harriet Vane]

What is your solution? Instead of a friend to make the calls, you want what? A stranger to make the call? It doesnt matter who you are, the ER is not an on call physician's office. Its purpose is not to diagnose all the underlying issues.

 

 

My solution:

 

On a human race scale, I wish people would treat other people well. I wish the ambulance driver had been kinder to my friend. I wish the hospital staff had been kinder. Because this sweet person was/is having a major, medical, potentially life-changing event. She was terrified and in pain, and they were brusque and impatient and treated her poorly.

 

(Incidentally, I saw exactly the same dynamic earlier this year. I brought someone to the ER in my state for a suicide risk assessment. The staff--especially the night staff--were horrible. Absolutely horrible. They treated everyone in that facility like animals. They were combative and responded in a way that escalated rather than diffused tension. And they used officious jargon when speaking to the clients.)

 

My solution would be for the hospital to admit her at least until she is stable. This was not an issue for my husband with his vasovagal syncope mentioned up thread. Booting a person from the ER who cannot talk and who cannot walk a straight line is putting that person's life at risk. There is no defense to that choice on the part of the hospital.

 

My solution would also include a referral to a physician who will actually see her. The dr they referred her to in the ER--the guy whose name is on the discharge paperwork as the official person she is supposed to see--refused to see her because of her insurance status. Yes, his staff stated so specifically and plainly.

 

I do not expect the ER to diagnose all the underlying issues. I merely ask that they not endanger people's lives and that they remember to speak kindly to those who are suffering. 

[Valley Girl]

My solution:

 

On a human race scale, I wish people would treat other people well. I wish the ambulance driver had been kinder to my friend. I wish the hospital staff had been kinder. Because this sweet person was/is having a major, medical, potentially life-changing event. She was terrified and in pain, and they were brusque and impatient and treated her poorly.

 

(Incidentally, I saw exactly the same dynamic earlier this year. I brought someone to the ER in my state for a suicide risk assessment. The staff--especially the night staff--were horrible. Absolutely horrible. They treated everyone in that facility like animals. They were combative and responded in a way that escalated rather than diffused tension. And they used officious jargon when speaking to the clients.)

 

My solution would be for the hospital to admit her at least until she is stable. This was not an issue for my husband with his vasovagal syncope mentioned up thread. Booting a person from the ER who cannot talk and who cannot walk a straight line is putting that person's life at risk. There is no defense to that choice on the part of the hospital.

 

My solution would also include a referral to a physician who will actually see her. The dr they referred her to in the ER--the guy whose name is on the discharge paperwork as the official person she is supposed to see--refused to see her because of her insurance status. Yes, his staff stated so specifically and plainly.

 

I do not expect the ER to diagnose all the underlying issues. I merely ask that they not endanger people's lives and that they remember to speak kindly to those who are suffering. 

 

Harriet, may I ask if you're in a position to file complaints about the treatment these people received with someone in the medical hierarchy? After reading about some of the experiences others have had, I'm wondering if enough complaints are being made to those who might be able to do something. The insurance issues are tough, but things like what you mentioned about the night staff should be reported and the patients themselves may be too sick or otherwise overwhelmed (as with a new baby) to be able to do that follow through.

 

[Garga]

I wonder the care of people in different states correlates to whether or not they're blue or red states politically. Just musing.

[Harriet Vane]

Harriet, may I ask if you're in a position to file complaints about the treatment these people received with someone in the medical hierarchy? After reading about some of the experiences others have had, I'm wondering if enough complaints are being made to those who might be able to do something. The insurance issues are tough, but things like what you mentioned about the night staff should be reported and the patients themselves may be too sick or otherwise overwhelmed (as with a new baby) to be able to do that follow through.

 

 

 

Not sure. In the two cases I mentioned here, I'm just a friend. Not the patient, and not a family member. 

[madteaparty]

I just don't trust doctors, poor or not. And my parents are both doctors.

 

My DH was told, at age 25, by a Harvard med school graduate at a top hospital in Boston, that his debilitating rheumatoid arthritis flare-up maybe was something else. Or maybe not, really who knows with this autoimmune stuff. What is he studying anyway? Oh finance? He won't *really* need his legs in that profession...I am not even exaggerating.

 

I refused to accept that and we saw a seasoned rheumatologist (this joker's former teacher as it turned out) whom we only were able to see through a colleague referral. It felt like the old country.

 

DH is fine and has full use of his legs, finance and all.

I think it is all about the care you can afford to pay for, but it's even worse. You have to have the know-how to at least ask questions. Like the orthodontist that because he could not have my money for braces (DS was leaving the country) insisted on jaw extensions for a child that is definitely still growing and still has his baby teeth. No thanks.

One has to become an expert themselves. Really it's exhausting.

Edited September 2, 2016 by madteaparty

[creekland]

 And once when I was foolish enough to vent about some medicaid related frustrations, a formerly close friend basically told me I have no right to complain since I am leeching off the taxes she pays.  

 

A leech?  Seriously?  This is the sort of thing I want my taxes going toward!  Not everyone has the same income or the same options to obtain a decent income - totally due to life circumstances - not "choices" or whatever.  Everyone deserves health care.  I like having "something" to balance that out with needs (food, shelter, health care).  

 

I consider people like politicians who all get incredible taxpayer-paid retirement packages & more for very little "service" to be leeches on the system.

[Guest]

..

Edited September 2, 2016 by Heigh Ho