Friday, July 22, 2011

one of our own

I got this e-mail today from the chairman of the Emergency Department of St. Joseph's Hospital where I work, and which I will share here, lightly edited for privacy purposes.

Dear Colleague:

On July 4th, after working the night shift in the Emergency Department, Dr. D.G. had a right ventricular hemorrhage with subcortical ischemic changes. He is currently in [the medical ICU] awaiting transfer to [a prominent local rehab center].

Mrs. G was recently informed that D’s insurance does not include benefits for inpatient rehabilitative services. This news follows a difficult financial year for the G family; D has also been supporting his brother’s family due to metastatic disease as a result of stomach cancer. His brother died three months ago.

Because D is now considered uninsured, [the rehab center] is requiring $60,000 prior to D’s transfer. We have requested donations from numerous sources including Saint Joseph’s Mercy Foundation, but no one source has the availability of the entire amount.

We would like to ask for your help in the form of a donation as soon as possible. The sooner D can begin rehabilitation the better chance he has for a positive outcome.

I talked about this a bit in an entry a few weeks ago, but again, when you're working in a hospital with sick people every day, mortality is all at once distant and immediate.  Morbidity and human frailty are all around us, but at the same time, the very fact of its constancy makes it fade into the background.  It's just the scene that you're in, but seemingly, it's never you.

But it could be.  It could be you.  It could be me.  It could be your co-worker, your friends, you family.  I've met this doctor several times (the Emergency Department and the Anesthesia Department, as you can imagine, have more than just a glancing interface) and this doctor is not old, maybe just ten years older than I.  The day of his stroke, he wasn't feeling well.  But he came in to do his job anyway.  See the letter above: "...after working the night shift in the Emergency Department..."  He came in to do his job anyway.  Maybe he shouldn't have, but was the job he was trained to do, the duty he was called on to provide, which was to take care of sick people.

Now let's help take care of him.

Here's how.

(I apologize that this is so cumbersome as I'm not the one who set this up, but I'm told you're to click "Donate Online" --> "General Donation" --> "Other Fund" --> "Physicians in Need of Medical Care" and help however you can.  And please pass this link around to anyone who you think may be interested.)

Thanks everyone.  And have a good weekend.


  1. Anonymous7:49 PM

    How completely stupid is it that a physician has health insurance that's such crap that this kind of begging has to happen? I suppose the broken insurance system is a whole other rant, though. Thanks for the heads-up; happy to help.

  2. Anonymous8:37 PM

    what does it say about our system when a physician can't get the health services he needs?

  3. As a charge nurse, my duties include attending the daily interdisciplinary team meetings, where we discuss each patient's current status.

    Insurance is always a part of these discussions, and it has been a MASSIVE eye opening learning experience to me how our case management team has to beg, plead, and coerce insurances to cover what they SHOULD, and go looking for all sorts of other avenues when insurances DON'T cover things you'd expect them to.

    Blows me away why most Americans fear health reform ... trust me, what we have now is HORRID.

    Michelle, thanks for letting us know of the opportunity to assist ... happy to help.

  4. Anonymous10:34 PM

    I live in Australia and I am always disturbed to learn about the American health system. How can this happen in the developed world - in the US no less? The rest of the world listens to the debate about healthcare reform in disbelief... How is this the way to treat your citizens? I am shocked.

  5. I too live in Australia - no doubt our system has faults but nothing like those we hear of in the US system. In Australia, this patient (be he a doctor/plumber/unemployed) would receive FREE inpatient rehabilitation. No need for begging/stealing/bending rules. If he also had private insurance then that would be a further option. It's so terribly sad for a first world country to not be able to take care of its people properly.

    My best wishes to this doctor and his family. Sounds like they are having a very rough run.

  6. Anonymous1:56 AM

    Wow, similar to previous posting, shocking that something like this is necessary. If a physician is not able to receive adequate hospital care, how do we expect the rest of the country to cope? While Canada's healthcare has its flaws, I am ever grateful that I will never be placed in situation like this.

  7. Victoria6:11 AM

    In the UK at the moment he would also have no worries about getting the exact care he needed, free at the point of use. The really sad thing is that in a few years time, UK patients will be in exactly the same situation as this man - failing to get the care they need thanks to our current government bringing in a US style private system.

  8. The American health system scares me to death. A close family member lives there. He is in his mid-fifties, and has a chronic, progressive, debilitating medical condition for which he needs to be in an SNF. (Not life-style related, if that makes a difference.) He has to wait and fight for necessary medical procedures, examinations, medications and rehabilitation.

    Although I have what in the US would be considered a low income for someone with my background, I send him money from here in Israel to help with his basic needs because the insurance situation is so dire.

    This is not the US I used to know.

  9. As a fourth year US med student, I'm saddened for your colleague and embarrassed for us all. I have family in a so-called Third World country, whose recent extensive medical care certainly did not break the bank.

    I realize you probably don't want to turn this into a political debate, but stories like this make it clear that our "system" is a mess. Unfortunately, there's too much chest-beating/willful ignorance in Congress to change. This is America, after all, not some Third World country where people actually get the care they need! Amazing things are happening here!

  10. I cant find Physicians in need of Medical Care on the site

  11. Anonymous11:49 AM

    If health care is so great in other countries, then why are people constantly coming to the United States for procedures? I work with in a low income neighborhood and believe me people aren't going into debt for expensive medical procedures here. They also don't care if there are cheaper treatments or preventive measures that can be taken.

    This is an unfortunate situation for this doctor. There does need to some changes in the system but I don't think the answer has to be do the same thing as the other countries. I really hate the gov't medaling in the health care industry.

  12. Anonymous12:00 PM

    Health care in the USA is one of the best. The best doctors, the best hospitals, the best research, etc. INSURANCE and INSURANCE COMPANIES, however, are where your problems lie. It prevents the health care system from working to its full advantage. Your reform needs to start there. The health care system is not broken, it's wounded and the salt is being poured in constantly by the denials and feet dragging of insurace companies.

    Please don't think that the United States is some third world country in regards to health care. If we didnt' have some of the best and the brightest working in our system, you wouldn't even be here reading Michelle's blog. What the USA does have, however, is a third world, or rather, third rate insurance scam going on.

    I am an insurance biller and I work for a small medical practice. I see this everyday. My doctor is great, our patient's level of care is the best. Our problems start when filing insurance and that slip of paper comes in with the words, "Denied for __________". Insurance disclaimers always start with, "There is no guarantee of payment".

    I'm not trying to be political, but I have a hunch that if Washington would have worded "Healthcare Reform" to say "Insurance Reform", and followed through with it, the political split in this country would not nearly be as wide as it is now. If anything the American people have had in common, both conservatives and liberals, is that at some point in their lifetimes they have or will have been screwed by an insurance company when it came to a medical procedure.

    It pays to be sick in America. It just doesn't pay to have insurance in America.

  13. Anonymous10:37 PM

    When other countries disparage our healthcare system and say how appalled they are, let's not forget that part of the reason we don't have enough money, is that we're subsidizing them: We pay a disproportionate amount of money for defense and aid for the rest of the world. In effect, we're subsidizing their healthcare and standard of living.

  14. Victoria Lewis5:46 AM

    It's not about not having enough money. It's the way it's spent. Paying the shareholders and executives of health insurance companies, rather than funding universal health coverage.

  15. Anonymous6:10 AM

    Sad that healthcare can be decided by the mighty dollar.

    i cannot help but wonder if the reaction would be the same if the employee in need were a housekeeper or a unit secretary.

  16. Anon at 11:49:

    I'm not saying that health care is bad in the US. Quite the opposite. The problem is that health care is not affordable, in part because of the for-profit insurance model. The exact numbers on medical tourism stats are notoriously all over the board, but every study by Deloitte, McKinsey, etc. suggests that about twice as many Americans go abroad for care as foreign citizens come here, with the biggest driver being cost of care.

    As for your second point, I also live and work in a low-income neighborhood, where fewer than 25% of adults have any college education, and I walk past the Medicaid line every day on my way to the hospital. I've also seen many self-pay patients refuse necessary treatment because they can't afford it, and heard similar stories from my college-educated friends whose jobs don't provide health benefits. And yes, people do go bankrupt over catastrophic medical expenses, as in the case Michelle just posted.

    Obviously, single-payer has problems, too, but please don't pretend like we have the best system in the world, when we actually pay more and have similar worse outcomes (check out the WHO database for stats).

  17. Anonymous3:49 PM

    In 2010 a family of four spent $4000 for insurance coverage where the overall cost was a bit over $13,000. I have seen copays rise each year along with deductibles and the coverage gets worse and not better.

    It is scary to have to actually depend on the insurance coverage provided by most employers. You could easily be facing thousands of dollars out of pocket and with the economy in the dumps that is hit many families cannot absorb.

    Insurance companies are making record profits and hospitals are having to cut costs as reimbursements dwindle - somewhere, somehow things are going to change or the whole system will collapse one day.

  18. Anonymous3:33 AM

    Anon at 10.37: How are you subsidising Australia's healthcare, exactly?