Friday, February 15, 2008

Busy days...

Things have been busy for us lately. I guess they're always busy! And, likely to remain so....

I just thought I'd take a few minutes to tell some stories. It's always so moving to me to be allowed to take part in the stories of people's lives. And, I consider it a privilege.

I want to tell you about a man I have known for a few years. He's a little younger than me; in his mid-thirties. He and his family are out patients. I recall how, a few years ago, he had told me about his concern that his neighborhood wasn't safe for his family. He was worried about having young children in a home where drug deals and prostitution sometimes took place just outside his front door. He was very happy to be able to sell that home, and move into a nicer suburban neighborhood. He and his wife have both been working hard to provide this for their children.

Well, I saw him a couple of weeks ago. His wife has had to have surgery, and is now unable to work, at least for several weeks. He tells me that he's on the verge of bankruptcy, will be losing his house, his car, and doesn't know where he's going to take his family.

In this time of political debate, I'm hearing some of my friends talk about "personal responsibility". But, I can't help but think that my patient has nothing to be ashamed of with regard to his decisions. He has kept his family's well-being as his priority. He and his wife have worked hard to provide a safe home and neighborhood for his children. And, it certainly wasn't a "moral failure" or "lack of responsibility" that led his wife to surgery. In fact, he tells me that it was his wife's work that led to the injury which required surgical care - somewhat ironic, I'd say.

Now, to talk more about that concept of "personal responsibility", I still wonder what "they" would say that my patient should do now. I get that question stuck in my head when I hear that a doctor or a medical practice has decided that they will no longer be seeing patients with (fill in the blank: no insurance/Medicaid/Medicare/Tricare...). So, if they were sitting across the exam table from that patient, what would they say the patient should do now? Okay, if you can't see them, who will? If I can't refer the man with the broken hand to the hand surgeon, what would you suggest I say to him, when I sit with him?

My wife used to take those phone calls, in her work as a medical assistant. And, she would tell patients, "I'm sorry; we're not taking your insurance." She now says that she had no idea that it meant that the patient might not get care - she assumed "someone else" was going to take care of the patient.

Well, that's my job - to take care of the patient that can't find care elsewhere. But, there just aren't enough parnters in my practice to take on all that burden...