Thursday, July 19, 2007

Packing packing..
You'd think i'd be used to it by now, after 3 and a bit years of gypsy-like moving.

Kinda stressed.. An assignment that I should be handing in in 2 weeks is barely done.

But anyways, an ethical situation occurred in the hospital i'm at.
I was seeing a patient who was visiting his daughter from China. So he spoke no english.
Anyway, he presented to hospital because of vomiting and central abdominal pain.
History and examination later, the consultant and I thought that an abdominal xray would be useful to rule out anything serious. (We were worried about a bowel obstruction, but this diagnosis wasn't the most probable, but the most dangerous in a way..)
Turns out that he didn't have proper medical insurance and couldn't afford the xray, let alone the treatment if necessary.

Scratching out heads, the doc and I came to the conclusion that we would get the xray, and it would probably show nothing and then we could send him home. Calling the Xray people, turns out an abdominal xray is $96!! (Which the patient couldn't pay.)

What would you do??

Well, the doc made a couple of phone calls and managed to organise free treatment for this unfortunate man.

Murphy's law came into play, because turns out that the xrays showed that he had a small bowel obstruction!
Which required a further abdominal CT and surgical consult with a possible operation.

Again, a few more phone calls later, and the hospital would take care of all expenses.

It made me aware of how often we order (and how often patients expect) investigations and tests. A common blood test alone costs the state government about $50! An abdominal CT is in the thousands of dollars..
And this is all 'free' due to our medicare system. It's good to hear about the positives of our system sometimes. It's a shame it's taken for granted by so many (including me) though.


Hoa said...

That's a pretty hairy situation J. If I was in the same situation, I couldn't stand to let him walk out of the hospital, knowing that there could be something wrong. I don't think my conscience would let me do it.

I'd fight tooth and nail to get him the treatment he would need.

Jaye said...

I know. In the end, that's the only real decision to make.

But I didn't quite tell it like it is- a few phone calls turned out to be hours of phone calls, escalating from the chief finance officer of the hospital to the SA health commission..
And meanwhile, one doc was out of the ED, while the other docs were dealing with the rest of the patients.. many of whom were waiting for 3 hours..

It's a difficult situation to be in. Usually people only hear of the crappy hospital service, the long waits, the 'incompetent' docs (who may or may not be terrorists =p)..

For me, it was an experience to witness the good that our health system can do if the right doctor fights for what it ethically sound- despite numerous obstacles.