It's a terrible time to be poor. It is rarely the physician who won't see the patient but most often the services within hospitals that are inaccessible.
I am a patient fellow and so even when I advocate for patient treatment, I’m willing to wait. Sometimes our patients aren’t that cooperative. I work within an FQHC (Federally Qualified Health Center) and we provide safety net services to those who have no other choices, including the un-insured. Our difficulty is not providing the services but having no upward paths to tertiary care.
While the hospitals protest that they “turn away no-one” we find that they “see” the patients, but then give them paths to care which are inaccessible to them. A lot of times it’s turning them away from admissions or surgical care which would impact their ‘bottom lines‘.
In our state (Connecticut) most of the hospitals are not-for-profit. Even our state-run hospital routinely buffs or turfs (sends patient’s back out through the revolving door) poor patients or patients with poor insurance.
It’s a terrible time to be poor. It is rarely the physician who won’t see the patient but most often the services within hospitals that are inaccessible. I do understand that the insurers of last resort (Medicaid and their ilk) have so undervalued such services as Operating Room so that none can afford to register those patients except at a loss. The charity exemptions don’t always cover. There are many examples of hospitals that have failed (gone out of business) because of overwhelming demand for non-compensated services.
What does this twisted path portend? I fear that like business, the corporatization of medicine, has become the norm. When the bottom line and not the patient’s bottom becomes the most important thing, we all lose. Mostly, our patients lose.
Dr. Buchbinder is a board-certified Podiatrist practicing within an FQHC (Federally Qualified Health Center) in Hartford, CT. He is director of the FreeMED Software Foundation, a non-profit dedicated to making accessible and extensible medical records available worldwide. Dr. Buchbinder also blogs at A view from the provinces. A new Yankee’s view of the world.