The first thing I notice are the dark circles under Mr. Jones’s eyes.
It’s 4:30 pm on a Wednesday during my third year of medical school. I’m in the fifth week of my family-medicine rotation, and we’re deep into our daily routine: triage, history, physical examination, differential diagnosis, present the case to the attending physician, repeat.
My Nicaraguan pediatrician friend astutely summarized her work: First you make the clinical assessment, then you make the financial assessment. In other words, a clinician may know the right treatment, but what good does that do the patient if the treatment is entirely out of reach financially?
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When I retired from teaching in a suburban school district north of Detroit in June 2003, I left Michigan for my hometown of Pittsburgh with boxes of belongings, twenty-nine years of memories, and health insurance tied to my state pension. That insurance has served me well–except when it has not.
About the artist:
“Krithika Kavanoor (left) and I are both family-medicine residents at Montefiore Medical Center in the Bronx. As primary-care providers in one of the poorest urban counties in the US, we see firsthand the impact that access to health care–and the lack thereof–can have on our patients. The narratives we share are
I’m no stranger to dealing with the medical world and its billing systems. I’m a triple cancer survivor, had knee surgery in 2012 and now have ulcerative colitis. All told, I’ve had eleven surgeries and fourteen colonoscopies. Paperwork is practically my middle name.
But the last twenty-four hours have been ridiculous.
In that time, I’ve had three different encounters with healthcare billing–each absurd in its own way, and each more challenging
Day 1: For over thirty-five years my strong, spirited spouse, Carlo, served around the world in the Air Force. Now retired from the military, he still serves at the air base as a civilian security police officer.
His neck hurts. A lot. He blames the pain on the unbalanced weight of the bulletproof vest that Uncle Sam added last year to the uniform he proudly wears every day.
When I read news articles about caring for elderly parents at a distance, I sometimes shake my head. There’s a tendency to put the best spin on the experience: as long as you contact the right people, get the right information and treat the ups and downs as just part of life’s challenges, you’ll be fine. You can do this!
I find myself wondering when the author last talked to a caregiver at
I am a family physician. Like most of my colleagues, though, I must sometimes step out of the comfort of my clinical role to take on the role of patient or family caregiver.
Generally, these trips to the other side of the exam table inspire a fair amount of anxiety.
During visits to the doctor, I find myself noticing many details and comparing the quality of care to that in my own practice.
I am a primary-care doctor who makes house calls in and around Tuscaloosa, Alabama. Most of my visits are in neighborhoods, but today my rounds start at a house located down a dirt road a few miles outside of town.
Gingerly, I cross the front walk; Mrs. Edgars told me that she killed a rattlesnake in her flowerbed last year.
She is at the door, expecting my visit. Mr. Edgars sits on the