Chris Rangel recounts a story where telling a patient that she can return to work disappoints a family:
Oh, ummm. It was only after I left the room that I realized my mistake. Usually patients and their families want to be reassured that their lives WON’T be adversely affected by a new or chronic illness. My bad.But to receive Social Security disability benefits patients with diabetes need to have severe neuropathy and/or diabetic retinopathy that prevents them from working. They also need to prove that they were actually working in a salaried position for a certain number of years to qualify. Apparently this patient has none of these criteria.
Still, the experience was depressing. It wasn’t about getting Medicaid coverage so she can afford to treat her diabetes (the local county hospital, supported by local and state taxes, provides a free health clinic). It was about this family’s apparent ease and willingness to try and get something for nothing . . to try and benefit from the unfortunate health problems of a loved one.
Related posts:
- Charity hospitals cherry-picking patients?
- Frequent fliers in the ER
- Does a physician’s bias color the informed consent discussion?
- Schwarzenegger Passes Spending Bill For Socialized Medicine
- How physicians can go on disability
- Diabetes and bariatric surgery
- Malpractice plaintiff wins case, wants more
{ 6 comments }
Nothing is as frustrating in the ER as to believe a patient’s story of illness, to do a complete workup, to find out it’s normal, and then when you go to discharge them they get angry and verbally abusive as they try to negotiate with you a longer work-note. I’ve had to call security to physically remove a patient when he became physically threateing and litigous when I wouldn’t give him a week-long note for low back pain.
Unfortunately, some jobs won’t simply let you take a day for “mental health”; i.e, general exhaustion on either the mental or physical levels, without getting a physician’s note that there’s something physically organically wrong.
And many lower income/working class people can afford the medication they need for their disorder only on disability. This leads to a hideous dilemma in which the meds let you work, but you can’t afford the meds unless you’re working, and you can’t work without being on the meds for a while, and you can’t afford the meds without having worked for a few months.
Disability is a way of life. Not the actual disability, but the expectation of the disability payment.
I was evaluating a 12 year old child with complaint of low back pain. Through the history it became apparent that the parents were hoping for some sort of declaration of disability for the child, in addition to prescription of opiates for the duration of her pain.
The rest of the social history tells the whole story: mother was on complete disability for low back pain, father was on disability for low back pain, both have been on prescriptions of oxycontin for years. They were merely hoping to get their kid into the family business at a young age. A prodigy!
Gasman, a tear came to my eye reading that story. Perhaps some of our lawyer bloggers on this site could get their kids into the family business too. They could share the KY jelly!
Anon 10:13 I know more doctors’ kids who are going to law school than to medical school. Guess this jives with a report I saw where 20% of the home buyers in the best neighborhood of my city were lawyers last year compared to only 5% who were physicians.
Don’t have insurance and don’t have a disability payment coming in? If you work at it you can. By working at it, I mean eat like a like a glutton, sit on your couch, smoke meth, crack, or whatever. Perhaps you can develop intractable back pain, neuropathy, renal failure, psychosis and then suck the taxpayer for whatever you can get.
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