I went to obtain an informed consent,
And explain to the patient what that meant,
I spent the next several moments explaining
Concepts I’d learned over eight years of training.
The patient said: “Fine,
I am ready to sign,
Just inform me what this procedure will cost”.
And I had to admit I was lost.

I can lecture on stents
‘til my face turns cyanotic,
Diagram how we treat flat lines
Like they’re merely asymptotic,
But billing codes for DRGs
Are a topic Gordian-knot-ic…

I told this patient, let’s call him ‘Joe’,
That his particular price I didn’t know,
But if I knew, I couldn’t say,
If Medicare or insurance was to pay.
He could try looking up reimbursement rates
On Medicare.dot.gov,
And if stymied at their portal gates
Joe really ought to love
The government rationale for why
In Medicare’s case, the Freedom of Information Act
Simply does not apply.

Now, Patient Joe was frugal, didn’t buy beyond his means,
And was dead-set on keeping his own body free of liens.
Said Joe: “I can’t sign an informed consent
If I’ve not been informed of price!”
I sighed, “Then you’ll have to sign this other form,
Entitled ‘Against Medical Advice’.”

Joe huffs and says: “…well, ok, but what about my stent?
I may just have to sue you for abandonment!”
Then he laughs and says “Just kidding doc, this system really sucks.
Howzabout just you and me, say, cash, three hundred bucks?”

I mustered all my dignity and drew myself erect,
And…and…

(“meet me in the alley out back at nine. Here’s a razor, and some Betadine.”)