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Patient volume and money instead of quality patient care

Linda Burke, MD
Patient
March 24, 2011
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To everything there is a season and mine comes to an end today. For 720 weeks I attempted to give quality care to my patients. The task was not always easy especially when most of my patients held the unenviable position of having a high risk pregnancy and receiving Medicaid or being uninsured. Babies have a right to be born healthy regardless of their mothers’ income or insurance status.

The memories of my tenure at the county health department are indelible. I remember the woman who paid to be taken across the border only to be abandoned and walked from San Salvador to Texas. And the obese patient who rode a bicycle to the clinic with a blood pressure of 221/110. Of course she refused to go to the hospital because she alleged that they treated her “like dirt.” I begged, pleaded, and personally drove up the street to fill her blood pressure medication prescription to avoid her having a stroke or seizure in my exam room. My nurse found an ambulance company that was willing to take her to the high risk specialty hospital where she delivered prematurely in order to save her life and that of her baby’s.

And then there was dear Priscilla* (name changed) who had a bipolar breakdown and was about to be inappropriately discharged from the labor room triage until I advocated from my home around midnight and found her a hospital bed in my county where she was appropriately admitted, treated and subsequently delivered. There was also Katy* (name changed) who was sent home inappropriately with low fluid and subsequently went “on vacation.” I tracked her down in another state, told her to go to the nearest hospital where she was emergently admitted and delivered via c/s. My advocacy, diagnostic saves and battles with hospital clerks (who practice medicine without a license) continued for almost 15 years. It was difficult, stressful and at times frustrating, especially when the administration’s emphasis was on patient volume and money as opposed to quality patient care.

As this chapter of my life closes, I’d like to think that I’ve made a small but unique difference in the lives of others. I will indeed miss my patients, but I will not miss the stress. Service is the price we pay for being here. I hope I have served humanity well.

Linda Burke-Galloway is an obstetrician-gynecologist and author of The Smart Mother’s Guide to a Better Pregnancy. She blogs at her self-titled site, Dr. Linda Burke-Galloway.

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Patient volume and money instead of quality patient care
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