Wednesday, December 29, 2010

2 Visits For The Price Of One ? Nope!

Psych Doc mentioned he would be posting an addendum to fill in the gaps for his previous post. But basically, whenever a psych patient gets violent like that, he must be restrained. At some point during that process, the patient apparently coded (which resolved quickly and allowed him to continue with his terror on the staff). Anyways back to my post......



A 54 year old male came in for a deep laceration to his leg. It needed to be repaired, obviously. But before I was allowed to do the repair, the patient demanded to get a "price quote." It was an unusual request, but we obliged and came up with a quote.

When he heard the price, he became very anxious and upset. He then developed chest pain, nausea, and diaphoresis. We quickly got an EKG, and sure enough he was having a heart attack. He got so worked up over the price of the lac repair that he had an acute MI!

I didn't tell him how much the price of his visit was going to skyrocket on his way to the cath lab.....

-ER Doc

15 comments:

Nurse K said...

The leg lac was probably him trying to grab a vein or two to use to get around the blocky-blocky artery. At least you got him to the cath lab before he stabbed himself in the chest to do his own CABG.

AJ said...

That's not funny at all. It's sad. That man was just ruined, financially, and he knows it.

arzt4empfaenger said...

How ironic!

ERP said...

Sucks. Some people gotta remember to take a deep breath and a chill pill...

E. Greene said...

I dunno, I think that dude was pretty lucky. Better to have the MI in the emergency department where he could receive immediate treatment vs. home alone, etc.

Dorothy Moody said...

I want to laugh, but it's really not funny. Imagine if the cost of the treatment caused him to walk out of the hospital.

arzt4empfaenger said...

Dorothy Moody - in Germany you've got to pay a fee of roughly USD13 to the Emergency dept (which is required by the health insurances). A friend of mine who volunteered with the EMS told me about a gentleman in his 50s who suffered an acute MI while browsing an exhibition (they did an ECG and the emergency physician wanted to start treatment), but refused the transfer to the hospital because he didn't want to pay the USD13. Sad, since the exhibition entry usually costs USD20 or more. :/
We were third year students then and incidents like this don't exactly make you like the study more.

Shash said...

That's so sad. It really tells you what kind of stress the general public is in over health care costs.

Our system is so very broken.

SuFu said...

This summer I had to go to the ER for abdominal pain that radiated into my mediastinum that literally dropped me in my tracks, gasping for air and in the more pain than I could imagine. Full US, CT and XR series came back with nothing. Nothing in the GB, appendix, pancreas, heart, clots, all labs normalish. I'm sure if I wasn't 26 and in good health, when I got the bill for an idiopathic dx I would have had an MI. I could buy an insulin pump for what I am paying for that visit. I'm not complaining, cause I want great ER docs there for when something bad does happen (e.g. hypoglycemic shock).

SerenityNow said...

Guys come on. This guy had a heart attack. Meaning that there was a pre existing plaque in his coronaries ready to do the damage (unless a rare case of prinzmentals which he didn't have).

So....he was going to have the big one soon anyways. Could have been at home when he was making love to his wife or mistress, or when he opened his next electric bill.

Point is it was coming. On the half glass full side, if he had the heart attack elsewhere he would have had ambulance bill, a separate ER bill, a separate ER doctor bill, and probably a worse outcome from the longer delay to get to the cathlab if not death.

Also, remember rule #4 of the house of god. "The patient is the one with the disease." Don't get so emotional. Tale it for what it is, a good story.

ER Doc

Anonymous said...

I'm guessing your patient didn't have insurance, wasn't covered by any government program and was planning to pay out-of-pocket, because he asked for an estimate. Most people who aren't planning to pay the bill themselves have no incentive to care and don't bother to ask. It sounds like this guy intended to pay you.

Not funny.

arzt4empfaenger said...

I still think it *is* funny - ER Doc's right, "Point is it was coming" and in another situation he couldn't ever had such a fast treatment.

That the health system in the US seems to be a whole world of suck is another (not funny) story, but if you don't take it easy on blogs, there wouldn't be anything to post! Either way, I'd prefer alive and financially ruined to dead and not financially ruined any given day!

Dc said...

Doctors should have some first hand experience of what it is like financially to be a patient. I understand the joke and its still not funny.

LivingDeadNurse said...

wow...that sucks

Mingle said...

just cuz someone's a doc doesn't mean life is peachy and free of money worries.