I just got up and took my OTC cold medicine plus some ibuprofen and a big glass of water. Because that’s what you should do for most crud. I thought, hrm, for probably less than $1.50 I just averted what many of our ER patients will pay $1200 or more for—or, rather, taxpayers will pay for them to do so. And many will do it at the finish because they either want pain medication or, wait for it, a prescription for Tylenol or Motrin. You see, they can’t AFFORD Motrin, but their medical card will pay for it with a prescription. (I was baffled by this when I was new to the ER and not yet jaded and cynical.)
Now people, I am not bitter about patients who are genuinely flat-ass broke and sick. The ER is a safety net, and sick people need to be able to come there. I believe that. I’m just sick of the blatant abuse and entitlement. By abuse and entitlement, I mean people who are using Medicaid/Medicare, smoke a pack of cigarettes a day, and regularly run up $1000 ER bills on the public ticket so they can get a prescription for a $3 OTC medication. How is that not ridiculous? I try to be compassionate and see some reason or commonality in every single patient I see, but this is wearing very thin.
Plus, I feel irresponsible for not pointing out, “Look, you need to quit smoking anyway. That’s probably why you have this URI to begin with, and it’s costing you a fortune. If you went one single day without smoking, you could buy the ibuprofen.” That would be the best health education I could probably give. But I NEVER point it out. Why? Because it would hurt my patient satisfaction scores and possibly my hospital’s reimbursement—we’re all about customer satisfaction. The sad thing is that some people probably actually haven’t thought of that and would change their behavior, but I have no way of knowing who would appreciate the idea and who would feel unfairly judged and complain about me.
This system is just BROKEN. Bad.
